utsangini.an eye disease of the eye, mentioned in ayurveda

utsangini is chalazion, an eye lid nodular growth. Its clinical features and treatment is explained

1. utsangini Prof Udaya shankar

2. अभ्यन्तरमुखी  बाह्योत्सङ्गेऽधो वर्त्मनश्च या  विज्ञेयोत्सङ्गिनी नाम  तद्रूपपिडकाचिता | Sushruta

3. अभ्यन्तरमुखी   ताम्रा   बाह्यतो   वर्त्मनश्च   या   | सोत्सङ्गोत्सङ्गपिडका   सर्वजा   स्थूलकण्डुरा   || उत्सङ्ग पिडका लक्षणम् Madhava 

4. Rakta raktena   pitaka tattulyapitikachita   utsangakhya   Vagbhata  

5. pratisheda कुम्भीकिनीं   शर्करां  च  तथैवोत्सङ्गिनीमपि  | कल्पयित्वा    तु   शस्त्रेण   लिखेत्   पश्चादतन्द्रितः  

6. Chalazion  chronic sterile lipogranuloma residing within eyelid that originates from an obstructed meibomian gland of the tarsal plates.

7. chalazion nodule of an eyelid.  arises from obstruction of the sebaceous (oil glands) of the eyelid tarsal plate.  affects the upper eyelids more commonly than lower lids because there are more meibomian (sebaceous) glands in the upper lid.

8. complications Large chalazia can occasionally exert mass effect on cornea and result in astigmatism and blurred vision;  Acute secondary infection can lead to pain 

9. Conservative treatment lid massage, warm compression and antibiotic-steroid eye drops or ointments  Risk - the intraocular pressure should be monitored and the treatment course should be limited.  Topical antibiotics eye drops are useful if the chalazion is associated with inflammatory conditions such as  blepharitis .

10. Injection  Local injection leads to resolution - steroid or 5-flurouracil.  repeated injection can be given 1-2 weeks later if lesion persists.    risks -skin necrosis, subcutaneous fat atrophy, embolic visual loss, incomplete resolution and need for surgical removal, and skin hypo-or hyper-pigmentation 

11.  Incision and curettage  Local anesthetic agent is injected to the area surrounding the lesion. Eyelid is then everted with special clamp and incision is made through conjunctiva. Contents of chalazion are curetted, and tarsus may be minimally resected   Since the operation is done at the inner side of eyelid, no scar will be seen over the anterior aspect of the lid. Preferably, specimens obtained during the procedure should be sent to pathology.