bubble_chart Concept

Red vessels crossing white eye (angular conjunctivitis) refers to the condition where red vessels start from the inner canthus or outer canthus and traverse the white of the eye.

The "Michuan Yanke Longmu Lun" records "red vessels at the outer canthus indicating external ophthalmopathy," while the "Yinhai Jingwei" and other texts categorize it into "red vessels crossing the white eye from the inner canthus (angular conjunctivitis)" and "red vessels crossing the white eye from the outer canthus (angular conjunctivitis)."

This condition must originate from the canthus areas to be confirmed. If the red vessels start elsewhere and twist and coil, it is called "red thread coiling vessels." If a large patch of red flesh grows from the canthus and traverses the white of the eye, resembling a fly's wing, it is called "pterygium." Neither of these falls within the scope of this discussion.

bubble_chart Pattern Analysis

1. Exuberance of Heart Fire︰The red vessels originate from one canthus or both canthi, traversing the white of the eye. The blood vessels are thick, deep red, accompanied by itching, astringency, and stabbing pain, with mostly dry and congealed eye discharge. Symptoms also include headache, irritability, feverish sensation, dry mouth, thirst, a red tongue with scant coating, and a rapid pulse. This condition is caused by excessive heart fire ascending to the eye orifices. The heart governs blood, and the two canthi belong to the blood orbiculus, internally corresponding to the heart. When heart fire blazes, it results in thick, deep-red vessels, itching, astringency, stabbing pain, and mostly dry, congealed eye discharge. Additional symptoms include headache, a flushed face, irritability, feverish sensation, thirst, a red tongue with scant coating, and a thin, rapid pulse. Treatment should focus on clearing the heart and reducing fire, using the Heart-Draining Decoction. For cases with dark urine and heart vexation, combine with the Redness-Removing Powder with modifications.
2. Yin Deficiency︰Red vessels emerge from one or both canthi, the white of the eye is pale red, the thread-like vessels are fine, there is mild stinging and itching, eye discharge is scant and does not crust, the eyes feel dry, accompanied by dizziness and blurred vision, a red tongue without coating, and a thin, rapid pulse. This is due to yin deficiency, where water fails to control fire, leading to deficient fire flaring upward. Hence, the canthi are not severely red, the vessels are fine like threads, and eye discharge is scant and does not crust. Additional symptoms include dizziness and blurred vision, dry eyes, palpitations or severe palpitations, restlessness and insomnia, a red tongue without coating, and a thin, rapid pulse. Treatment should focus on nourishing yin and reducing fire, using Anemarrhena, Phellodendron, and Rehmannia Pill. For cases with palpitations or severe palpitations, restlessness, and insomnia, combine with the effective Heart-Nourishing Elixir.
3. Deficiency of Kidney Essence︰The canthus area shows fine red vessels, the white of the eye is pale red, with dry and blurry vision, tinnitus, deafness, soreness and weakness in the lumbar region and knees, seminal emission, premature ejaculation, a red tongue with scant coating, and a thin, weak pulse. This condition is often caused by excessive sexual activity, overexertion injuring the heart and kidneys, depletion of essence and body fluids, leading to inadequate nourishment of the eyes. Symptoms include faint red vessels, dryness, blurry vision, accompanied by tinnitus, deafness, soreness and weakness in the lumbar region and knees, seminal emission, and premature ejaculation. The tongue is red, and the pulse is weak and feeble. Treatment should focus on tonifying the kidney and replenishing essence. The recommended formula is Permanent Eyesight Pill.

Red vessels crossing the white eye (angular conjunctivitis) are always caused by "fire," but should be differentiated into deficiency and excess. Key points for differentiation: internal blazing of excess fire in the Heart meridian is characterized by thick and large red vessels, redness in the canthus, stabbing pain, itching, and astringency; yin deficiency leading to water failing to nourish fire, with deficiency fire flaming upward, is marked by thin and small red vessels, a light red color, and dry, astringent eyes; kidney essence deficiency is indicated by sparse red vessels in the canthus, absence of stabbing pain or itching, but only dryness and blurred vision.

bubble_chart Documentation

1. Yizong Jinjian-Yanke Xinfa Yaojue: "The symptom of red canthus, if the red vessels start from the inner canthus, it is the real fire of the heart meridian; if the red vessels start from the outer canthus, it is the deficient heat of the heart meridian. For the real fire, use Xixin Powder to resolve both evils; for the deficient heat, use Nine Immortals Powder to clear and reduce the deficient heat."