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For acute onset eye diseases (sudden onset of ocular pathology), one must examine whether it is caused by extreme heat. If so, use Shuangjie San (Double Release Powder), Jiuku Tang (Rescue from Suffering Decoction), Danggui Longdan Tang (Angelica and Gentian Root Decoction), Xiugan San (Liver Repair Powder), Xigan San (Liver Cleansing Powder), Xiegan San (Liver Draining Powder), or Yujin Jiu Tiao San (Curcuma Wine-Adjusted Powder).

If the condition is due to wind-fire-heat pathogens and does not improve after taking cooling medicines, use Mingmu Xixin Tang (Eye-Brightening Asarum Decoction), Zhuyang Huoxue Tang (Yang-Assisting and Blood-Activating Decoction), Zijin Chuanxiong Chatiao San (Purple-Gold Ligusticum Tea-Adjusted Powder), Mingmu Liuqi Yin (Eye-Brightening Qi-Circulating Drink), or Sangpiaoxiao Jiu Tiao San (Mantis Egg Case Wine-Adjusted Powder).

If the condition results from long-standing disease with blood stasis and severe wind, use Danggui Hexue Jian (Angelica Blood-Harmonizing Decoction), Shenqing San (Spirit-Clearing Powder), Moyao San (Myrrh Powder), or Juanyun Tang (Rolling Cloud Decoction). If the attacks occur at irregular times, use Shengdihuang San (Rehmannia Powder) or Pohonghua San (Breaking Blood Safflower Powder).

If the condition is caused by wind-toxin, use Chanhuas San (Cicada Flower Powder), Rusheng San (Like-Sage Powder), Chuanxiong Chatiao San (Ligusticum Tea-Adjusted Powder), Shenqing San (Spirit-Clearing Powder), or Yeguang Liuhong Wan (Night-Luminous Willow-Red Pill). For phlegm-related diseases, use heat-clearing agents, Banxia (Pinelliae Rhizoma), Erchen Tang (Two-Aged Decoction), and similar formulas; for old phlegm (stubborn phlegm accumulation), use Sisheng Tang (Four-Life Decoction).

If the condition is chronic with neither exterior nor interior syndromes, and the interior of the eye is clear, use Chanhuas San (Cicada Flower Powder), Mimenghua San (Buddleja Flower Powder), Juemingzi San (Cassia Seed Powder), or Shiwei Huanjing Wan (Ten-Ingredient Eye-Rejuvenating Pill).

If there are no internal organ pathologies, but only external manifestations, follow standard protocols sequentially without administering oral medicine; if nebulae (corneal opacities) are present, treat them solely with加减 (modified) anti-nebula medications.

Someone asked me: "The human eyes are the essence of the five zang and six fu organs. If there is injury to the internal organs, what is the rationale? Furthermore, why does left-sided disease not transmit to the right, right-sided disease not transmit to the left, and sometimes both sides are diseased simultaneously? I do not understand the details; please explain." I replied: "Only those who have mastered the profound theories of Qibo, Huangdi, Nagarakretagama (Longshu), and Muzhi can clarify this."

The eyes are the concentrated essence of the five zang organs; the eyes are the orifice of the Heart; the pupil is the essence of the Kidney. The water of Zongjing (ancestral essence) does not flow out freely because it is wrapped by blood and assisted by qi, gathering together in the eyes. The head is where all yang meridians converge. The Foot-Taiyang Bladder Meridian originates at the outer canthus, travels up to the vertex, enters the brain, and directly connects to the root of the eye, known as the "eye system" (Yanxi). It intersects with the Du Meridian and Yang Wei Mai at the Fufu point; entering the brain system constitutes Wind-Eye. The Jueyin Liver Meridian ascends to the forehead and converges at the vertex; its branches intersect from the eye system, where wind pathogens contend, causing blindness. Between the two tendons at the vertex and Fufu point, yin and yang qi intersect at the inner canthus. When yin qi is excessive, the eyelids close; when yang qi is excessive, the eyes open. In cases where one cannot lie down due to illness, it is because Wei Qi (Defensive Qi) cannot enter the yin aspect, resulting in fullness of yang and deficiency of yin, thus preventing eye closure and vision. In cases where one cannot open the eyes, it is because Wei Qi flows into the yin but fails to emerge into the yang, resulting in yang deficiency, thus causing eye closure. Therefore, diseases involve principles of excess and deficiency. Diet contains five flavors, heaven and earth possess six excesses (Liuyin), and the human body harbors seven emotions (Qiqing); all can cause disease. There are distinctions among thief pathogens, subtle pathogens, and righteous pathogens. Qi and flavor are formless yet can damage有形 (form/material) substances; how could they fail to produce disease? Moreover, ophthalmology distinguishes between major and minor formulas, each with different treatments. One must examine the cause of the disease and observe the severity and depth of symptoms. Treating everything uniformly risks exacerbating the condition like adding firewood to a fire, which is truly regrettable! Since my youth, I suffered from illnesses and sought medical treatment. Over these years, I have studied various texts thoroughly to grasp their profound principles. I visited teachers and friends, collected extensive prescriptions, traced origins, and did not hesitate to ask subordinates about doubts, striving to explore deep meanings. If you focus your mind diligently, even if you do not reach the shore of Qibo, Huangdi, Longshu, and Muzhi's theories, you can still be considered a leader in medicine.

In examining eyes, first assess the pupil and Shen Guang (spiritual light); second, inspect the Feng Lun (Wind Wheel/black cornea); third, observe the Bai Ren (White Wheel/white sclera); fourth, distinguish the Baojian (Eyelid/Flesh Wheel). These four points are the essentials of ophthalmology. During examination, have the patient stand upright, raise hands slowly, and gently retract the eyelids. First, check the pupil: if Shen Guang is present, opening and closing are vigorous. Second, check the Feng Lun: if expansion and contraction are robust, the Hun and Po spirits are healthy. Third, check the Qi Lun: if healthy, it is moist, smooth, and lustrous. Fourth, check the Rou Lun: if healthy, opening and closing are forceful, and the eyelids are not ulcerated or red.

Regarding the examination of nebulae (opacities): Nebulae formed over many years that can be removed are typically floating, void, rot-red, and prevent eye opening. Recent intermittent eye diseases present with red-white nebulae; if floating and purulent with residual redness, or accompanied by tears, they disperse easily. However, "dead nails" (hard, unremovable opacities) within may persist. Red-mist-like nebulae disperse easily. Nebulae arising from headaches that are white and hard are difficult to remove. Another type of dense nebula, once removed, leads to complete recovery. A thin, pale-white cloudiness on the black cornea that cannot be removed is called Leng Yi (Cold Nebula).

For cauterization therapy, remain calm and steady while holding the eye open. Apply wet paper to cover healthy flesh around the four corners, exposing only the area to be cauterized. Heat an iron spoon until red, wipe it on fine cotton, and then cauterize. Do not injure the four corners. After cauterization dries, apply harmonizing medicines externally to draw out the fire toxin.