The condition refers to a child's eyes (or one eye) appearing normal, with clear distinction between the black and white parts, but the child is unable to see.

This condition was first mentioned in the Tang Dynasty Michuan Yanke Longmu Lun , referred to as "pediatric bluish blindness (optic atrophy) external ophthalmopathy". Zhubing Yuanhou Lun in the section on miscellaneous diseases in pediatrics, under the symptom of blindness, states: "The eye has no nebula obstruction, yet cannot see objects, this is called bluish blindness (optic atrophy)". The Qing Dynasty's "Ophthalmology Golden Mirror" provides a more vivid and detailed description of this condition, such as "pediatric bluish blindness (optic atrophy) eye, this condition is extremely dangerous, many suffer from this disease due to residual heat after rashes..., there is no pain, no itch, no redness, no swelling, as if there are no symptoms, only the inability to see objects, being blind for a long time, parents do not realize the blindness."

bubble_chart Pattern Analysis

1. Wind-heat in the Liver Meridian︰No light perception in both eyes, dilated pupils, mental restlessness with excessive speech, deafness in both ears, eyelid drooping and mouth deviation, teeth grinding and kicking of the feet, accompanied by neck rigidity, lockjaw, difficulty in flexion and extension of limbs or hemiplegia. The tongue is crimson with thin yellow coating, the pulse is wiry and rapid, and the fingerprints appear bluish-purple, showing wind pass or qi pass. Mostly caused by pathogenic heat obstructing the orifices after warm febrile disease, leading to bluish blindness (optic atrophy) and deafness in both ears; extreme heat producing wind, internal stirring of liver wind, hence dilated pupils, mental restlessness, teeth grinding, and kicking of the feet; heart and lung heat evils stagnating and obstructing, leading to mental restlessness with excessive speech or lockjaw; liver wind carrying heat lingering in the sinews and vessels, hence neck rigidity, limb stiffness, difficulty in flexion and extension, or hemiplegia; wind evils invading the collaterals, where the evils strike, the blood vessels disperse, manifesting as eyelid drooping and mouth deviation. Treatment should focus on pacifying the liver and extinguishing wind, clearing heat and removing toxin, and resuscitation with aromatics. The formula selected is Uncaria Extinguishing Wind Drink with modifications, and take Peaceful Palace Bovine Bezoar Pill or Taiping Huimin Heji JufangSupreme Treasured Pill. For cases with alternating chills and fever, accompanied by neck rigidity and convulsions, it is due to pathogenic heat stagnating in the Shaoyang, and treatment should focus on clearing and dispersing Shaoyang, harmonizing and resolving, with the formula selected as Minor Bupleurum Decoction, appropriately adding Scorpion, Stiff Silkworm, Uncaria, Sweet Wormwood, etc., to extinguish wind and calm fright, nourish yin and clear heat. For limb stiffness and difficulty in flexion and extension, appropriately add Chinese Taxillus Herb, Achyranthes Root, Common Clubmoss Herb, and Floweringqince Fruit to tonify the liver and kidneys, strengthen the sinews and bones, and unblock the blood vessels. Mostly an excess pattern, with a short course of disease, the key points of pattern identification are dilated pupils, mental restlessness, teeth grinding and kicking of the feet, neck rigidity and lockjaw, limb stiffness or difficulty in flexion and extension, thin yellow tongue coating, wiry and rapid pulse, bluish-purple fingerprints, and other signs of wind and heat pattern. With timely treatment, most cases can regain vision.
2. Liver Depressionblood Deficiency︰No light perception or only light perception in both eyes, occasionally with dilated pupils, dysphoria and restlessness, accompanied by limb tremors or hemiplegia, slightly red tongue with thin white or slightly yellow coating, and thin rapid pulse. Mostly caused by residual pathogens remaining after insufficient or incomplete treatment of warm febrile disease, with heat lingering in the meridians and sweat pores blocked, preventing essence and blood from nourishing the upper body. "The liver opens into the eyes, and the eyes receive blood to see." When sweat pores are unobstructed and liver blood is abundant, the eyes are nourished and spiritual light is ample. Due to unextinguished liver wind, the pupils are slightly dilated. Rebing damages yin, and yin deficiency leads to liver hyperactivity and mental restlessness. The liver governs the tendons; when liver yin is insufficient, the tendons and bones lose nourishment, manifesting as limb tremors or hemiplegia, and difficulty in flexing and extending the fingers. Treatment should focus on soothing the liver to relieve stagnation, nourishing blood and activating blood circulation, nourishing water to moisten wood. The empirical formula Xiaoyao Decoction is selected, supplemented with tendon-strengthening, collateral-harmonizing, wind-extinguishing, and shock-calming ingredients. For dilated pupils, Schisandra Fruit, Cornus Officinalis, and Magnetite can be added to tonify the kidneys, induce astringency, calm the liver, and constrict the pupils. This condition is mostly a transformation of the pattern of wind and heat in the liver meridian. The key points of differentiation are dysphoria and restlessness, limb tremors or hemiplegia, thin rapid pulse, slightly yellow tongue coating, and other symptoms and signs of deficiency and excess intermingling.
3. Spleen Qi Deficiency︰The eyes are light-sensitive, complexion shallow yellow, appetite poor with qi deficiency, loose stool in large quantity, indigestion, accompanied by weak eyelids, limp limbs, pale and swollen tongue with tooth marks or peeling coating, deep and thin pulse. Mostly caused by improper post-illness care or excessive intake of cold and calming fright medications. The spleen is the acquired foundation and the source of generation and transformation. Spleen deficiency leads to impaired transportation and transformation, insufficient middle qi, sinking of clear yang, and the inability of zang-fu organs' essential qi to ascend to the eyes, resulting in a shallow yellow complexion, weak eyelids, indigestion, and loose stool. The spleen governs the muscles and limbs, and deficiency of qi and blood leads to malnutrition of tendons and bones, hence limp lower limbs. Treatment should focus on tonifying qi and raising yang, regulating the spleen and strengthening the stomach. The recommended formula is Middle-Tonifying Qi-Replenishing Decoction. If there is hearing loss, Qi-Tonifying Smartness Decoction can be used with Acorus resuscitation with aromatics and hearing-improving vision herbs.
4. Liver and Kidney Deficiency︰Photophobia in both eyes, dry mouth and eyes, trembling hands and feet or weakness in the legs, restlessness with little sleep, intellectual deficiency, frequent urination, dry mouth and throat, reddish tongue with scant coating, and a thin, rapid pulse. There are two causes: first, congenital deficiency of kidney qi, or fetal exposure to pathogenic fright, leading to bluish blindness (optic atrophy) after birth; second, after a warm febrile disease, damage to yin depletes fluids, resulting in liver-kidney yin deficiency and insufficient essence-blood, manifesting as dry eyes, weakness in the legs, restlessness with little sleep. The brain is the sea of marrow, and when the marrow sea is inadequately filled, intellectual deficiency arises. Kidney deficiency leads to the bladder's inability to retain and control, resulting in frequent urination. Yinhai Jingwei·Preface: "When the qi of the liver and kidney is sufficient, the eyes are bright and clear; when the qi of the liver and kidney is deficient, mental confusion and vertigo occur." "The liver (Yi) and kidney (Gui) share the same origin." Treatment should focus on nourishing water to moisten wood, with prescriptions such as Lycium and Chrysanthemum Rehmannia Decoction or Kidney Qi Pill to enrich yin. The liver stores blood, and the kidney stores essence. If both essence and blood are deficient, treatment should aim to nourish blood, activate blood circulation, and tonify the liver and kidney, with prescriptions like Four Substances and Five Seeds Decoction. For prolonged conditions, consider adding Salvia, suberect spatholobus stem, Sweetgum Fruit, Luffa Vegetable Sponge, dried Earthworm, etc., to invigorate blood and unblock collaterals.
5. Impact Trauma︰No light perception in one or both eyes, with dilated pupils, accompanied by distending pain in the head and eyes. The tongue coating is thin and white, and the pulse is slightly rapid. The eyeball is intact, but vision is impaired. This condition is often caused by damage to the head and eye meridians, blood stasis, qi stagnation, obstruction leading to pain, internal stagnation, and external invasion of wind pathogens. The clinical manifestations include distending pain in the head and eyes. The key diagnostic points are vision impairment in one or both eyes, distending pain in the head and eyes, and a history of trauma. Treatment should focus on nourishing blood, promoting blood circulation, and dispelling wind to relieve pain. The recommended formula is Wind-Eliminating Impairment-Repairing Decoction, optionally supplemented with Chastetree Fruit, dried Earthworm, or Luffa Vegetable Sponge. Alternatively, Peach Kernel, Carthamus and Four-Ingredient Decoction can be used with the addition of Saposhnikovia Root, Notopterygium, and Dahurian Angelica, along with ingredients like wolfberry, glossy privet fruit, and Schisandra Fruit to tonify the kidney and improve vision.

bubble_chart Documentation

1. Michuan Yanke Longmu Lun: "When this eye is first observed, it is easily affected by the evil qi of fright in the mother's womb. From the age of five to seven after birth, it often suffers from eye diseases. Initially, the child may experience frequent frights during sleep at night, vomiting phlegm and yellow fluid, gradually leading to blindness. It usually starts with one eye and then affects the other. At the first sign, it is crucial to rest and treat promptly. Taking Niudan Wan (Ox Gallbladder Pill) and Rhinoceros Horn drink will have an immediate effect."