Comparative Evaluation of Isotonic Saline Jal Neti versus Sterile Triphala Water Eye Wash on Digital Asthenopia, Tear Film Dynamics, and Visual Comfort in Undergraduate Physiotherapy Students: A Single-Center Empirical Pilot Study

Background: The rapid digitisation of allied health education has led to an alarming rise in Digital Eye Strain (DES), also termed Computer Vision Syndrome (CVS), among undergraduate Bachelor of Physiotherapy (BPT) students. Standard therapies like artificial tears provide temporary lubrication without resolving the underlying neuro-vascular tension and oxidative ocular stress.

Objectives: To evaluate and compare the therapeutic efficacy of daily Isotonic Saline Jal Neti versus Sterile Triphala Water Eye Wash over 4 weeks on digital asthenopia, tear film stability, tear volume, and visual comfort in a cohort of 16 BPT students.

Methodology: A 4-week prospective, parallel-group, randomized controlled empirical pilot trial was conducted at Maya Devi University, Dehradun. Sixteen BPT students (aged 18–25) meeting inclusion criteria (screen time ≥ 6 hrs/day, CVS-Q ≥ 6, TBUT < 10 s) were randomized 1:1 into Group A (Jal Neti, n=8) and Group B (Sterile Triphala Water Eye Wash, n=8). Outcome metrics assessed at baseline (Day 0) and post-intervention (Day 28) included: Computer Vision Syndrome Questionnaire (CVS-Q), Visual Fatigue Scale (VFS, 0-60), Tear Break-Up Time (TBUT, seconds), and Schirmer’s Test-I (mm/5 min).

Results: Both groups exhibited statistically significant intra-group improvements across all parameters (p < 0.001). Group B (Triphala) achieved superior improvement in tear film stability and lacrimal secretion: TBUT increased by +4.15 ± 0.80 s in Group B vs. +2.30 ± 0.60 s in Group A (p < 0.001); Schirmer-I values increased by +4.85 ± 1.10 mm in Group B vs. +2.65 ± 0.85 mm in Group A (p < 0.001). Conversely, Group A (Jal Neti) achieved greater relief from central visual fatigue and periocular headaches: VFS scores decreased by -18.60 ± 2.95 points in Group A vs. -14.25 ± 2.75 points in Group B (p < 0.01). Total CVS-Q scores dropped markedly in both groups (Group A: 12.75 to 5.25; Group B: 13.00 to 4.90).

Conclusion: Both modalities significantly alleviate digital eye strain in BPT students. Sterile Triphala eye wash is particularly potent for restoring ocular surface hydration and tear film stability, whereas Jal Neti excels in alleviating deep neuromuscular fatigue and periorbital strain.