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The sinews of the Foot-Taiyang channel serve as the upper framework of the eyes; the sinews of the Foot-Yangming channel serve as the lower framework. If affected by heat, the sinews become flaccid, resulting in inability to open the eyes; this can be treated with Zuyang Hexue Tang (Warming Yang and Nourishing Blood Decoction). However, there are cases where damp-heat is constrained, presenting with slight swelling of the eyelids; these can be treated with Shengyang Chushi Fangfeng Tang (Raising Yang and Expelling Dampness with Saposhnikovia Decoction). If true yang fails to ascend, the patient prefers warmth and fears light; this can be treated with Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction). In cases of liver deficiency, the patient closes the eyes and avoids looking at people; this can be treated with Jinkui Shenqi Wan (Jin Gui Kidney Qi Pill). Treatment should address the root cause in each case.

Injuries caused by being struck by objects involve damage to the eyelids from falls or blows. If blood accumulates turning purple or blue, or if the sclera (white part) is broken but the hard shell remains intact, it is not considered dangerous. The critical danger arises only if the iris (yellow part) and cornea (wind wheel) are ruptured, causing blood to flood the pupil and mix with the internal eye structures (water wheel). Alternatively, even without rupture, if tears are profuse and bitter like cypress juice, the prognosis is poor. Urgently use Jiu Jian San Qu (Wine-Boiled Dispersion Formula) combined with Stephaniae Tetrandrae Radix (Fangji) and Arctii Fructus (Niubangzi), plus Notopterygii Rhizoma et Radix (Qianghuo) and Equiseti Herba (Muzei). Apply compresses of scallion and mugwort, and protect with Qingliang Gao (Cooling Paste). Alternatively, apply a warm poultice made of pounded fresh Rehmanniae Radix (Shengdihuang) to the temporal acupoint and eyelids, changing once daily to dissipate blood stasis. If fresh Rehmanniae Radix is unavailable, use pounded Hibisci Mutabilis Folium (Furongye) heated for application; if dry, mix with egg white. For black-and-blue orbits, apply pounded fresh Raphani Radix (Laifu). Strictly avoid wind and observe dietary restrictions. For severe pain, add Myrrha (Moyao) to the wine-boiled dispersion. If nebulae gradually form, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) substituting Paeoniae Radix Rubra (Chishao), and add Rhei Radix et Rhizoma (Dahuang), Angelicae Sinensis Radix (Danggui), Bupleuri Radix (Chaihu), Forsythiae Fructus (Lianqiao), and Glycyrrhizae Radix et Rhizoma (Gancao). If the condition progresses to blood dispersal with non-painful white nebulae, it is incurable.

Jingzhen External Obstruction Syndrome: External obstruction forms after the eye is struck or touched. This differs from acute injuries to the internal eye tissues. Initially, there is pain, astringency, and distension in the eyeball. Due to mild injury, blood stasis resolves spontaneously; thus, although pain subsides, lack of caution may trigger fire pathogens, leading to turbid fluids, qi stagnation, and collateral涩 (stiffness), causing external obstruction. Use Shenxiao San Qu (Spirit-Dispersing Powder) removing Atractylodis Rhizoma (Cangzhu), adding Haliotidis Concha (Shijueming), and concurrently administer Zaojia Wan (Gleditsiae Fructus Pill). Whenever external obstruction causes eyeball pain leading to headache and swelling, it is a malignant sign requiring urgent treatment to prevent complications.

Jingzhen Internal Obstruction Syndrome: An already diseased eye suffers further trauma, transforming into internal obstruction. There is day-and-night pain, gradually developing visual obscuration, with red membranes surrounding the eye preventing vision of light sources, resembling chronic internal obstruction. Treat with Zaojia Wan combined with Sheng Shu Dihuang Wan (Raw and Cooked Rehmannia Pills).

Physical Damage to True Eye: Trauma to the cornea (wind wheel) varies in size and color. Yellow lesions indicate rapid harm; white lesions progress slower. If the internal eye tissues are touched or ruptured, fluid discharge occurs—either dark/black or white like phlegm—which is extremely urgent. Even with immediate treatment, if the pupil remains, deviation risks persist. Foreign bodies such as wood thorns, metal fragments, plant tips, or needles penetrating the cornea cause unbearable day-and-night pain; they must be removed immediately. Delay leads to yellow-white granules forming, resembling millet grains or silver stars, with green fluid stagnation and obstruction. Remove the foreign body first, then treat the obstruction. If injury is within the conjunctiva/sclera (qi wheel) and removal is delayed, blood flooding the eye may occur. Remove the object, guide out the stasis first, then treat remaining symptoms. If vision is blurred with pupillary distortion, long-term neglect results in sunken or protruding eyes. Generally, regardless of lesion size or color, symptoms like tearing, redness, and swelling indicate urgency. Eyeball pain with heavy head is particularly critical. Patients with pre-existing wind-heat, phlegm-fire depletion have internal pathogen accumulation triggered by external trauma. Severe pain with difficult urination is the most ominous sign.

Flying Thread Entering Eye Syndrome: Wind-blown threads accidentally enter the eye causing pain. Threads from wild silkworms, spiders, or insects pose slower risks. However, threads from "Golden Silkworm" or Old Stork Grass can cause eye rupture within three days. Treatment: Apply human hair垢 (Tougou) into the eye, followed by Torreya Seedling Juice (Zheshujiang). Wrap thread around chopstick tip, dip in water, and wipe away toxic saliva. Soak one unit of Cannabis Seed (Huomazi) in a bowl of well water, stir, then dip tongue in water to induce salivation—a miraculous effect. Alternative: Pound fresh Solanum Melongena Leaf (Qieziye) similarly. For swollen, painful, unopen eyes with clear nasal discharge, grind Beijing Ink (Jingmo) thickly, apply with new brush into eye, keep closed briefly, then open; the thread clumps on the sclera. Gently roll off with cotton. Reapply if necessary.

Accidental Object Entry Syndrome: Pain occurs when an object accidentally falls into the eye. Do not rub rashly due to irritation. Restrain impulse, wait for tears to fill the eye, then gently wipe; lubrication aids expulsion. If the object is heavy or has barbs and cannot exit, seek immediate removal. Do not rub, as this drives the object deeper. For deep insertion, gently evert the upper eyelid to retrieve. Failure to remove causes qi stagnation and blood coagulation, leading to pathology. Barbed or sharp metallic objects left too long or rubbed heavily damage the cornea/lens, causing conditions like scar nebula or purulent membrane. Mild cases present as blood stasis and fluid retention causing pain or obstruction. Objects trapped inside the eyelid require eversion and examination for targeted treatment.

Sand and Dust Syndrome: Caused by wind-blown sand/dust during travel, exacerbated by frequent rubbing, leading to qi-blood stagnation. Initial symptoms include sudden tearing and astringency, progressing to obstruction nebulae. Treat based on presentation. Initially, wrap cotton around hairpin tip to roll out dust. For long-standing cases, evert eyelids, locate deposits, and scrape flat without blowing powder. For objects in the eye, use a new brush to extract. For rice/wheat awns, place a ground beetle larva (Qicao) covered by fresh cloth over the eye; the larva’s movement draws the awn onto the cloth. Another method: Hang a duck upside down, collect its saliva, and drip into the eye to expel awns.