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Itching of the eyes may be caused by Wind (Feng), Fire (Huo), or Blood Deficiency (Xue Xu). Generally, the treatment principle is to clear Fire. However, itching occurring due to the smooth circulation of Blood indicates that vision is about to recover; itching caused by the dispersion of Fire should be treated primarily by soothing the Liver and nourishing Ying (Nutritive Qi).

If the sensation is like insects crawling, the disease involves the Liver and Heart. Itching without an underlying disease suggests the initial invasion of pathogenic factors; itching in the presence of existing disease indicates a deeper pathological state. Occasional mild itching requires careful differentiation based on the severity and progression of symptoms to determine the etiology. This condition refers not to mild occasional itching, but to severe, unbearable itching akin to insect movement. One must examine whether there are visible lesions on the eye surface to judge the progression of the disease. Whether glaucoma or cataracts (Zhang) are present or absent, extreme itching can occur, with various etiologies. Itching may result from Wind-Evil invasion, or from the resolution of pathogens and Fire, allowing Qi and Blood to circulate freely and meridians to become unobstructed. Generally, if an affected eye remains untreated for a long time and develops itching, each episode of itching signifies a worsening of the condition. Conversely, if itching occurs after medical treatment, it indicates that the pathogenic factors are being rapidly expelled. If itching is extremely intolerable, frequent, and accompanied by a sunken appearance of the eyeball, life expectancy is short. In cases where extreme itching leads to the prolapse of the eyeball, death is imminent. Excessive tearing often indicates Blood Deficiency combined with Fire. Generally, pain belongs to Excess patterns, while itching belongs to Deficiency patterns. Although Fire may invade due to deficiency, this is not the root cause of the disease. The following prescriptions are suitable:

Qufeng Yizi San (Wind-Expelling One-Character Powder): Treats severe, unbearable eye itching.
Ingredients: Chuanwu (Prepared Aconiti Lateralis Radix), Chuanxiong (Chuanxiong Rhizoma), Jingjie Sui (Perillae Folium), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix). Dosage: Chuanwu, Chuanxiong, Jingjie Sui (each 5 qian); Qianghuo, Fangfeng (each 2 liang 5 qian).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mixed with Su Bohe Tang (Mint Decoction) after meals.

Renshen Qianghuo Tang (Ginseng and Notopterygium Decoction): Treats liver heat causing astringency, itching, and blurred vision.
Ingredients: Chi Fuling (Poria Cocos with Red Skin), Renshen (Ginseng Radix), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Digupi (Lycii Cortex), Chuanxiong (Chuanxiong Rhizoma), Chaihu (Bupleuri Radix), Jiegeng (Platycodonis Radix), Xi Gancao (Licorice Root), Zhike (Aurantii Fructus Immaturus), Qianhu (Peucedani Radix), Tianma (Gastrodiae Rhizoma). Dosage: Equal parts.
Preparation and Administration: Cut into pieces. Add two zhong of water, decoct until reduced to eight-tenths, strain, and take hot. For severe itching, add Fangfeng and Jingjie Sui.

Guangda Chongming Tang (Broad and Heavy Brightening Decoction): Treats redness, ulceration, heat, swelling, and pain of both eyelids, redness at the canthi, extreme eyelid itching leading to excoriation, sores and scabs on the eyelid margins, excessive discharge with pain, and difficulty opening the eyes due to adhesion.
Ingredients: Fangfeng (Saposhnikoviae Radix), Chuan Huajiao (Zanthoxyli Pericarpium), Longdan Cao (Gentianae Radix), Gancao (Licorice Root), Xixin (Asari Radix et Rhizoma). Dosage: Equal parts.
Preparation and Administration: Cut into pieces the size of hemp seeds, except for Gancao, which should remain whole as a stick. First, decoct Longdan Cao alone in one and a half bowls of water until the volume is halved. Then add the remaining three herbs and decoct until only a small half-bowl remains. Strain and use the clear liquid to wash the eyes while warm. Heat the liquid further in a double boiler until very hot. Use five to seven times daily. After washing, close the eyes for a moment, and the itching will subside.