Neurophysiological mechanisms of trataka in ocular health: A systematic review of randomized controlled trials
Arjun Ram Roj, Harish Sharma, Pallabi Pal, Sanjib PatraObjectives:
Dry eye disease affects 10–20% of the global population and 32% in India, while digital eye strain is reported in 45–70% of regular screen users. Conventional treatments often provide only temporary relief, may produce side effects, and depend heavily on adherence. Trataka , a yogic visual fixation technique, has shown preliminary benefits for intraocular pressure, visual comfort, and autonomic regulation. This review aimed to systematically evaluate randomized controlled trials assessing the effects of trataka and its proposed neurophysiological mechanisms on ocular health.
Materials and Methods:
A systematic search of PubMed, Science Direct, and the Cochrane Library identified randomized controlled trials published between 2014 and 2024 investigating trataka in adults. Studies were screened using predefined eligibility criteria, and methodological quality was assessed using the physiotherapy evidence database (PEDro) scale.
Results:
Three trials involving 214 participants met the inclusion criteria, with intervention durations ranging from 2 to 8 weeks. Trataka practice was associated with significant reductions in intraocular pressure and an approximate 25% decrease in visual fatigue scores. No adverse events were reported. While the included studies demonstrated clinical improvements, the specific neurophysiological mechanisms remain unmapped in these trials. Consequently, we hypothesize and propose a theoretical framework, suggesting that trataka may improve ocular physiology through trigeminal–parasympathetic reflex activation, enhancing lacrimal secretion, modulation of midbrain nuclei affecting pupillary responses, and increased engagement of extraocular muscles during sustained fixation.
Conclusion:
Although evidence is limited by small sample sizes, moderate methodological rigor, and short follow-up, current findings indicate that trataka is a safe, low-cost adjunct with promising effects on ocular parameters. Larger, well-designed randomized controlled trials incorporating objective ocular biomarkers are needed to substantiate its therapeutic potential.