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Fengyan (Marginal Blepharitis) involves the eye meridians. There is accumulated heat in the upper jiao (upper burner/diaphragm), formed by dietary indiscretion combined with anger. Stubborn phlegm causes obstruction, turbid qi fails to descend, and clear qi fails to ascend. Consequently, fire becomes more intense while kidney water (yin fluids) descends excessively. Over time, the eyelid margins swell due to pus accumulation, and fine worm-like filaments grow within, leading to chronic non-healing conditions characterized by severe itching. This is Fengyan. Treatment involves taking Chaihu Yinzi (Bupleurum Decoction) and applying Ruiren Gao (Buckthorn Fruit Ointment) as eye drops.

Zhengfeng Chilan Syndrome (Wind-Induced Red and Ulcerated Eyelids): Regardless of which wind pathogen is encountered, exposure causes redness and ulceration; without wind, there is a sensation of stagnation or fullness. Redness indicates a fire syndrome within Wood (Liver); ulceration indicates a dampness syndrome within Earth (Spleen). This specifically discusses the pathology of redness and ulceration upon wind exposure, which differs from subsequent syndromes involving tearing upon wind exposure. Treatment uses Chuanxiong Chatiao San (Ligusticum Tea-Pingling Powder).

Chilan Syndrome (Red and Ulcerated Eyes): Refers to eyes that are only ulcerated without other distinct diseases. If redness predominates over ulceration, it is mostly due to fire, caused by mental exhaustion, worry, depression, and anger, injuring the body with formless fire. If ulceration predominates over redness, it is mostly due to dampness, caused by indulging in dry foods and alcohol, steamed by wind-heat, injuring the body with tangible dampness. The disease belongs to the Heart collaterals. In severe cases, excessive fire clouds the water (kidney yin), leading to sores on the margins. Treatment uses Xigan San (Liver-Washing Powder) added with Mahuang (Ephedrae Herba), Jili (Tribuli Fructus), and Chuanlian (Coptidis Rhizoma). Additionally, decoct Chishao (Paeoniae Radix Rubra), Fangfeng (Saposhnikoviae Radix), Wubeizi (Galla Chinensis), and Chuanlian in water. Add a small amount of salt and Qingfen (Calomelas) to wash the area. Apply Luganshi San (Calamine Powder) for eye application. Also, soak Wancangsha (Mulberry Silkworm Feces) in Sesame Oil for over a month, filter through heavy silk cloth, and apply as eye drops.

The Classics state: Wind qi enters the stomach along with the Yangming meridian, circulating up the vessels to the inner canthus. In obese individuals, wind qi cannot escape outward, resulting in "Heat in the Middle" (Re Zhong) and yellow eyes. In thin individuals, wind escapes outward accompanied by cold, resulting in "Cold in the Middle" (Han Zhong) and tearing. Thus, yellow eyes belong to heat, and tearing belongs to cold, which is clear.

Li Dongyuan stated: Water overcoming Wood leads upward to eye dryness, discharge (Chi), and cold tears. All these result from deficiency of Lung Metal, causing Liver Wood to lack restraint. Whenever the eyes encounter winds from the Northwest, dryness, pain, and tearing occur; this is a disease of Liver deficiency being overcome (Metal overcomes Wood). Treatment uses Zhilei Bugan San (Tear-Stopping Liver-Nourishing Powder) and moxa is applied to both Jingming (BL1) acupoints. Encountering winds from the Southeast causes dryness, pain, and tearing; this is a primary Liver disorder (Wood matches Wood). Treatment uses Juhua San (Chrysanthemum Powder). If regardless of the wind, cold tears flow upon exposure, this is latent fluid retention (Fu Yin) in the Liver and Kidney meridians, insufficient blood, empty orifices allowing wind entry, and evil triggering evil. Treatment uses Yeguang Jiaohong Wan (Night-Shining Pepper-Red Pill), or modify Siwu Tang by replacing Chishao with Shengdi, adding Fangfeng, Rougui, Qianghuo, and Muzei. If regardless of the wind, hot tears flow upon exposure, this is latent fire in the Liver and Kidney meridians, loose orifices, and wind drawing out the tears. Selectively use Chuanxiong Chatiao San or Juhua San. Pang Anchang stated: For head wind with cold tears, decoct and wash with Juhua (Chrysanthemi Flos), Juemingzi (Cassiae Semen), Baizhu (Atractylodis Macrocephalae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Xixin (Asari Radix et Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), and Jingjie (Schizonepetae Spica). If the eyes are not red or painful, with no other distress, and cold tears flow frequently even without wind exposure, potentially leading to blurred vision, this is weak Qi of Liver and Gallbladder and insufficient Kidney water. Use Bawei Wan (Eight-Ingredient Pill) using Sichuan pepper-processed Dihuang, added with Chuanxiong and Danggui. For postpartum cases of excessive weeping, use Shiquan Dabu Tang added with Chuanjiao and Xixin. If hot tears flow intermittently, this is internal fire agitating water, due to depletion of essence and blood in Liver and Kidney, where yang fire easily moves and damages fluids. Use Liuyun Wan (Six-Ingredient Pill) added with Chuanjiao and Zhi Shudi, doubling Danpi. For injury from excessive crying, use Bazhen Tang added with Chuanjiao and Wuweizi. Furthermore, if the Lung organ has long-standing cold, cold tears accumulate in the lacrimal sac at times; since these tears connect to the Lung, they are difficult to treat, and prolonged flow causes visual dimness. Another condition involves phlegm-like substance inside the eyelids, white, thick, and greasy, appearing upon wiping; this is phlegm-fire obstructing upwards, caused by Spleen and Lung damp-heat. Thus, those who enjoy alcohol, crave dry foods, and are prone to irritability and depression often suffer from this. Modify Xiaoyao San by removing Chaihu and Chenpi, adding Qianghuo, Fangfeng, and Juhua. If eyelid swelling and twisted, red vascular patterns are felt, the pathogen must have stagnated in the Blood level, guarding against complications such as Yu Xue Guan Jing (Blood Stasis Irrigating the Eye).