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Exposure-induced red eyes with corneal opacity share the same pathogenesis as epidemic red eyes (Epidemic Keratoconjunctivitis). Epidemic red eyes are contagious to others; exposure-induced red eyes occur in a single individual without contagious symptoms. In epidemic cases, there may be pain and swelling but no corneal opacity. In exposure-induced cases, pain is accompanied by corneal opacity; thus, they require distinct treatment methods. Treatment should address the etiology, assessing the patient's age and deficiency or excess patterns. If heat is present, clear it with cooling agents; if qi stagnation exists, regulate and smooth the qi flow. Even if blood stasis is present in these eyes, washing is strictly contraindicated, nor should strong tonification be used. Medications should be decocted in wine to promote dispersion. Formulas such as Mahuang Cangzhu San (Ephedra and Atractylodes Powder) or Dahuang Danggui San (Rhubarb and Angelica Sinensis Powder) can be used to unblock blood and qi, followed by instillation of the mild Jiu Yi Dan (Nine-One Pill). If the opacity is dense, Zhenzhu San (Pearl Powder) should be instilled, and the eye washed with decoctions containing Huanglian (Coptidis Rhizoma), Danggui (Angelicae Sinensis Radix), Fangfeng (Saposhnikoviae Radix), Juhua (Chrysanthemi Flos), Cebaiye (Platycladi Cacumen), Chishao (Paeoniae Radix Rubra), Bohe (Menthae Haplocalycis Herba), and Jingjie (Schizonepetae Spica).

Jiujian San (Wine-Decoction Powder)
Hanfangji (Stephaniae Tetrandrae Radix), Fangfeng, Gancao (Glycyrrhizae Radix et Rhizoma), Jingjie, Danggui, Chishao, Niubangzi (Arctii Fructus), Gan Juhua (Dried Chrysanthemum).
All ingredients in equal proportions. Decoct in wine and take warm after meals.

Dahuang Danggui San (Rhubarb and Angelica Sinensis Powder)
Indicated for eye swelling and congestion, where blood stasis condenses and fails to dissipate, leading to corneal opacity.
Danggui (soaked in wine, 2 qian), Juhua (3 qian), Dahuang (steamed in wine), Huangqin (Scutellariae Radix, each 1 liang), Honghua (Carthami Flos, roasted), Sumu (Sappan Lignum), Zhizi (Gardeniae Fructus, fried in wine), Muzei (Equiseti Herba).
Decoct in water and take warm after meals.

Stormy Guest Heat (Fengbao Ke Re) shares similarities with exposure-induced red eyes. Exposure-induced red eyes involve the Liver and Heart meridians, resulting in redness and pain, leading to corneal opacity. Stormy guest heat involves the Liver and Lung meridians, causing false opacity on the sclera surrounded by congestion, appearing dark in the morning, sunken into the sclera, with red opacity rising, causing painful stiffness and difficulty opening the eye. Thus, distinct symptoms differentiate exposure from stormy guest heat. "Stormy" implies suddenness and abrupt onset. The treatment method involves unblocking, reducing heat, clearing the chest, purging the liver, and modifying the Jiutiao San (Wine-Regulating Powder) to disperse wind-heat. Common belief states that hot eyes should avoid alcohol; however, who knows that alcohol can guide blood, and without wine, medicinal effects cannot reach the head and eyes. These eyes should not be washed, nor should cold medications be instilled. The pathogenic factors of stormy guest heat arrive quickly and depart quickly. This differs from conditions arising from accumulation in the five zang and six fu organs, which flare up irregularly, commonly known as "cold damage eye."

Question: What causes the sclera to swell, covering the dark pupil, with severe pain making it difficult to open? At this stage, toxic wind accumulates in the Lung meridian and fails to dissipate. Over time, heat develops and attacks the eye, causing edema of the white sclera, named Stormy Guest Heat. It is appropriate to administer Jiutiao San combined with Bugan Tang (Liver-Tonifying Decoction), and use Sofeng Jian (Wind-Searching Decoction) for washing and ingestion.

Xiegan San (Liver-Purging Powder)
Indicated for intermittent eye flare-ups.
Qianghuo (Notopterygii Rhizoma et Radix), Huangqin, Heishen (Adenophorae Radix, each 1.5 liang), Jiegeng (Platycodonis Radix), Dahuang, Mangxiao (Natrii Sulfas), Digupi (Lycii Cortex).
Take 6 qian per dose, decoct in water and drink.

Bugan Tang (Liver-Tonifying Decoction)
Ben Cao (likely referring to a specific root, contextually possibly Baizhi or similar, literal translation "Root"), Baizhi (Angelicae Dahuricae Radix), Cheqianzi (Plantaginis Semen), Shijueming (Haliotidis Concha), Tianma (Gastrodiae Rhizoma), Chishao, Fangfeng, Xixin (Asari Radix et Rhizoma, each 1 liang).
Take 2 qian per dose, mix with water and swallow.

Sofeng San (Wind-Searching Powder)
For washing the eyes, treating black spots in vision.
Chenpi (Citri Reticulatae Pericarpium), Qinjiao (Gentianae Macrophyllae Radix), Fangfeng, Xixin (each 1 liang), Huanglian (Coptidis Rhizoma), Muxiang (Aucklandiae Radix, each 5 qian).
Grind into powder. Soak in one zhong of water overnight, strain, add 1 qian of Longnao (Borneolum Syntheticum), and 4 liang of honey. Simmer over fire until it becomes a paste for instillation. Alternatively, decoct in water for fumigation without honey.

Additionally, Danggui Huoxue Jian (Angelica Blood-Invigorating Decoction) is primarily used. For severe swelling and pain, Shuangjie San (Double-Release Powder) mixed with wine can be used to release the exterior. For instillation, heavy medications with ginger powder are used to disperse via pungency.

Shuangjie San (Double-Release Powder)
Fangfeng, Chuanxiong (Ligustici Chuanxiong Rhizoma), Guiwei (Angelicae Sinensis Radix tail), Chishao, Dahuang, Mahuang (Ephedrae Herba), Bohe (Menthae Haplocalycis Herba), Lianqiao (Forsythiae Fructus), Mangxiao, Huangqin, Jiegeng, Shigao (Gypsum Fibrosum), Huashi (Talcum), Jingjie, Gancao, Shanzhi (Gardeniae Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma - omit if excess pattern).
Equal proportions. Decoct in water and take warm after meals. For sudden onset, add three stalks of scallion.

[Severe Wind and Eye Pain]
Sangpiaoxiao Jiutiao San (Mantis Egg-case Wine-Regulating Powder)
Indicated for red and swollen eyes with blood opacity and congestion.
Danggui, Gancao, Dahuang, Chishao, Juhua, Cangzhu (Atractylodis Rhizoma), Sangpiaoxiao (Mantidis Oötheca), Qianghuo, Huangma (likely Ephedra or similar, literal "Yellow Hemp"), Chongweizi (Leonuri Fructus).
Equal proportions. Decoct in water, add wine, and take warm after meals. If heat is severe, increase Dahuang and Puxiao (Mirabilitum). Alternatively, grind into powder, take warm, and mix with wine, 3 qian per dose.