bubble_chart Concept

The term "cloudy nebula" refers to scars of varying sizes and shapes that remain after the occurrence of "black of the eye star nebula".

This condition has various names depending on the size, thickness, shape, and color of the scars. For example, the "Secret Book of Experiential Ophthalmology" refers to "thin ones as clouds, thick ones as nebula". There are also terms such as: "thin nebula", "crystal nebula", "jade nebula floating full", "ice wheel", "maculate and lipid nebula", "sword ridge nebula", "yin-yang nebula", and so on.

"Eye star nebula" also occurs in the black of the eye area, but "star nebula" is tender and concave, accompanied by photophobia, tearing, and pain; whereas "cloudy nebula" is smooth in form, without photophobia, pain, or tearing, and can be distinguished.

bubble_chart Pattern Analysis

1. Residual Wind-heat Pathogen︰The nebula of the black of the eye has subsided, but the eyes feel dry and uncomfortable, with a remaining cloudy nebula. The white of the eye shows grade I redness. The tongue coating is thin, and the pulse is slightly rapid. This is often caused by external wind-heat pathogens invading the head and eyes. Although the nebula of the black of the eye has subsided, residual pathogens have not been completely eliminated. Although pain and photophobia have stopped, the eyes still feel dry and uncomfortable, with lingering hyperemia of the ocular conjunctiva and a cloudy nebula remaining in the black of the eye. The tongue coating is thin, and the pulse is slightly rapid. Treatment should focus on removing the nebula to improve vision, supplemented by dispersing wind and clearing heat. The modified Bow Yun Tui Nebula Powder is recommended. Cloudy nebula caused by residual wind-heat pathogens and cloudy nebula due to stomach yin deficiency! Both result from pathogenic heat attacking the eye orifices, leading to nebula in the black of the eye. After the pathogenic heat recedes, a cloudy nebula remains. However, in the first case, residual pathogens persist, with lingering redness and dryness, requiring clearing and dispersing the remaining pathogens. In the second case, stomach yin is scorched, and body fluids are insufficient, manifesting as dry mouth, red tongue, and peeled coating, necessitating enriching yin and promoting fluid production. This is the distinction between the two.
2. Stomach Yin Deficiency︰The black of the eye star nebula has just healed, the white of the eye is pale red, the eyes feel dry, there is dryness in the mouth, and anorexia. The tongue is red with peeling coating, and the pulse is thin and slightly rapid. This is often due to the consumption of stomach yin after pathogenic heat recedes, hence although the black of the eye star nebula has healed, a cloudy nebula remains, and the eyes feel dry. It is accompanied by dryness in the mouth and anorexia. The tongue is red with peeling coating, and the pulse is thin and slightly rapid. Treatment should focus on nourishing yin and removing the nebula to improve vision. The recommended formula is the Enriching Yin and Dissipating Nebula Decoction with modifications. Both conditions involve damage to yin fluids, but the key points for differentiation are: pathogenic heat scorching stomach yin, leading to dryness in the mouth and anorexia, which is a mild case of yin damage; the disease location differs, one being in the kidney and the other in the stomach, and this should be carefully analyzed.
3. Kidney Yin Deficiency︰Black of the eye cloudy nebula, dizziness and blurred vision, soreness and weakness of the waist and knees, forgetfulness, vexing heat in the chest, palms, and soles. The tongue is red with scant coating, and the pulse is thin and rapid. Often due to constitutional kidney deficiency, after the black of the eye star nebula heals, a cloudy nebula remains. Kidney yin depletion leads to emptiness in the lumbar region, hence soreness and weakness of the waist and knees; yin deficiency below causes yang exuberance above, resulting in dizziness and blurred vision; yin deficiency generates internal heat, leading to vexing heat in the chest, palms, and soles, a red tongue with scant coating, and a thin, rapid pulse. Treatment should focus on replenishing kidney yin and removing the nebula to improve vision, using a modified Tongming Bushen Wan. This is a severe case of constitutional kidney yin depletion, marked by dizziness and blurred vision, vexing heat in the chest, palms, and soles, soreness and weakness of the waist and knees, and severe yin damage.
4. Qi Stagnation and Blood Stasis︰The black of the eye appears as a cloudy nebula, with a scorched yellow or slightly red hue resembling agate, and a desire to rinse the mouth when thirsty. The tongue texture is dark, with thin coating, and the pulse is thin and rough. This condition often results from intense heat toxin, leading to star-like nebula in the black of the eye and severe injury, which leaves behind a lower energizer yellow or slightly red cloudy nebula after healing. Alternatively, prolonged illness may cause poor circulation of qi and blood, leading to stasis in the collaterals, resulting in a scorched yellow or slightly red nebula resembling agate, a dark tongue texture, thin coating, and a thin, rough pulse. Treatment should focus on regulating qi and resolving stasis, removing the nebula to improve vision. The recommended formula is Nebula-Removing Decoction with modifications.

Qi stagnation and blood stasis cloudy nebula, the star nebula arising from the black of the eye is a severe condition, hence the residual cloudy nebula is also severe, with blood vessels crawling on it, presenting a scorched yellow and slightly red color, which is different from the general cloudy nebula.

The occurrence of cloudy nebula in the eye is a residual disease of the star nebula in the black of the eye. Although clinically there are excess pattern of pathogenic heat not completely resolved and qi stagnation and blood stasis, deficiency pattern are also common, and often present with a combination of deficiency and excess. Treatment should focus on both reinforcing healthy qi and eliminating pathogenic factors.