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Mu Yang (Ulcer of the Wood Wheel) resembles a bean attached to the Qing Jing (Black Cornea), with colors of cyan-green and pale yellow, difficult to depict. If it deeply invades the Jin Jing (Pupil), water ripples will ripple and green moss will grow.

This condition arises on the left and right sides of the Feng Lun (Black Cornea), presenting with a cyan-green hue and a shape resembling a rotten bean. The primary etiology involves either depletion of essence and blood in the lower jiao leading to deficiency fire attacking upwards, or excessive consumption of rich foods from mountains and seas, where toxins follow the qi mechanism to erupt. Consequently, upon onset, there is internal heat, reduced appetite, severe headache and eye pain, making opening the eyes unbearable. As the disease momentum subsides, this current presentation forms. Although distinct from Huang Ye Shang Chong (Yellow Fluid Rushing Upward) where pus flows from within, its malignancy is even greater; if untreated, the eyeball will surely rupture. After healing, obvious lichen-like erosions and mossy patches remain, appearing as nebulae but not true cataracts, posing a challenge even for divine physicians.

Huo Yang (Fire Ulcer) resembles a red cardamom pod; its cause can be known as pathogenic toxin. It becomes intolerable between the two canthi, and when invading the Qi Lun (White Sclera), it is difficult to distinguish and dissect.

Initially, this condition appears like a pepper grain, subsequently resembling a red cardamom pod, growing between the inner eyelid and the Qi Lun interface, with invasion of the Qi Lun being critical. This is due to excess fire pathogen now residing in the Metal sector (Lung/White Sclera), described as "Ghost Thief Invasion" (reverse overcoming in Five Elements). If neglected or mismanaged, it may ulcerate into a fistula. Huanglian Jiedu Tang (Coptis Decoction for Detoxification) should be used. If ineffective, Bazheng San (Eight Corrective Powder) or Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) are appropriate. Further treatment should nourish Water to assist Fire, or tonify Yin to harmonize Yang, employing flexible methods rather than solely focusing on detoxification.

Tu Yang (Earth Ulcer) is commonly known as Bao Zhen Zhu (Pearl Enveloped), caused by blood stasis generating phlegm and fire eroding the skin. Do not consider minor ailments unworthy of treatment; once an ulcerated fistula forms, even miraculous skills struggle.

Also called Tou Zhen Yan (Stolen Needle Eye), it grows on the outer eyelid margin. Initially, it presents only with itching and swelling, followed by a small nodule that becomes painful, often resolving spontaneously without medication. If the pathology is full-excess, it must reach the stage of large nodule suppuration to heal. One nodule may ulcerate while another forms; one day it ceases, the next it rises again, due to pore deficiency allowing external wind invasion, causing total facial swelling and red, painful eyes. Further exposure to dry-hot substances will inevitably lead to rot, fistula, trichiasis, and deformity. Such a trivial ailment brings such disaster; patients must not ignore it. Initially, use Xiehuang San (Drain Yellow Powder) or Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction); later, Guishao Liujun Tang (Angelica Sinensis, Paeonia and Six Gentlemen Decoction) or Jinshui Liujun Tang (Metal-Water Six Gentlemen Decoction). If eyes are red/painful and face slightly swollen, urgently administer Qingwei San (Clear Stomach Powder) or Ershu Shengshi Tang (Two Atractylodes Dampness-Overcoming Powder), or apply heavy pricking at the ulcer apex to release blood and qi, preventing rot.

Jin Yang (Metal Ulcer) produces jade-like grains on the eye surface, obstructing the clear Shui Lun (Water Wheel/Pupil/Lens), akin to overgrown weeds. During times of yin qi transition and clear metal-water energy, with flowing fire in the west, mental clarity slightly improves.

This condition arises in the Qi Lun (White Sclera), shaped like golden millet, with variable numbers of grains. Discharge, tearing, and astringent pain persist. Occasionally, nodules connect to the upper eyelid interior, particularly obstructing the Qing Jing (Black Cornea), and trauma may induce nebulae/cataracts, resembling pepper grains. However, this is hyperactive Fire-Metal conflict, not wind-dampness in Wood-Earth. Symptoms exacerbate during the period from Zi hour to Wu hour when yang qi rises. Large doses of Xiebai San (Drain White Powder) or Zhijin Jian (Treat Metal Decoction) are required. If no reduction occurs, Xiaodu Zhuyu Tang (Detoxify and Remove Blood Stasis Decoction) is effective. Violating taboos risks further calamity.

Shui Yang (Water Ulcer) adheres to the Zhen-Xun Lun (Wind Wheel/Cornea area), with black qi obstructing the void and pale qi thinning. Taiyang channel attachment causes severe cephalalgia; the pupil dislikes the Jin Jing (Pupil) sinking.

This condition still arises in the Feng Lun (Black Cornea), mimicking Mu Yang closely, but starting in the Xun perimeter with yellowish color, sometimes turning cyan/blue, pressing inward to the Qing Jing. It is among the most bizarre and malignant eye diseases; failure to penetrate the eyeball and cause blindness results in a pseudo-diplopia appearance. Some ask: ulcers are typically fire-stagnation with wind-headache, why attribute this to Water? Because Liver Wood wind-dryness generates Fire; excessive Fire insults Water. Jin Jing refers to Kidney meridian; wind attacks above, fire burns within, while the lower transformation source cannot quickly support. Minimal essence fluids mix with the flow, entering Wood with the wind, forming ulcers. Wind moves water, a natural law; any severe cephalalgia attacks damages the pupil, not limited to Water Ulcers. This ulcer stems from heat dominance, fire combining with water transformation, kidney water deficiency and fatigue, clearly evident.

Shui and Mu Yangs originally lack fixed prescriptions, hence none listed. However, for early onset, medicine is benevolent art; the physician must sincerely seek cure, unable to sit idle. For Mu Yang, use Sanhuang Wan (Three Yellows Pill) or Yiyang Jiutiao San (Suppress Yang Wine-Mixed Powder); for Shui Yang, use Zhibai Dihuang Tang (Anemarrhena, Phellodendron and Rehmannia Decoction) or Tongyou Wan (Unblocking Source Pill), aiming to relieve pain and preserve globe convexity. For fortunate cases with efficacy, pulse diagnosis guides medication selection, achieving recovery occasionally. Pre-explaining the etiology prevents future complaints and criticism from others.