bubble_chart Concept

Dysmenorrheal eye pain refers to the symptoms experienced by women during menstruation, where the eyes may feel dull pain, astringent pain, or even swollen and astringent to the point of difficulty in opening, with the black of the eye developing nebula.

This condition is referred to as "blood chamber astringent pain syndrome" in Yinhai Jingwei, as "Jingmai eye disease" in "Ophthalmic Golden Mirror", and as "dysmenorrheal eye pain" in the supplementary chapter of Yizong Jinjian. Yanke Xinfa Yaojue.

bubble_chart Pattern Analysis

1. Liver Blood Deficiency︰Eyeball dull pain, accompanied by dizziness and blurred vision, pale complexion, palpitation and insomnia, pale lips and tongue, and deep thin pulse. It is mostly caused by women's inherent weakness, excessive menstrual blood loss, insufficient nutrient-blood, and malnourishment of the seven orifices. The key points of pattern identification are: eyeball dull pain, dizziness and blurred vision, accompanied by pale complexion; blood failing to nourish the heart leads to palpitation and insomnia, pale lips and tongue, and deep thin pulse. Treatment should focus on tonifying blood and nourishing the nutrient system. The recommended formula is Four Ingredients Decoction with modifications; however, blood deficiency is often accompanied by qi deficiency. If accompanied by shortness of breath and mental fatigue, consider adding Astragalus Root and Tangshen.
2. Wind Attack Due to Blood Deficiency︰Eyeball pain, soreness in the eyebrow sockets, and unilateral headache, accompanied by pale complexion, pale tongue texture, and wiry-thin pulse. It is often caused by excessive menstrual flow, blood deficiency and physical weakness, nutrient-blood failing to ascend and nourish, and wind pathogens taking advantage of the deficiency to invade. The key points for diagnosis are: eyeball pain, soreness in the eyebrow sockets and unilateral headache, pale tongue, and wiry-thin pulse. The treatment should focus on nourishing blood and dispersing wind. The recommended formula is Chinese Angelica Nourishing Decoction with added Schizonepeta and Chastetree Fruit, which is particularly effective.
3. Wind-heat in the Liver︰Hyperemia of the ocular conjunctiva, headache and eye pain, photophobia, tearing, accompanied by astringent pain that is difficult to relieve, nebula or congealed fat on the black of the eye, a red tongue texture with thin white or thin yellow coating, and a wiry, thin, and rapid pulse. This is mostly caused by accumulated heat in the liver and external exposure to wind pathogens, leading to the interaction of wind and heat that ascends to attack the eyes. The key points for pattern identification are: headache, red eyes, photophobia, tearing, astringent pain that makes it hard to open the eyes, nebula on the black of the eye, or even congealed fat. Treatment should focus on dispelling wind, clearing heat, enriching yin, activating blood circulation, and removing nebula to improve vision. The recommended formula is the Red Swelling Nebula Obstruction Experiential Prescription. If menstrual flow is excessive, pathogenic qi is exuberant, and healthy qi is insufficient, leading to aggravated astringent pain in the eyeball, treatment should aim to clear the liver and harmonize the nutrient aspect, dispel wind, and dissolve nebula. The recommended formulas are the Chinese Angelica Tonifying Blood Powder or Angelica Blood-Tonifying Decoction.
4. Blood Coagulation and Nebula Retention︰Black of the eye macula nebula is tender and fragile, with eyeball distending pain that worsens during menstruation. The tongue texture appears pale red, and the pulse is thin and slow. This condition is often caused by prolonged use of cold and dispelling wind remedies for eye diseases. Blood congeals when encountering cold, and wind medicinal properties are drying, which can easily damage yin and transform into heat. The nebula itself generates heat, and since the disease is located in the black of the eye, the nebula becomes stubborn and difficult to resolve. Key diagnostic points include: eyeball distending pain that worsens during menstruation, fragile and tender macula nebula, a thin pulse, a pale red tongue texture with ecchymosis at the edges. Treatment should focus on enriching yin and activating blood circulation, removing nebula to improve vision. The recommended formula is the Four Substances Nebula-Resolving Decoction.

Eye pain during menstruation is a common gynecological symptom. Those with liver deficiency and blood deficiency experience dull pain in the eyeballs; those with blood deficiency affected by wind experience eye pain accompanied by soreness around the eyebrows and one-sided headache; those with liver heat affected by wind experience headache, red eyes, photophobia, tearing, and difficulty opening the eyes due to astringent pain; those with blood stasis and nebula retention experience distending pain in the eyeballs, which worsens during menstruation. Clinically, these conditions are not difficult to differentiate.

bubble_chart Documentation

1. Yuanji Qiwei．Disease of excessive blood loss: "...Women after childbirth suffering from menorrhagia and metrostaxis, excessive blood loss, can all lead to illness. The disease manifests as eyeball pain, pain in the eye making it difficult to see, photophobia, dryness and discomfort... The taiyang of the eyebrow bone, because of soreness and pain, should be treated with the main formula of Xiong Gui tonifying blood decoction."
2. 《Ophthalmic Golden Mirror．Jingmai Eye Diseases: "When women encounter the time of menstruation, they experience dry eyes pain, headache vertigo, soreness and difficulty in opening the eyes, photophobia and fear of light, thin clouds and light fog on the black pearl, or the appearance of star points and broken nebula, or the formation of sunken nebula, all due to excessive blood loss, inherent weakness, and discomfort in the qi aspect."