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Those presenting with cyan-yellow protrusion indicate the rupture of the Wind Wheel (the cornea, corresponding to the Liver), with the internal essence and juice leaking out. Some cases involve spontaneous rupture followed by swelling and protrusion that cannot retract; others result from external obstructions where cold-natured herbs were used to forcibly clear internal fire, leading to a loss of balance in external treatment and subsequent protrusion. Even with skilled hands, these are incurable. One may only use Zao Ying Wan (Soap Pod Pill) with a small amount of Peng Sha (Borax) to alleviate the redness and protrusion.

When Qi moves within the eye, observing deep into the pupil reveals a wisp of Qi moving faintly and curling, resembling a thin stream of clear smoke reflected in a distant mirror. Patients suffering from Head Wind and Phlegm-Fire often experience prolonged stagnation where Fire prevails, beating against the Qi in the collaterals, causing it to wander and fluctuate. These should be treated according to the protocols for Head Wind. If vision becomes dim after the movement subsides, internal pathology has already formed.

Inverted eyelashes (Juan Mao) are caused by the contraction and shrinking of the eyelid skin. Over time, this leads to redness, ulceration, turbidity of Shen Water (aqueous humor), and the formation of nebulae that cause obstruction, astringency, and painful tearing. Some patients pluck or cut off their lashes; some physicians clamp the upper eyelid with a bamboo board, removing the skin along with the lid after seven days. Although effective quickly, the internal disease remains unaddressed, and inversion recurs shortly thereafter. This is akin to withered vegetation where branches hang limp; merely picking yellow leaves in the morning and cutting dead branches in the evening only damages the root. It is better to nourish Earth and Water, so that yellow turns green and hanging branches stand upright. This condition involves latent internal Heat and outward-flowing Yin Qi; one must drain the Heat. Once the eyelids relax, the lashes will naturally grow out, and nebulae will recede. Manually evert the inner eyelid outward, and immediately prick with a Three-edged Needle to bleed. Using the thumbnail of the left hand to guide the needle tip can yield immediate results. Additionally, for red and ulcerated eye orbits, prick the orbit with a Three-edged Needle to drain Damp-Heat, then administer Fang Feng Yin Zi (Saposhnikovia Decoction). Use Bi Yun San (Green Cloud Powder) via nasal insufflation as an adjunct. To treat inverted lashes: powder one Mu Bie (Semen Strychnos), wrap in cotton, and insert into the nostril opposite the affected eye (left nostril for right eye, right for left); after one night, the lashes straighten naturally. If short lashes grow inward on the palpebral conjunctiva touching the globe, remove them with tweezers and apply blood from lice to prevent regrowth.

Tight and small eyelids refer to the constriction of the eyelid margins, which is a precursor to inverted lashes. If they shrink gradually without treatment, it is due to the depletion of essence, blood, and body fluids, causing tension in the sinews and vessels. If tightness occurs after treatment, it is often because lax eyelids with inverted lashes were repeatedly clamped or surgically incised without internal regulation, depleting blood and causing constriction. Nourishment should be applied promptly using Shen Xiao Huang Qi Tang (Miraculous Astragalus Decoction). If the outer canthus is particularly tight, remove Chen Pi (Citri Reticulatae Pericarpium) and add Lian Qiao (Forsythiae Fructus), Sheng Di Huang (Rehmanniae Radix), and Dang Gui (Angelicae Sinensis Radix). If the collaterals become fixed and Qi stagnates, cure is unlikely despite treatment. Lou Quanshan stated: Yang deficiency causes eyelid tension, while Yin deficiency causes pupil dilation. Therefore, Li Dongyuan treated eyelid tension by using Ren Shen (Ginseng) and Huang Qi (Astragalus) to tonify Qi as sovereign herbs, assisted by acrid herbs to disperse, while avoiding Sour-astringent herbs like Shao Yao (Paeoniae Radix Alba) and Wu Wei Zi (Schisandrae Fructus). For pupil dilation, he used Di Huang (Rehmanniae Radix) to tonify Blood as sovereign, assisted by Sour herbs to astringe, while avoiding Pungent-dispersing herbs like Chong Wei Zi (Leonuri Fructus) and Qing Xiang Zi (Pharbitidis Semen).

Bao Rou Nian Lun (Palpebral Flesh Adhering to the White Eye): The flesh of the inner eyelid adheres to the Qi Wheel (sclera/conjunctiva) and does not separate. Administer herbs that drain Damp-Heat, such as Fang Feng (Saposhnikoviae Radix), Xi Xin (Asari Radix et Rhizoma), Dan Cao (Gentianae Radix), Ku Shen (Sophorae Flavescentis Radix), Xie Shao (Scorpio), and Niu Bang Zi (Arctii Fructus). Wind herbs can drain water within the Earth element.

Bao Rou Jiao Nian Zheng (Adhesive Palpebral Mass): Both eyelids adhere and close, especially during sleep, requiring lubrication to open. The pathology lies primarily in Damp-Heat of the Spleen and Lung. Treatment should focus on cooling and moistening. Although nebulae appear on the cornea, this is due to internal stagnation of Damp-Heat, not the fault of the nebula itself. Untreated over time, it may lead to ulceration.

Fan Yan Zhan Jian Zheng (Eyelid Eversion Adhering to Lid): The eyelid everts and adheres to the outer surface of the opposing eyelid. This results from internal Qi stagnation and Blood congestion, combined with external skin tension, preventing return to normal position. It is caused by stagnation of Wind-Damp. Patients with Wind diseases are prone to this. Surgical excision and release with a scalpel are indicated.

Feng Qian Chu Jian Zheng (Wind-Induced Eyelid Eversion): This is a syndrome where the Spleen and Stomach receive Wind-Toxin. Wind affecting the eyelid causes skin tightness; Wind affecting the eyelid flesh causes swelling. Tears overflow and macerate the eyelid, representing Earth failing to contain Water. Treatment: First, massage with ginger juice powder mixed in sesame oil to dispel Wind. Evert the eyelid skin and cauterize three to five times. If red veins extend upward and nebulae cover the black cornea, insufflate with Dan Yao (Medicated Pellets). For deviation, moxa-burn Jiache (ST6) and Ermen (TE21), locating points with the mouth open. Also burn Taiyang (EX-HN5), Renzhong (GV26), and Chengjiang (CV24). Treat contralaterally: right side lesions burn left, left side lesions burn right. Recent onset resolves easily; chronic cases are difficult to cure. Additionally, individuals exposed to severe wind often suffer facial traction leading to this condition, which is hard to manage.

Xue Yu Pi Fan (Blood Stasis with Eyelid Protrusion): The tissue inside the eyelid appears purplish, stagnant, and floating, sometimes forming numerous small blisters connected in patches. This is due to Blood stasis in eyelid collaterals exacerbated by Fire-Toxin and dryness/grease, leading to accumulation. It may also result from bleeding after lacerating the eyelid followed by exposure to Wind. Treatment prioritizes invigorating Blood and employing release methods.

Pi Xu Ru Qiu (Eyelid Deficiency Resembling a Ball): The eyelids swell like a ball. Rubbing with warm palms flattens them temporarily, but they revert quickly. This indicates Blood deficiency and the congestion of Deficient Fire in the Qi level. Use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), removing Sheng Ma (Cimicifugae Rhizoma), and adding Ge Gen (Puerariae Lobatae Radix), Mu Tong (Akebiae Caulis), and Ze Xie (Alismatis Rhizoma).