EYES

Chapter contents

VISION

Blurred vision and floaters

Strabismus

Myopia

Hyperopia

Decreased night vision

Decreased visual acuity

DISCHARGE FROM THE EYES

EYE COLOUR

Yellow (sclera)

Red (sclera)

Bluish-greenish (sclera)

Loss of control of the eyelids

Nodules within the eyelids

Small red grains inside the eyelids

Redness inside the lower lids

GLAUCOMA

FEELING OF DISTENSION OF THE EYES

ECCHYMOSIS UNDER CONJUNCTIVA

RED VEINS/MEMBRANE

Red veins in the eyes

Drooping red membrane

Red membrane in the corner of the eye

CORNEA

Corneal opacity

Scarring after corneal opacity

WHITE SPECKS

PUPILS

Red ring around the pupil

White membrane on the pupil in children

Yellow fluid between pupil and iris

Bleeding between pupil and iris

VISION

Myopia

Liver-Blood deficiency

Myopia, blurred vision, floaters, dizziness, numbness/tingling of the limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver- and Kidney-Yin deficiency

Myopia from childhood, blurred vision, floaters, weak child, nocturnal enuresis, pulse Weak on both Rear positions.

This is a congenital Kidney and Liver deficiency in children causing myopia; due to their young age, there are not many symptoms. The myopia itself, the weakness of the child, possibly nocturnal enuresis and a Weak pulse on the Kidney positions are enough to diagnose this pattern.

Hyperopia

‘Hyperopia’ is the opposite of myopia; that is, the vision is better for far objects than for near.

Kidney-Essence deficiency

Hyperopia, poor bone development in children, softening of the bones in adults, deafness, weakness of the knees and legs, poor memory, loose teeth, falling hair or premature greying of the hair, weakness from sexual activity, lower backache, infertility, sterility, dizziness, tinnitus, normal-coloured tongue and Floating-Empty or Leather pulse if Kidney-Essence deficiency occurs against a background of Kidney-Yin deficiency, or Pale tongue and Deep-Weak pulse if against a background of Kidney-Yang deficiency.

Kidney-Yin deficiency with Empty-Heat

Hyperopia, red and dry eyes, blurred vision, dizziness, tinnitus, hardness of hearing, night sweating, dry mouth at night, five-palm heat, a feeling of heat in the evening, malar flush, thirst with a desire to drink in small sips, lower backache, scanty dark urine, insomnia, Red tongue without coating, Floating-Empty and Rapid pulse.

Deficiency of Qi and Blood

Hyperopia, blurred vision, poor appetite, loose stools, weak voice, tiredness, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Decreased night vision

Liver-Blood deficiency

Decreased night vision, blurred vision, floaters, dizziness, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver- and Kidney-Yin deficiency

Decreased night vision, blurred vision, floaters, dry eyes, dizziness, tinnitus, hardness of hearing, lower backache, dull occipital or vertical headache, insomnia, numbness/tingling of limbs, dry throat, dry hair and skin, brittle nails, night sweating, dry stools, scanty menstruation or amenorrhoea, normal-coloured without coating, Floating-Empty pulse.

Spleen-Qi deficiency

Decreased night vision, poor appetite, slight abdominal distension after eating, tiredness, pale complexion, weakness of the limbs, loose stools, Pale tongue, Empty pulse.

Spleen- and Kidney-Yang deficiency

Decreased night vision, lower backache, cold knees, a sensation of cold in the back, a feeling of cold, weak legs, bright-white complexion, weak knees, impotence, tiredness, abundant clear or scanty clear urination, urination at night, loose stools, poor appetite, slight abdominal distension, a desire to lie down, early-morning diarrhoea, chronic diarrhoea, Pale and wet tongue, Deep-Weak pulse.

Deficiency of Qi and Blood

Decreased night vision, blurred vision, poor appetite, loose stools, weak voice, tiredness, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Decreased visual acuity

Liver-Blood deficiency

Decreased visual acuity, dizziness, blurred vision, floaters, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Liver-Yin deficiency

Decreased visual acuity, blurred vision, floaters, dry eyes, dizziness, numbness/tingling of the limbs, scanty menstruation, dull-pale complexion but with red cheekbones, withered and brittle nails, dry skin and hair, night sweating, normal-coloured tongue without coating, Fine or Floating-Empty pulse.

Kidney-Yin deficiency

Decreased visual acuity, dry eyes, floaters, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, dry mouth and throat at night, lower backache, constipation, scanty dark urine, tiredness, normal-coloured tongue without coating, Floating-Empty pulse.

Turbid Phlegm obstructing the head’s orifices

Decreased visual acuity, blurred vision, floaters, dizziness, dull headache with a feeling of heaviness and muzziness of the head, poor memory and concentration, sputum in the throat, a feeling of oppression of the chest, nausea, Swollen tongue with sticky coating, Slippery pulse.

Heart-Blood deficiency

Decreased visual acuity, blurred vision, palpitations, dizziness, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, dull-pale complexion, pale lips, Pale and Thin tongue, Choppy or Fine pulse.

Sudden blindness

Liver-Fire

Sudden unilateral blindness, bloodshot eyes, headaches, dizziness, tinnitus, irritability, propensity to outbursts of anger, red face, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Liver-Blood stasis

Sudden unilateral blindness, pain in the eyes, hypochondrial/abdominal pain, painful periods, dark and clotted menstrual blood, masses in abdomen, purple nails and lips, purple or dark complexion, Purple tongue, Wiry or Firm pulse.

Phlegm-Heat in the Liver

Sudden blindness, red face and eyes, irritability, propensity to outbursts of anger, tinnitus/deafness (with sudden onset), temporal headache, dizziness, thirst, bitter taste, dream-disturbed sleep, constipation with dry stools, dark-yellow urine, epistaxis, hae-matemesis, haemoptysis, a feeling of oppression of the chest, rattling sound in the throat, a feeling of muzzi-ness of the head, expectoration of sputum, hypertension, Red and Swollen tongue with redder sides and with sticky yellow coating, Wiry-Slippery-Rapid pulse.

Phlegm-Heat in the Heart

Sudden blindness, red face, red eyes, palpitations, mental restlessness, thirst, red face, a feeling of oppression of the chest, dark urine, expectoration of phlegm, rattling sound in the throat, bitter taste, insomnia, dream-disturbed sleep, a feeling of agitation, mental confusion, incoherent speech, rash behaviour, tendency to hit or scold people, uncontrolled laughter or crying, shouting, muttering to oneself, depression, manic behaviour, Red tongue with redder-swollen tip and Heart crack with a sticky yellow coating inside it, Slippery-Rapid or Slippery-Overflowing-Rapid pulse.

Liver-Wind

Sudden unilateral blindness, tremors, severe dizziness, tinnitus, headache, numbness of limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Heat at the Blood level (within the Four Levels)

Sudden blindness, high fever at night, macular skin eruptions, mental confusion, coma, bleeding, Dark-Red and dry tongue without coating, Fine-Rapid pulse.

ITCHY EYES

Interrogation, Chapter 42

Liver-Blood deficiency

Slightly itchy eyes, blurred vision, floaters, dizziness, numbness/tingling of limbs, dull-pale complexion, scanty menstruation, Pale tongue, Choppy or Fine pulse.

Liver-Yin deficiency

Itchy eyes, floaters, dry eyes, blurred vision, dizziness, numbness/tingling of the limbs, scanty menstruation, dull-pale complexion but with red cheekbones, withered and brittle nails, dry skin and hair, night sweating, normal-coloured tongue without coating, Fine or Floating-Empty pulse.

Liver-Fire

Severely itchy eyes, bloodshot eyes, painful eyes, headache, red face, dizziness, tinnitus, irritability, propensity to outbursts of anger, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Heart-Fire

Itchy eyes, red eyes, burning sensation in the eyes, redness in the inner canthus of the eyes, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Liver-Wind

Itchy eyes, dry eyes, blurred vision, tremors, severe dizziness, tinnitus, headache, numbness of the limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Damp-Heat in the Gall-Bladder

Itchy eyes, discharge from the eyes, yellow complexion and eyes, blurred vision, a heavy feeling in the eyelids, dizziness, hypochondrial pain, fullness and distension, nausea, vomiting, inability to digest fats, tinnitus, irritability, a feeling of heaviness, unilateral or bilateral thick, sticky yellow coating, Slippery-Rapid pulse.

Invasion of Wind-Heat

Itchy eyes with sudden onset, unbearable itching, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

DRY EYES

Interrogation, Chapter 42

Liver-Yin deficiency

Dry eyes, blurred vision, floaters, dizziness, numbness/tingling of the limbs, scanty menstruation, dull-pale complexion but with red cheekbones, withered and brittle nails, dry skin and hair, night sweating, normal-coloured tongue without coating, Fine or Floating-Empty pulse.

Kidney-Yin deficiency

Dry eyes, blurred vision, floaters, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, vertigo, dry mouth and throat at night, lower backache, constipation, scanty dark urine, tiredness, lassitude, normal-coloured tongue without coating, Floating-Empty pulse.

Liver-Fire

Dry and red eyes with burning sensation, bloodshot eyes, painful eyes, headache, red face, dizziness, tinnitus, irritability, propensity to outbursts of anger, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Heart-Yin deficiency

Dry eyes, palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, mental restlessness, uneasiness, ‘feeling hot and bothered’, dry mouth and throat, night sweating, normal-coloured tongue without coating or with rootless coating, Floating-Empty pulse, especially on the left Front position.

Severe Liver-Blood deficiency

Dry eyes, blurred vision, floaters, dizziness, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale and Thin tongue with very Pale or orangey sides, Choppy or Fine pulse.

Lung- and Kidney-Yin deficiency

Dry eyes, blurred vision, floaters, dry cough which is worse in the evening, dry throat and mouth, thin body breathlessness on exertion, lower backache, night sweating, dizziness, tinnitus, hardness of hearing, scanty urination, normal-coloured tongue without coating, Floating-Empty pulse.

HOT AND PAINFUL EYES

Interrogation, Chapter 42

Liver-Fire

Hot and painful eyes, bloodshot eyes, headaches, dizziness, tinnitus, irritability, propensity to outbursts of anger, red face, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Liver-Yang rising

Hot and painful eyes, a feeling of distension of the eyes, headache, dizziness, tinnitus, irritability, propensity to outbursts of anger, Wiry pulse.

Heart-Fire

Hot and painful eyes, red eyes, redness of the inner canthus of the eyes, burning sensation in the eyes, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Liver-Wind

Painful eyes (not necessarily hot), tremors, severe dizziness, tinnitus, headache, numbness of limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Damp-Heat in the head

Hot and painful eyes, sticky eyelids, heaviness of the eyelids, sticky taste, facial pain, sticky yellow nasal discharge, a feeling of heaviness of the head, thirst without desire to drink, a feeling of heat, dull-yellow complexion, sticky yellow tongue coating, Slippery-Rapid pulse.

Phlegm-Heat

Hot and painful eyes, sticky eyelids, blurred vision, a feeling of heaviness and muzziness of the head, a feeling of heat, red face, greasy skin, a feeling of oppression of the chest, sputum in the throat, expectoration of yellow sputum, dizziness, nausea, Red and Swollen tongue with sticky yellow coating, Slippery-Rapid pulse.

Blood stasis in the head

Painful eyes (not necessarily hot), dark rings under the eyes, headache, dark complexion, bulging eyes, mental agitation, Purple tongue, Wiry pulse.

Liver-Blood deficiency

Dull ache in the eyes (not necessarily hot), blurred vision, floaters, dizziness, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

Heart-Blood deficiency

Dull ache in the eyes (not necessarily hot), dull headache, palpitations, dizziness, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, dull-pale complexion, pale lips, Pale and Thin tongue, Choppy or Fine pulse.

Kidney deficiency

Dull ache in the eyes (not necessarily hot), dull occipital headache, blurred vision, floaters, dizziness, tinnitus, lower backache, poor memory.

Other manifestations, including tongue and pulse, depend on whether there is Kidney-Yang or Kidney-Yin deficiency.

Deficiency of Qi and Yin

Slightly hot and painful eyes, mild pain, a desire to shut the eyes, dry eyes, slightly red eyes, dizziness, tiredness, dry throat, loose stools, poor appetite, Pale tongue or normal-coloured tongue without coating, Weak or Floating-Empty pulse.

Invasion of Wind-Heat

Hot and painful eyes with sudden onset, red eyes, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

STREAMING EYES

Observation, Chapter 6; Interrogation, Chapter 42

There are traditionally two types of streaming eyes: one is called liu lei, which indicates runny and streaming eyes and is described here; the other is called yan chi, which indicates a thick discharge from the eye and is described under ‘Discharge from the eyes’.

Liver-Blood deficiency

Streaming eyes, floaters, blurred vision, dizziness, numbness/tingling of limbs, scanty menstruation, dull-pale complexion, Pale tongue, Choppy or Fine pulse.

This is called ‘cold streaming’.

Kidney-Yang deficiency

Streaming eyes, lower backache, cold knees, a feeling of cold, bright-white complexion, weak knees, tiredness, abundant clear urination, urination at night, Pale and wet tongue, Deep-Weak pulse.

This is called ‘cold streaming’.

Liver-Blood deficiency with Liver-Heat

Streaming eyes, itchy eyes, dizziness, blurred vision, floaters, numbness/tingling of the limbs, scanty menstruation, dull pale face with ‘floating’ red colour on the cheeks, thirst, irritability, headache, tongue Pale but also slightly Red on the sides, pulse Choppy or Fine and slightly Rapid.

Liver-Fire

Streaming eyes, bloodshot eyes, headaches, dizziness, tinnitus, irritability, propensity to outbursts of anger, red face, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Kidney- and Liver-Yin deficiency with Empty-Heat

Streaming eyes, itchy eyes, red and dry eyes, dizziness, tinnitus, hardness of hearing, dull occipital or vertical headache, insomnia, numbness/tingling of the limbs, malar flush, lower backache, dry throat, dry hair and skin, brittle nails, dry vagina, night sweating, dry stools, scanty menstruation or amenorrhoea, five-palm heat, a feeling of heat in the evening, Red tongue without coating, Floating-Empty and Rapid pulse.

Heart-Fire

Streaming eyes, red, red inner canthus of the eyes, painful eyes, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Damp-Phlegm in the Spleen and Lungs

Streaming eyes, swollen eyelids, sticky eyelids, chronic cough coming in bouts with profuse sticky white sputum which is easy to expectorate, pasty-white complexion, a feeling of oppression in the chest, shortness of breath, a dislike of lying down, wheezing, nausea, abdominal fullness, tendency to obesity, Swollen tongue with a sticky white coating, Slippery pulse.

Empty-Cold in the Liver channel

Streaming eyes, fullness and distension of the hypogas-trium with pain which refers downwards to the scrotum and testis and upwards to the hypochon-drium, alleviation of the pain by warmth, straining of the testis or contraction of the scrotum, vertical headache, a feeling of cold, cold hands and feet, vomiting of clear watery fluid or dry vomiting, Pale and wet tongue with a white coating, Deep-Wiry-Fine-Slow pulse.

Invasion of Wind-Heat

Streaming eyes with sudden onset, itchy eyes, pain in the eye, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

This is called ‘hot streaming’.

Invasion of Wind-Cold

Streaming eyes with sudden onset, itchy eyes, aversion to cold, fever, cough, itchy throat, slight breathless-ness, stuffed or runny nose with clear watery discharge, sneezing, occipital headache, body aches, thin white tongue coating, Floating-Tight pulse.

DISCHARGE FROM THE EYES

Observation Chapter 6; Interrogation, Chapter 42

‘Discharge from the eyes’ is a translation of the Chinese term yan chi, which indicates a thick discharge from the eyes as opposed to a watery one, which is called liu lei.

Liver-Fire

Yellow discharge from the eyes, bloodshot eyes, painful eyes, headache, red face, dizziness, tinnitus, irritability propensity to outbursts of anger, thirst, bitter taste, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Heart-Fire

Yellow discharge from the eyes, red, painful eyes, palpitations, thirst, agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Yin deficiency with Empty-Heat

Yellow, thin discharge from the eyes, dry and red eyes, a feeling of heat in the evening, dry mouth at night, night sweating, five-palm heat, Red tongue without coating, Floating-Empty and Rapid pulse.

Other symptoms and signs depend on the organ involved, which may be the Liver, Heart, Kidneys or Lungs.

Deficiency of Qi and Blood

Chronic light watery discharge from the eyes that is aggravated by overexertion, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of the limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Invasion of Wind-Heat

Yellow discharge from the eyes, itchy and red eyes, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Toxic Heat (measles)

Thick, yellow discharge from the eyes, fever, thirst, restlessness, red eyes, Red tongue with red points and thick, dark-yellow coating, Overflowing-Rapid pulse.

This corresponds to the Qi level of measles.

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Tags: Diagnosis in Chinese Medicine A Comprehensive Guide

Apr 15, 2017 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off

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