Bridging Ayurveda and Modern Microbiome Research: The Gut–Eye Axis in Vernal Keratoconjunctivitis

Abstract

Vernal Keratoconjunctivitis (VKC) is a chronic, recurrent ocular allergy affecting children and young adults. Traditionally seen as a localized hypersensitivity reaction, recent research highlights a systemic immune component involving gut microbiome dysbiosis and Th2-skewed responses. Ayurveda parallels this understanding through the concept of Kaphaja-Pittaja Abhishyanda, linked to Agnimandya (digestive fire impairment) and Ama (toxin) accumulation. Objective: To review and synthesize emerging biomedical evidence on the gut-eye axis in VKC with Ayurvedic principles, particularly the role of Langhana therapy in managing systemic immune imbalance. Materials and Methods: This study involved a thorough review of a wide range of literature sources, including authoritative ophthalmology textbooks such as A.K. Khurana, Scopus-indexed peer-reviewed journal articles, relevant health publications, and classical Ayurvedic texts like Charak Samhita, Sushruta Samhita, and Ashtanga Hridaya. The analysis integrated modern clinical perspectives with traditional medical knowledge to offer a well-rounded and in-depth understanding of the subject matter. Discussion: This narrative review integrates findings from Mendelian randomization studies on gut microbiota and allergic conjunctivitis with classical Ayurvedic texts. The therapeutic rationale and application of Langhana modalities- Pachana, Rukshana, Upavasa are evaluated in the context of gut-immune modulation. Conclusion: Gut microbiome composition significantly influences immune responses in VKC. Ayurvedic Langhana therapy offers a holistic approach by restoring digestive balance, detoxifying the gut, and modulating immunity. Bridging Ayurveda with modern microbiome science presents a novel, integrative framework for managing VKC and similar allergic eye disorders.