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Redness of the eyes (Mu Chi) presents in three forms. First, wind aids fire, causing stagnation in the upper body; second, excessive fire; third, dryness pathogen injuring the Liver. Dai Fu'an stated that red eyes also have three types: those caused by Qi toxicity, those caused by heat stagnation, and epidemic eye diseases. All are essentially due to blood stagnation and congestion in the Liver Meridian. For exterior syndromes, use Qianghuo Shengfeng Tang (Notopterygium Decoction for Overcoming Wind); for interior syndromes, use Xiegan San (Liver-Draining Powder) and similar formulas. If redness persists and leads to the formation of corneal opacity (Yi Mo), select Chunxue Gao (Spring Snow Ointment) or Ruren Gao (Buckthorn Seed Ointment), and apply Biyun San (Green Cloud Powder) insufflated into the nasal cavity. For swollen and red eyes accompanied by cold feet, frequent warm foot baths are essential, and treatment should be targeted according to the meridian where the red vessels are located. Wang Jiezhai stated that for red, swollen, and painful eyes, ancient prescriptions differentiate between internal and external treatments. Internally, decoctions and powders use bitter-cold and acrid-cool herbs to drain fire. Externally, eye drops and washes use acrid-hot and acrid-cool herbs to disperse pathogens. Therefore, among eye drops, none is more important than Bingpian (Borneolum Syntheticum). Bingpian is extremely acrid and hot; due to its intense acridity, it helps extract fire pathogen and dissipate heat. Laypeople do not know that Bingpian is a "robbery" herb (a strong agent that rapidly eliminates pathogens) and mistakenly consider it cold. Frequent misuse leads to accumulated heat entering the eyes, causing dim vision and opacities. Furthermore, ignorance of avoiding cold herbs leads to the reckless use of cold washes, often resulting in dim vision, which is common. For red, swollen, and painful eyes with Spleen deficiency manifesting as poor appetite, if the Liver pulse is excess and the Spleen pulse is weak, using cold herbs to treat the Liver further damages the Spleen, while warming herbs to tonify the Spleen exacerbates Liver fire. The solution is to add a doubled dose of Rougui (Cinnamomi Cortex) to mild harmonizing herbs to suppress Liver fire and benefit the Spleen, achieving two goals with one action. The Classic states: "Wood withers when it meets Cinnamon." Combined with Shaoyao (Paeoniae Radix Alba) to restrain it, this is an efficient method for clearing heat and preserving Yin. Human milk applied to the eyes is highly effective for long-term dim vision, as milk shares the same source as blood, and the eyes see only when nourished by blood. For redness with swelling and pain, disperse damp-heat; for redness with dryness and pain, disperse fire-toxin; for redness with excessive tearing, disperse wind-pathogen; for redness without pain, promote urination. If redness starts in the left eye and spreads to the right, it is wind-heat carrying fire; prioritize dispersing wind and avoid cold herbs, as cold nature causes fire stagnation. If redness starts in the right eye and spreads to the left, it is phlegm-dampness carrying heat; include wind-dispersing herbs in fire-draining formulas, as wind can overcome dampness. In cases of severe redness, swelling, and pain, puncturing the upper eyelid to release bad blood prevents damage to the eyeball (Zhu).

Blood Pouring into the Eye Syndrome (Xue Guan Jing Zheng) This condition is most toxic. If patients insist on their own views and refuse surgical incision (opening the vein), the eye will surely be destroyed. Initially, there is only redness; subsequently, purple swelling occurs; later, the sclera (white part) swells up, the eyelids swell like a cup, and the limbus bulges. Without proper treatment, there is a risk of yellow-green discharge and proptosis. Whenever white sclera appears red-purple, eyelids are swollen with tortuous purple vessels, and point-treatment fails to resolve it, there must be internal blood stasis. The eyelid can be everted for inspection. If the inner eyelid shows discoloration, floating papillae (Jiao Chuang) or follicles (Su Chuang), drainage methods should be used. After drainage, administer Xuanming Wan.

Blood Pouring into the Pupil Syndrome (Xue Guan Tong Shen Zheng) This occurs when toxic blood pours into the Shen Water within the pupil (Jin Jing). Clear and turbid energies mix, causing intermittent pain and astringency, full-field red glow, blurred vision as if looking through silk or in smoke. There are three types: 1. Liver-Kidney blood heat pouring into the pupil, usually starting in one eye and spreading to both, making recovery difficult. 2. Traumatic blood infiltration, which resolves quickly despite severity. 3. Iatrogenic injury during cataract surgery, where accidental manipulation of the iris causes blood infiltration. Treatment for all three is similar: use Dahuang Danggui San. Treat opacities flexibly.

Red Vessels Penetrating the Eye Syndrome (Chi Mai Guan Jing Zheng) Regardless of thickness or number, if vessels penetrate the Wind Wheel (cornea), passing outside the pupil to connect with the Qi Wheel (sclera), it is very difficult to treat. Thin vessels are milder; thick ones are severe. Penetration leads to complications; coarse vessels with tortuous branches indicate complications. Any vascular coverage over various opacities, even in easily resolvable cases, heals slowly. Penetration into the Wind Wheel, even if not connected, is hard to resolve. Originating from large collaterals indicates Heart Excess Fire, treated with Xixin San. Large tendons/vessels require pricking with a small sharp needle. Originating from small collaterals indicates Heart Deficiency Fire, treated with Daochi San, no need for pricking. Violent, alcohol-abusing individuals presenting with red vessels pouring into the eye exhibit a malignant sign, excluded from these standard examples.

Chaotic Red Threads Syndrome (Chi Si Luan Mai Zheng) Pathology arises on the Qi Wheel (sclera) with crisscrossing thread-like vessels, varying in density and thickness. Symptoms include pain or lack thereof, tearing or absence thereof, photophobia or lack thereof. It persists chronically without healing, unlike epidemic acute conjunctivitis or Red Vessels Penetrating the Eye. One must trace the origin of the main vessel to identify the affected meridian for treatment. For external disorders, thin vessels resolve easily; tortuous purple thick vessels resolve slowly and require persistent treatment to prevent recurrence. Otherwise, violating dietary/lifestyle taboos will cause relapse. Thread-like vessels extending to the Wind Wheel indicate severe pathology prone to transformation. Tortuous purple threads respond to internal and external treatment: application shrinks them, withdrawal causes dilation. Even without black cornea discoloration or eyelid swelling, deep stasis may exist in the collaterals. Inspect the deep upper eyelid for irregular coloration. Mild drainage suffices; excessive drainage injures true blood, leading to Yin deficiency, dry eye, and visual impairment. Apply Shiyan Dan internally/externally; take Dahuang Danggui San or Jiu Jian San.

White Sclera Yellow-Red Syndrome (Bai Jing Huang Chi Zheng) Gradual yellow-red discoloration of the white sclera is due to alcohol toxin damaging the Spleen Meridian's dampness, allowing Liver-Gallbladder evil fire to overflow into the Lung Meridian. Use Wuling San with Yinchen (Artemisiae Scopariae Herba). Severe cases use Huanglian Jiedu Tang with Zhizi (Gardeniae Fructus) and Dachangcao (Scutellariae Barbatae Herba).