视珠外神水干涩而不莹润，最不好识，虽形于言不能妙其状。乃火郁蒸膏泽，故精液不清，而珠
不莹润，汁将内竭。虽有淫泪盈珠，亦不润泽，视病气色，干涩如蜒蝣唾涎之光，凡见此证，必有危
急病来。治之缓失，则神膏干涩，神膏干涩则瞳神危矣。夫神水为目之机要，其病幽微，人不知之，
致变出危证，而救之已迟。其状难识，非心志巧眼力精，虽师指不得尽其妙。若小儿素有疳证，粪如
鸭溏，而目疾神水将枯者死。五十以外人，粪如羊矢，而目病神水将枯者死。热结膀胱证，神水将枯
者，盖下水热蒸不清，故上亦不清，澄其源而流自清矣。（一云瞳神干缺证，其睛干涩，全无泪液，
或白或黑，始则疼痛，后来稍定而黑不见，此证不可治疗，宜泻胆散。）
目病六气不和，或有风邪所击，脑筋如拽，神珠不待人转，而自蓦然察上，蓦然察下，下之不能
上，上之不能下，或左或右，倏易无时。盖气搏激不定，筋脉振惕，缓急无常，被其牵拽而为害。轻
则气定脉偏而珠歪，如神珠将反之状，甚则翻转而为瞳神反背矣。（天门冬饮子、泻肝散、聚宝丹、
雄猪散、牛蒡子丸、还睛丸、退血散。）
亦曰 目。《甲乙经》云∶ 目者，水沟主之。此证谓幼时所患目珠偏斜，视亦不正，至长不能
愈者。患非一端，有因脆嫩之时，目病风热，攻损脑筋急缩者；有因惊风天吊，带转筋络，失于散治
风热，遂致凝滞经络而定者；有因小儿眠之牖下亮处，侧视久之，遂致筋脉滞定而偏者。凡有此病，
急宜乘病嫩血气未定治之。若至长、筋络血气已定，不复愈矣。此专言幼患至长不可医者，非神珠将
反急病之比。
眼珠外层的“神水”（指房水）干涩且不晶莹润泽，是最难辨识的证候，即使口头描述也难以精准形容其状态。这是因为火邪郁结蒸灼膏泽，导致精液浑浊不清，从而使眼珠失去莹润光泽，津液即将在内枯竭。虽然眼中可能有泪水充盈，但并不能起到润泽作用。观察患者的病气面色，眼神干涩如同蜗牛爬行留下的涎液般反光，凡是见到这种证候，必定有危急的重病即将到来。如果治疗迟缓失误，就会导致“神膏”（指晶状体及玻璃体等眼内组织）干涩，神膏一旦干涩，瞳神（瞳孔及其相关功能）就会面临危险。神水是眼睛的关键所在，其病变幽深微妙，人们往往不了解，从而导致危重证候出现时再去救治已经太迟了。这种症状难以识别，如果不是心志专注、眼力精准的人，即使是老师指着也讲不尽其中的奥妙。如果小儿素来患有疳积证，大便像鸭粪一样稀薄，同时眼部疾病表现为神水将枯的，预后不良致死。五十岁以上的人，大便像羊屎一样干结，同时眼部疾病表现为神水将枯的，预后不良致死。热结膀胱证中，若出现神水将枯的情况，是因为下焦的水液受热蒸腾而浑浊不清，所以上部的眼液也不清，澄清源头则水流自然清澈。（另一种说法是瞳神干缺证，眼球干涩，完全没有泪液，或白或黑，起初疼痛，后来稍定但黑色部分看不见，此证不可治疗，宜用泻胆散。）
眼部疾病因六气不和，或有风邪侵袭，感觉脑筋被拉扯，眼珠不等待转动指令，就突然向上看，突然向下看，想下不能下，想上不能上，或者向左向右，随时变化不定。这是因为气机搏击激荡不安，筋脉震颤惊惕，舒缓与紧急无常，被牵拉而产生危害。轻则气机安定后脉象偏斜且眼珠歪斜，像是神珠将要翻转的样子；重则发生翻转，导致瞳神反背（眼球固定偏向一侧）。（可用天门冬饮子、泻肝散、聚宝丹、雄猪散、牛蒡子丸、还睛丸、退血散治疗。）
也称为目偏视。《甲乙经》说：目偏视由水沟穴主治。此证是指幼年时患有的眼珠偏斜，视物不正，直到成年也不能痊愈的疾病。患病原因不一，有的在身体脆嫩之时，因目病受风热侵袭，攻损脑筋急剧收缩所致；有的因惊风天吊（小儿惊风的一种），牵连筋络，失于疏散治疗风热，致使经络凝滞而定型；有的因小儿在窗户明亮处睡觉，侧视时间过长，致使筋脉滞定而偏斜。凡是有这种病，应当趁病情尚嫩、血气未定时迅速治疗。如果等到成年，筋络血气已定型，就不再能治愈了。这里专门讲述的是幼年患病至成年不可医治的情况，不是神珠将反这类急病的类比。
The "Shen Shui" (aqueous humor) on the outer layer of the eyeball is dry, astringent, and lacks luster. This is the most difficult syndrome to identify; even verbal description cannot capture its precise appearance. It arises because Fire pathogen stagnation steams and evaporates the nourishing fluids, causing the essence and fluids to become turbid, thus making the eyeball lose its luster and the juices nearly exhausted internally. Although tears may fill the eye, they do not provide moisture. Observing the patient's complexion and gaze, the eyes appear dry and astringent with a sheen like snail slime. Whenever this syndrome is seen, it indicates that a critical illness is imminent. If treatment is delayed or erroneous, the "Shen Gao" (lens and vitreous body) will become dry; once the Shen Gao is dry, the Tong Shen (pupil and its associated functions) will be in danger. The Shen Shui is the key mechanism of the eye; its pathology is subtle and profound, often unknown to people, leading to critical syndromes appearing before rescue efforts begin, by which time it is too late. The presentation is difficult to recognize; unless one has a focused mind and precise vision, even a teacher pointing it out cannot fully explain its subtleties. If a child has had Gan syndrome (malnutrition due to parasitic infection or poor digestion) since early life, with stools resembling duck feces (watery), and the eye disease presents as the Shen Shui about to wither, death ensues. For individuals over fifty years old, if stools resemble sheep pellets (dry and hard), and the eye disease presents as the Shen Shui about to wither, death ensues. In cases of Heat binding the Bladder, if the Shen Shui is about to wither, it is because the water in the lower jiao is steamed by heat and becomes turbid, consequently causing the upper fluids to be turbid as well; clarifying the source will naturally clear the flow. (Another view states this is the Tong Shen Gan Que syndrome [irregular pupil shape], where the eye is dry and astringent with no tears, appearing white or black. Initially painful, later stabilizing but with loss of vision in the black area. This syndrome is untreatable; use Xie Dan San [Gallbladder-Draining Powder].)
Eye diseases caused by disharmony of the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) or attack by Wind pathogen can cause a sensation of the brain nerves being pulled. The eyeball may suddenly look up or down without waiting for voluntary movement, unable to move down when intended to go up, or vice versa, shifting left or right unpredictably. This is due to unstable Qi agitation, trembling and spasms of the sinews and vessels, and irregular tension, resulting in harm from traction. Mildly, after the Qi settles, the pulse may be deviant and the eyeball tilted, resembling the state of the Shen Zhu (divine pearl/eyeball) about to reverse. Severely, it may flip completely, resulting in Tong Shen Fan Bei (reverse deviation of the pupil). (Treatments include Tian Dong Men Yin Zi [Asparagus Decoction], Xie Gan San [Liver-Draining Powder], Ju Bao Dan [Treasure-Gathering Pill], Xiong Zhu San [Male Pig Powder], Niu Bang Zi Wan [Burdock Seed Pill], Huan Jing Wan [Restore Vision Pill], Tui Xue San [Blood-Removing Powder].)
This is also called Mu Pian Shi (Oblique Deviation of the Eye). The *Jia Yi Jing* states: "Mu Pian Shi is treated by Shui Gou (GV26)." This syndrome refers to ocular deviation present since childhood, where vision is abnormal, which fails to resolve upon reaching adulthood. The etiology varies: some cases arise when the body is tender and vulnerable, and an eye disease affected by Wind-Heat attacks and damages the brain nerves, causing rapid contraction; some cases result from Jing Feng Tian Diao (infantile convulsions with upward deviation of the eyes), involving the sinews and collaterals, where failure to disperse Wind-Heat leads to stagnation in the meridians fixing the deviation; some cases occur because children sleep near bright windows and stare sideways for long periods, causing stagnation in the sinews and vessels leading to deviation. For any such disease, urgent treatment should be administered while the condition is still tender and the Qi and Blood have not yet stabilized. If one waits until adulthood, when the sinews, collaterals, Qi, and Blood are fixed, recovery is no longer possible. This section specifically discusses conditions originating in childhood that are incurable in adulthood, distinct from acute syndromes like Shen Zhu Jiang Fan (impending reversal of the eyeball).