bubble_chart Concept

Eye twitching refers to the abnormal opening and closing of the eyelid, characterized by frequent blinking that cannot be controlled. It is commonly seen in children. This condition is referred to as "目連札" in Xiao'er Yaozheng Zhijue. It is also known as "childhood eye twitching". Habitual or naturally occurring eye twitching is not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Wind-heat in the Liver Meridian︰The eyes blink continuously, moving up, down, left, and right uncontrollably like being blown by the wind. It may be accompanied by fever or lead to wind convulsions, with a thin white tongue coating, a red tongue body, and a thin, rapid pulse. This condition is mostly caused by wind-heat invading the liver meridian, stirring up internal wind, which ascends along the meridian to disturb the eyelid muscles, causing them to move up, down, left, and right like being blown by the wind, blinking frequently and uncontrollably. In severe cases, it may even cause convulsions in the hands and feet. Treatment should focus on dispersing wind and clearing heat, calming the liver to stop convulsions. The recommended formulas are Green-Blue-Draining Pill or Bupleurum Liver-Clearing Decoction. If the yin fluids are already damaged, it should be combined with Six-Ingredient Rehmannia Pill.
2. Liver and Spleen Disharmony︰The eyelids frequently twitch, the complexion appears bluish, the patient is easily startled during sleep, experiences poor appetite (anorexia), and lacks strength. The tongue coating is white and greasy, and the pulse is soggy and thin. Although this syndrome and eyelid twitching due to wind-heat in the liver channel are both caused by liver wind affecting the eyes, eyelid twitching due to wind-heat in the liver channel results from external pathogens stirring internal wind. In contrast, eyelid twitching due to liver qi invading the spleen arises from excessive liver qi transforming into wind, which then attacks the spleen earth. Hence, symptoms such as a bluish complexion, being easily startled during sleep, mental fatigue, and anorexia manifest. However, there is no fever or convulsion, which helps differentiate the two. The treatment should focus on calming the liver and fortifying the spleen. The recommended formula is the Extraordinary Efficacy Powder of five flavors, supplemented with Bupleurum, Peony Root, and Fresh Ginger Rhizome. If liver wind is particularly severe, remove Ginseng and add Red Peony Root, scorpion tail, and Uncaria.
3. Liver Blood Deficiency︰The eyelids twitch incessantly, with dryness and itching in the eyes, often prompting rubbing, with symptoms fluctuating in severity. In severe cases, vision becomes impaired by dusk. The tongue appears pale red, and the pulse is soft and thin. This condition is primarily caused by liver blood deficiency, where blood deficiency generates wind, leading to malnourishment of the eyelid muscles, and is purely a deficiency pattern. Symptoms include persistent eyelid twitching accompanied by unbearable dryness and itching. Treatment should focus on nourishing the liver and replenishing blood, using modified Nourishing Liver Pills. Fresh pork liver or sheep liver can also be cooked and consumed.
4. Spleen Injury with Malnutrition and Food Stagnatio︰The eyelids frequently twitch; in mild cases, the eyes appear normal, while in severe cases, there is grade I photophobia, tearing, occasional itching and dryness, or burning pain, hyperemia of the ocular conjunctiva, with symptoms worsening in the afternoon. There may also be tidal fever, dysphoria, and irritability. The tongue coating is slightly yellow, and the pulse is wiry and thin. This condition is often caused by dietary imbalances, irregular eating habits, damage to the spleen and stomach, leading to infantile malnutrition with accumulation. Over time, heat is generated, and malnutrition-heat rises to the eyes. Hence, the eyelids frequently twitch, accompanied by photophobia, tearing, dryness, itching, burning, and faint redness of the white of the eye, along with afternoon tidal fever. Treatment should focus on strengthening the spleen to resolve malnutrition, soothing the liver, and clearing heat. The recommended formula is Chubby Child Pill.

Eye twitching is a common symptom in children, often related to the liver and spleen, but with differences in deficiency and excess. For example, eye twitching due to wind-heat in the liver meridian is an excess pattern caused by excessive heat generating wind. Eye twitching due to liver deficiency and blood deficiency is a deficiency condition where insufficient blood fails to nourish the muscles and tendons or moisten the eye orifices. Eye twitching due to liver qi overacting on the spleen results from a strong liver and weak spleen, while eye twitching due to spleen injury from infantile malnutrition with accumulation is caused by spleen damage from infantile malnutrition with accumulation, both of which are conditions where deficiency leads to excess. Clinical differentiation is necessary.

bubble_chart Documentation

1. Shenshi Yaohan："According to the eye twitching, it is due to wind in the liver. When wind enters the eyes, it moves up, down, left, and right like the wind blowing, neither too light nor too heavy, but unbearable, hence the continuous eye twitching. There are four types of this ailment: continuous twitching of both eyes, sometimes with redness, or occasionally wiping the eyebrows, this is due to wind-heat in the gallbladder meridian, leading to infantile malnutrition involving the liver. (Use Four-Ingredient Chubby Child Pill plus Gentian to cure); there is nyctalopia with eye twitching, (take boiled liver drink, along with Four-Ingredient Chubby Child Pill, and the eyes will be clear and not twitch); there is convulsive eye twitching, belonging to wind-heat in the liver and gallbladder meridians, (first use Bupleurum to clear the liver, combined with Six-Ingredient Rehmannia Pill to nourish the kidney and cure); frightened eye twitching or convulsions, (first use modified Minor Bupleurum Decoction, add large-fruited elm, Coptis Rhizome to clear liver heat, combined with Six-Ingredient Rehmannia Pill to nourish the kidney and generate liver and recover)."