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Ni Shun Sheng Yi (Obstructive and Unobstructive Corneal Opacities) is quite similar to Chi Mo Xia Chui (Downward-growing Red Membrane, i.e., pannus) and Huang Mo Xia Chui (Downward-growing Yellow Membrane) with upward filling symptoms. However, the terms "Shun" (Obstructive/Normal direction) and "Ni" (Unobstructive/Reverse direction) refer to deficiency and exhaustion of the Five Zang Organs, where Wind-Heat pathogenic factors rush towards the Liver and Diaphragm. If the pathology affects the upper eyelid, it is due to toxicity stagnation in the Yangming Meridian, causing blood and Qi stagnation, thus generating a red membrane that hangs down, called Chui Lian Yi (Curtain-like Pannus); this is considered a "Shun" pattern. If the pathology affects the lower eyelid, it is due to toxicity stagnation in the Taiyin Liver Meridian, causing the opacity to grow upwards from below, called Ni Yi (Reverse Opacity). Treatment method: It is appropriate to administer formulas that drain Spleen and Stomach heat. Generally, drugs for removing opacities should be used with dosage adjustments according to severity, and one should avoid all toxic or irritating foods.

Question: What causes corneal opacities appearing in reverse or normal directions on the upper and lower eyes? Answer: This is caused by deficiency and damage to the Liver Meridian, with accumulated severe heat and toxicity, leading to multiple opacities rising and invading the Hei Jing (Black Eye, i.e., cornea). Treatment should utilize Ming Mu Liu Qi Yin (Brighten Eyes Regulate Qi Decoction), Chan Hua Wu Bi San (Cicada Flower Matchless Powder), apply Zhen Zhu San (Pearl Powder) topically, followed by San Qi Dan (Notoginseng Pill). If swelling occurs, washing may also be performed.

Ming Mu Liu Qi Yin (Formula found in the previous section on Cold Damage Heat Syndromes): Treats Spleen affected by evil heat, or Obstructive and Unobstructive Corneal Opacities.

Chan Hua Wu Bi San: Treats wind-toxin damaging the eyes, resulting in dim vision and gradually developing white opacities obscuring the pupil.

Bai Fu Ling (Poria), Gan Cao (Licorice Root, honey-fried, to support Stomach), Fang Feng (Saposhnikovia Root) (each 4 liang), Chuan Xiong (Ligusticum Rhizome), Chi Shao Yao (Red Peony Root) (each 2 liang), Shi Jue Ming (Abalone Shell, boiled in salt water and ground extremely fine), Bai Ji Li (Tribulus Fruit, stir-fried and thorns removed) (each 4 liang), She Tui (Snake Slough, fried, 3 liang), Chan Tui (Cicada Slough, heads and feet removed, 4 liang), Cang Zhu (Atractylodes Rhizome, 1 liang), Dang Gui (Angelica Sinensis Root, soaked in wine, 2 liang).
Grind the above into powder. Take 3 qian per dose, mixed with rice juice after meals; tea can also be used. Avoid toxic foods.

Lou Yan Nong Xue (Leaking Eye with Pus and Blood) is more harmful than Ding Yi (Nail-shaped Opacity) and Mo Ru Shui Lun (Membrane entering the Water Wheel, i.e., iris/pupil area). Before this syndrome manifests, the head initially feels heavy and dizzy, limbs feel fatigued, and the Five Zang Organs accumulate wind-heat and stagnant toxicity. This attacks the Hei Jing (Cornea) and Huang Ren (Yellow Iris, i.e., iris), generating toxic sores, flooding the Shui Lun (Water Wheel, i.e., pupil area) with blood, ulcerating and flowing pus. Treatment method: It is appropriate to stir-fry Cong Bai (Scallion White), Ai Ye (Mugwort Leaf), and Bai Zhi (Angelica Dahurica Root) together until hot, wrap in cotton, and apply as a hot compress to the eyelids, changing frequently while hot, to dissipate bad blood, eliminate foul pus, and stop severe pain. It is even better to use crushed Sheng Di Huang (Rehmannia Root) heated and applied as a compress to the sore site. Alternatively, blow Yin Er Yang Si Dan onto the sore site, or simply use Ku Fan (Alum), Qing Fen (Calomel), Xue Jie (Dragon's Blood), and Ru Xiang (Frankincense) ground finely and blown/dotted onto the sore. Washing with Sang Bai Pi (Mulberry Root Bark) infused with salt crystals and Ming Fan (Alum) for fumigation and washing is also suitable. Internally take Zhui Yi Ming Mu Wan (Drop Opacity Brighten Eyes Pill) and Mo Yao San (Myrrh Powder). Avoid foods that move wind or blood.

Zhui Yi Ming Mu Wan (Formula found in the previous section on Blood Pouring into Pupil Syndrome).

Mo Yao San (Myrrh Powder)
Mo Yao (Myrrh), Da Huang (Rhubarb Root, steamed, used in small amounts), Po Xiao (Mirabilite).
Grind the above into powder. Take 3 qian per dose, mixed with wine; tea can also be used.