青黄凸出者。风轮破碎。内中膏汁绽出也。有自破而胀出不收者。有因外障。以寒凉逐退内
火。外失平治而凸起者。纵有妙手。不复可救。但用皂荚丸入硼砂少许。免其HT 凸而已。
气动者。视瞳神深处。有气一道。隐隐袅袅而动。状若明镜远照一缕清烟也。患头风痰火人。
郁久火胜。则搏击其络中之气。游散飘忽。宜以头风例治之。动而定后光冥者。内证成矣。
倒睫拳毛者。由目紧皮缩所致也。久则赤烂。神水不清。以致障结涩碍泪出之苦。人有拔去
剪去者。有医以竹板夹起上睥。七日连皮脱下者。得效虽速。殊不知内病未除。未几复倒。譬之
草木枯槁。则枝叶萎垂。即朝摘黄叶。暮去枯
枝。徒伤其本。不若培益水土。则黄者翠而垂者耸矣。此证内伏火热而阴气外行。当泻其热。眼
皮缓则毛自出。翳膜亦退。用手法扳出内睑向外。速以三棱针出血。以左手爪甲迎其锋立愈。又
目眶赤烂。亦当以三棱针刺目眶泻其湿热。后服防风饮子。搐鼻。碧云散。亦宜兼用。起倒睫法。
以木鳖一枚为末。绵裹塞鼻中。左塞右。右塞左。一夜其毛自直。若内边另出一层短毛撩于珠上
者。镊去。以虱血涂。则不复生矣。
睥急紧小。谓眼楞紧缩。乃倒睫拳毛之渐也。若不因治而渐自缩小者。乃膏血津液涩耗。筋
脉紧急之故。若因治而急小者。多因睥宽倒睫。屡次夹去上睥。失于内治。或不当割导而频数开
导。致血液耗而紧小者。当乘时滋养。神效黄 汤。小角偏紧。去陈皮。加连翘、生地、当归。
若络定气滞。虽治不复愈矣。楼全善云。阳虚则眼楞紧急。阴虚则瞳子散大。故东垣治眼楞紧急。
用参、 补气为君。佐以辛味疏散之。而忌芍药、五味之类。酸收故也。治瞳子散大。用地黄补
血为君。佐以酸味收敛之。而忌茺蔚子、青葙子之类。辛散故也。
睥肉粘轮 目内睥之肉与气轮相粘不开。宜服泻湿热药。如防风、细辛、胆草、苦参、蝎梢、
牛蒡子之类。以风药能于土中泻水故也。
胞肉胶粘证 两睥粘闭。夜卧尤甚。必得润而后可开。其病重在脾肺湿热。当以清凉滋润为
主。虽有障在珠。亦是湿热内滞之故。非障之愆。久而不治。则有疮烂之变。
睥翻粘睑证 乃睥翻转贴在外睑之上。此气滞血壅于内。皮急系吊于外。故不能复转。皆由
风湿之滞所致。故风疾人患此者多。宜用镰剔开导之法。
风牵出睑证 乃脾胃受风毒之证。睑受风而皮紧。睥受风而肉壅。泪出水渍于睑而湿烂。此
土陷不能堤水也。治法。先用香油调姜汁粉摩散风邪。翻转睑皮。烙三五度。若眼有红筋贯上。
黑睛有翳膜者。吹以丹药。 斜者。灸颊车耳门。开口取之。太阳人中承浆。 右灸左。 左灸
右。近患者易退。年久者难愈。又大风人面部所牵。多受是病。难以调治。
血瘀睥泛 谓睥内之肉。紫瘀浮泛。甚则如细泡无数。相连成片。盖睥络血滞又不忌火毒燥
腻。致积而不散。或碎睥出血冒风所致。宜活血为主。并用开导。
睥虚如球 谓目睥浮肿如球也。以两手掌擦热拭之。少平。顷复如故。可见其血不足。而虚
火壅于气分也。补中益气汤去升麻加葛根、木通、泽泻。
青黄色且向外凸出的，是黑睛（风轮）破碎，内部膏汁渗出所致。有的因黑睛自破后肿胀外突无法收回；有的因患外障眼病，使用寒凉药物强行退去内火，导致外部失去平衡治疗而凸起。即使有高明医生，也无法救治。只能使用皂荚丸加入少许硼砂，以减轻其红肿凸出而已。
眼部出现气动的，观察瞳孔深处，有一道气息隐隐约约、袅袅飘动，形状如同明镜远照时一缕清烟。患有头风痰火的人，郁结日久火势旺盛，就会搏击络脉中的气机，使其游散飘忽不定。应当按照头风的例子进行治疗。如果气动平息后视力昏暗，说明内部病变已经形成。
倒睫拳毛（睫毛向内卷曲刺眼），是由眼睑皮肤紧缩所致。时间久了会导致眼睑红肿溃烂，神水不清，进而产生翳膜阻滞、涩痛流泪的痛苦。有人将睫毛拔掉或剪掉；有的医生用竹板夹起上眼睑，七天连皮一起脱下。虽然见效快，但殊不知内部疾病未除，不久又会复发。这就像草木枯槁，枝叶萎垂，即使早上摘黄叶、晚上去枯枝，也只是徒然损伤根本，不如培补水土，那么黄色的会变翠绿，下垂的会挺立起来。此证内部潜伏火热而阴气外行，应当泻热，眼皮松弛后睫毛自然长出，翳膜也会消退。用手手法将内睑扳向外侧，迅速用三棱针出血，用左手指甲迎着针锋操作可立即痊愈。另外，眼眶红肿溃烂，也应用三棱针刺眼眶以泻湿热，之后服用防风饮子，搐鼻使用碧云散，也适宜兼用。治疗倒睫的方法：取一枚木鳖子研为粉末，用棉布包裹塞入鼻孔，左鼻塞右眼，右鼻塞左眼，一夜之间睫毛自然变直。如果在内侧另长出一层短毛撩在角膜上的，用镊子去除，涂上虱血，就不再生长了。
眼睑紧缩细小，指眼角眼睑紧缩，这是倒睫拳毛的初期表现。如果不是经过治疗而逐渐自行缩小，是由于膏血津液枯竭耗损，筋脉紧急的缘故。如果是经过治疗后出现紧缩细小的，多是因为眼睑宽弛倒睫，屡次夹去上眼睑，缺乏内部调理，或者不应当切开引导却频繁开导，导致血液耗损而紧缩细小。应当趁时机滋养，使用神效黄芪汤。如果小眼角偏紧，去掉陈皮，加入连翘、生地、当归。如果络脉固定、气机停滞，即使治疗也不再痊愈。楼全善说：阳虚则眼睑紧急，阴虚则瞳孔散大。所以李东垣治疗眼睑紧急，用人参、黄芪补气作为君药，佐以辛味药物疏散，而忌讳芍药、五味子之类，因为它们是酸收之品。治疗瞳孔散大，用地黄补血作为君药，佐以酸味药物收敛，而忌讳茺蔚子、青葙子之类，因为它们是辛散之品。
胞肉粘轮：指内眼睑的肉与白睛（气轮）粘连不开。宜服用泻湿热的药物，如防风、细辛、龙胆草、苦参、蝎梢、牛蒡子之类。因为风药能在土中泻水。
胞肉胶粘证：上下眼睑粘连闭合，夜间尤其严重，必须滋润后才能打开。此病重在脾肺湿热，应当以清凉滋润为主。虽然有翳膜在角膜上，也是湿热内滞的缘故，不是翳膜的过错。时间久了不治疗，会有疮烂的变化。
眼睑翻转粘睑证：指眼睑翻转贴在外眼睑之上。这是气滞血壅于内，皮肤紧张系吊于外，所以不能复原。皆由风湿阻滞所致。所以风疾患者患此病的较多。宜用镰刀剔除开导的方法。
风牵出睑证：是脾胃受风毒的证候。眼睑受风则皮肤紧绷，眼睑受风则肌肉壅肿，泪水流出浸渍眼睑而湿烂。这是土陷不能堤防水液。治疗方法：先用香油调和姜汁粉按摩以散风邪，翻转眼睑皮肤，烙烫三五次。如果眼睛有红筋贯上，黑睛有翳膜的，吹入丹药。眼睑歪斜的，灸颊车穴、耳门穴，张口取穴。太阳穴、人中穴、承浆穴，右侧患病灸左侧，左侧患病灸右侧。病程近的患者容易消退，年久者难愈。另外大风人面部被牵拉，多受此病，难以调治。
血瘀胞泛：指眼睑内的肉，紫暗瘀滞浮泛，严重时像无数小水泡，相连成片。这是因为眼睑络脉血滞又不忌火毒燥腻，导致积聚不散，或者切碎眼睑出血后受风所致。宜以活血为主，并用开导法。
眼睑虚如球：指眼睑浮肿如球状。用两手掌擦热擦拭它，稍平复，一会儿又恢复原状。可见其血不足，而虚火壅滞在气分。使用补中益气汤去掉升麻，加入葛根、木通、泽泻。
Those presenting with cyan-yellow protrusion indicate the rupture of the Wind Wheel (the cornea, corresponding to the Liver), with the internal essence and juice leaking out. Some cases involve spontaneous rupture followed by swelling and protrusion that cannot retract; others result from external obstructions where cold-natured herbs were used to forcibly clear internal fire, leading to a loss of balance in external treatment and subsequent protrusion. Even with skilled hands, these are incurable. One may only use Zao Ying Wan (Soap Pod Pill) with a small amount of Peng Sha (Borax) to alleviate the redness and protrusion.
When Qi moves within the eye, observing deep into the pupil reveals a wisp of Qi moving faintly and curling, resembling a thin stream of clear smoke reflected in a distant mirror. Patients suffering from Head Wind and Phlegm-Fire often experience prolonged stagnation where Fire prevails, beating against the Qi in the collaterals, causing it to wander and fluctuate. These should be treated according to the protocols for Head Wind. If vision becomes dim after the movement subsides, internal pathology has already formed.
Inverted eyelashes (Juan Mao) are caused by the contraction and shrinking of the eyelid skin. Over time, this leads to redness, ulceration, turbidity of Shen Water (aqueous humor), and the formation of nebulae that cause obstruction, astringency, and painful tearing. Some patients pluck or cut off their lashes; some physicians clamp the upper eyelid with a bamboo board, removing the skin along with the lid after seven days. Although effective quickly, the internal disease remains unaddressed, and inversion recurs shortly thereafter. This is akin to withered vegetation where branches hang limp; merely picking yellow leaves in the morning and cutting dead branches in the evening only damages the root. It is better to nourish Earth and Water, so that yellow turns green and hanging branches stand upright. This condition involves latent internal Heat and outward-flowing Yin Qi; one must drain the Heat. Once the eyelids relax, the lashes will naturally grow out, and nebulae will recede. Manually evert the inner eyelid outward, and immediately prick with a Three-edged Needle to bleed. Using the thumbnail of the left hand to guide the needle tip can yield immediate results. Additionally, for red and ulcerated eye orbits, prick the orbit with a Three-edged Needle to drain Damp-Heat, then administer Fang Feng Yin Zi (Saposhnikovia Decoction). Use Bi Yun San (Green Cloud Powder) via nasal insufflation as an adjunct. To treat inverted lashes: powder one Mu Bie (Semen Strychnos), wrap in cotton, and insert into the nostril opposite the affected eye (left nostril for right eye, right for left); after one night, the lashes straighten naturally. If short lashes grow inward on the palpebral conjunctiva touching the globe, remove them with tweezers and apply blood from lice to prevent regrowth.
Tight and small eyelids refer to the constriction of the eyelid margins, which is a precursor to inverted lashes. If they shrink gradually without treatment, it is due to the depletion of essence, blood, and body fluids, causing tension in the sinews and vessels. If tightness occurs after treatment, it is often because lax eyelids with inverted lashes were repeatedly clamped or surgically incised without internal regulation, depleting blood and causing constriction. Nourishment should be applied promptly using Shen Xiao Huang Qi Tang (Miraculous Astragalus Decoction). If the outer canthus is particularly tight, remove Chen Pi (Citri Reticulatae Pericarpium) and add Lian Qiao (Forsythiae Fructus), Sheng Di Huang (Rehmanniae Radix), and Dang Gui (Angelicae Sinensis Radix). If the collaterals become fixed and Qi stagnates, cure is unlikely despite treatment. Lou Quanshan stated: Yang deficiency causes eyelid tension, while Yin deficiency causes pupil dilation. Therefore, Li Dongyuan treated eyelid tension by using Ren Shen (Ginseng) and Huang Qi (Astragalus) to tonify Qi as sovereign herbs, assisted by acrid herbs to disperse, while avoiding Sour-astringent herbs like Shao Yao (Paeoniae Radix Alba) and Wu Wei Zi (Schisandrae Fructus). For pupil dilation, he used Di Huang (Rehmanniae Radix) to tonify Blood as sovereign, assisted by Sour herbs to astringe, while avoiding Pungent-dispersing herbs like Chong Wei Zi (Leonuri Fructus) and Qing Xiang Zi (Pharbitidis Semen).
Bao Rou Nian Lun (Palpebral Flesh Adhering to the White Eye): The flesh of the inner eyelid adheres to the Qi Wheel (sclera/conjunctiva) and does not separate. Administer herbs that drain Damp-Heat, such as Fang Feng (Saposhnikoviae Radix), Xi Xin (Asari Radix et Rhizoma), Dan Cao (Gentianae Radix), Ku Shen (Sophorae Flavescentis Radix), Xie Shao (Scorpio), and Niu Bang Zi (Arctii Fructus). Wind herbs can drain water within the Earth element.
Bao Rou Jiao Nian Zheng (Adhesive Palpebral Mass): Both eyelids adhere and close, especially during sleep, requiring lubrication to open. The pathology lies primarily in Damp-Heat of the Spleen and Lung. Treatment should focus on cooling and moistening. Although nebulae appear on the cornea, this is due to internal stagnation of Damp-Heat, not the fault of the nebula itself. Untreated over time, it may lead to ulceration.
Fan Yan Zhan Jian Zheng (Eyelid Eversion Adhering to Lid): The eyelid everts and adheres to the outer surface of the opposing eyelid. This results from internal Qi stagnation and Blood congestion, combined with external skin tension, preventing return to normal position. It is caused by stagnation of Wind-Damp. Patients with Wind diseases are prone to this. Surgical excision and release with a scalpel are indicated.
Feng Qian Chu Jian Zheng (Wind-Induced Eyelid Eversion): This is a syndrome where the Spleen and Stomach receive Wind-Toxin. Wind affecting the eyelid causes skin tightness; Wind affecting the eyelid flesh causes swelling. Tears overflow and macerate the eyelid, representing Earth failing to contain Water. Treatment: First, massage with ginger juice powder mixed in sesame oil to dispel Wind. Evert the eyelid skin and cauterize three to five times. If red veins extend upward and nebulae cover the black cornea, insufflate with Dan Yao (Medicated Pellets). For deviation, moxa-burn Jiache (ST6) and Ermen (TE21), locating points with the mouth open. Also burn Taiyang (EX-HN5), Renzhong (GV26), and Chengjiang (CV24). Treat contralaterally: right side lesions burn left, left side lesions burn right. Recent onset resolves easily; chronic cases are difficult to cure. Additionally, individuals exposed to severe wind often suffer facial traction leading to this condition, which is hard to manage.
Xue Yu Pi Fan (Blood Stasis with Eyelid Protrusion): The tissue inside the eyelid appears purplish, stagnant, and floating, sometimes forming numerous small blisters connected in patches. This is due to Blood stasis in eyelid collaterals exacerbated by Fire-Toxin and dryness/grease, leading to accumulation. It may also result from bleeding after lacerating the eyelid followed by exposure to Wind. Treatment prioritizes invigorating Blood and employing release methods.
Pi Xu Ru Qiu (Eyelid Deficiency Resembling a Ball): The eyelids swell like a ball. Rubbing with warm palms flattens them temporarily, but they revert quickly. This indicates Blood deficiency and the congestion of Deficient Fire in the Qi level. Use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), removing Sheng Ma (Cimicifugae Rhizoma), and adding Ge Gen (Puerariae Lobatae Radix), Mu Tong (Akebiae Caulis), and Ze Xie (Alismatis Rhizoma).