Paryakula drishti of Unmada: Deficits of smooth pursuit eye movements and anti-saccades in schizophrenia

Abstract

Bhuta vidya (Ayurvedic psychiatry) is one of the eight specialties of Ayurveda. Unmada is a broad term which includes various psychiatric disorders described in modern psychiatry. The classification, etiology, pathogenesis, signs and symptoms, prognosis, and treatment of Unmada are available in all Ayurvedic classical texts. Abnormal eye movements such as “Paryakula drishti” (abnormal eye movements which denotes excitement or confusion or agitation)/“Chakshusho aakulata” (abnormal eye movements denotes confusion or perplexity)/“Chakshusho aswasthatvam” (abnormal eye movements) and “Chakshushoscha apasarpanam” (abnormal tracking) are mentioned among various signs and symptoms of Unmada. In Ayurveda, till date, no studies have been conducted, and no focus has been given on these abnormal eye movements of Unmada. The present study aims at understanding of these abnormal eye movements mentioned in Unmada with the help of modern research and literature. Abnormal smooth pursuit eye movements, decreased pursuit gain, increased saccadic frequency, increased anticipatory saccades, and anti-saccade errors are well-documented in schizophrenia patients. It seems that ancient Indian Ayurvedic sages had tremendous observational and clinical skills by which they were able to detect abnormal eye movements in the patients suffering from various psychiatric disorders thousands of years before. Various abnormal eye movements such as smooth pursuit eye movements deficits, abnormal saccadic eye movements, and other abnormal eye movements in schizophrenia resembles with “Paryakula drishti/Chakshusho aakulata/Chakshusho apasarpanam” of Unmada. Currently available research based on abnormal eye movements in schizophrenia supports the Ayurvedic view.