bubble_chart Concept

Eye itching refers to the main symptom of itching at the eyelid margin, inner canthus, or even extending to the eyeball, with the itching being extremely unbearable. However, the eyeball remains intact, and vision is normal, hence the name.

Clinically, eye itching can be caused by wind, fire, dampness-heat, blood deficiency, as well as the retreat of pathogenic factors and the recovery of healthy qi, allowing the smooth flow of qi and blood. In mild cases, the itching may be intermittent, while in severe cases, it may feel like insects crawling or be unbearably intense. Puji Fang states in the chapter on eye diseases: "When the liver meridian is deficient, wind evil takes advantage, leading to eye itching." Shenshi Yaohan mentions in the section on eye itching: "Itching can be caused by wind, fire, or blood deficiency." Additionally, occasional mild itching is not considered a pathological condition. Itching caused by conditions such as "eyelid foxtail millet" or "red and ulcerated eyelid margins" is not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Wind-heat External Contraction︰The eyes feel intensely itchy, unbearably so, as if insects were crawling, with a burning sensation, slight photophobia, tearing, and sticky, stringy but scant eye discharge. Alternatively, there may be small, uneven bumps inside the eyelids resembling peppercorns or foxtail millet. Sometimes, a grayish-yellow, slightly raised, gelatinous ring appears around the black and white parts of the eye. This condition is more common in adolescents during spring, with a floating and rapid pulse, and a thin white tongue coating. Wind-heat eye itching is caused by Xieke of the liver and gallbladder Jingmai, ascending along the meridians to affect the eyes. The syndrome is characterized by intense itching and burning in both eyes, photophobia, tearing, and a tendency to worsen in spring and summer, particularly in adolescents. Treatment should focus on dispersing wind and clearing heat, expelling pathogens to stop itching. The recommended formula is Qufeng Powder on Quarter of a Coin Powder.
2. External Contractionwind-cold︰The symptoms include itching in both eyes, aggravated by wind, watery eye discharge, and the patient's eyes appear normal without any nebula or obstruction, with normal vision. However, the eyeball is extremely itchy, accompanied by soreness and discomfort extending to the supraorbital ridge, along with aversion to cold and nasal congestion. The pulse is floating and wiry, and the tongue coating is thin and white. Wind-cold eye itching is characterized by itching in both eyes, worsened by cold wind, and watery eye discharge. The treatment aims to disperse wind-cold, and the prescription selected is Ginseng Notopterygium Decoction, removing Submature Bitter Orange and Gastrodia Tuber, and adding Sichuan Lovage Rhizome and Aconite Mother Root. Externally, ginger powder mixed with white honey can be applied (Zhang's Medical Experience, "Eye Itching").
3. Excessive Fire︰The eyes feel burning and intensely itchy, the white of the eye is red, the tears are hot and the eye discharge is thick, accompanied by a dry mouth, bitter taste in the mouth, yellow urine, and constipation. The pulse is rapid, and the tongue is red with a yellow coating. The severe eye itching is caused by zang-fu organ heat excess, where intense fire and heat rise upward and disturb the eyes. It is characterized by burning eye itching, redness of the white of the eye, and thick, heat-induced tearing eye discharge, along with symptoms of internal heat excess such as dry mouth, bitter taste in the mouth, yellow urine, and constipation. The treatment involves clearing fire and draining heat, using Diaphragm-Cooling Powder with belvedere fruit added.
4. Blood Deficiency︰The eyes are itchy, with mild and intermittent itching that subsides upon rubbing but recurs afterward. The eyes feel dry and uncomfortable, the complexion is dull, the tongue is pale, and the pulse is wiry and thin. Blood deficiency producing wind causes eye itching, characterized by intermittent itching that stops temporarily upon rubbing but recurs repeatedly. Eye itching due to excessive fire is a excess condition, while eye itching due to blood deficiency is a deficiency condition. The treatment should focus on nourishing blood, promoting blood circulation, and extinguishing wind to relieve itching. The recommended formula is Four Ingredients Decoction combined with Saposhnikovia Root, Dahurian Angelica, scorpion, and Aconite Mother Root.

In addition to the differentiation of syndromes mentioned above, the symptom of eye itching can also provide significant reference value for the diagnosis and prognosis of various eye diseases based on its severity and nature. For instance, if the eyes itch without any apparent disease, it may be a precursor symptom of an eye disease. If the itching persists but gradually decreases after treatment, it indicates the retreat of pathogenic factors and the recovery of healthy qi, suggesting that the eye disease is about to heal. These distinctions should be carefully discerned during clinical practice.

bubble_chart Documentation

1. Yinhai Jingwei．Extreme itching is unbearable: "Extreme itching that is unbearable is due to heat in the liver meridian, deficiency heat in the gallbladder, wind evil attacking and filling, the liver containing extreme heat, the liver being agitated by the dryness of wind, the wood shaking and wind moving, thus the itching occurs. Therefore, all itching belongs to deficiency, deficiency causes itching, all pain belongs to excess, excess causes pain." It is also said: "Why do the eyes itch when facing the wind? It is because the liver and lung meridians are affected by wind evil."
2. 《Yishou Ophthalmology．Seventy-two Eye Conditions and Their Treatments》: "Why do the eyes itch when encountering wind? It is said: There is wind evil in the liver meridian, the liver belongs to wood, and upon encountering wind, it becomes dry and agitated, hence it itches."