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Eyes Handout PDF
Eyes Handout PDF
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Julian Scott
Julian Scott
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Eye diseases
Old-fashioned view
The old fashioned view (which is to be found, for example in the Nei Jing) is based on a
simple attribution of the parts of the eye on the basis of colour. So we see the following
table of relations:
Organ
Kidney
Liver
Heart
Spleen
Lung
Colour
Black
Green/brown
Red
Yellow
White
Part of eye
pupil
Iris
Inner canthus
Eyelids
Sclera
More recently
The Liver
...which opens into the eyes is particularly concerned with the perception of light.
Liver blood deficiency
Liver heat
Rage
The Heart
"the Heart rules the blood vessels" Blood clots, hardening of the arteries, poor blood supply
can all be seen in eye pathologies. In particular we see:
Stagnation of Blood
Occlusion of the arteries
Poor circulation of blood
Heat in blood
Perception
the recognition of objects, the cognitive aspect of the Shen.
Shen shows in the eyes
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The Spleen
..."controls flesh" the eye-lids.
The Spleen also rules the transportation and transportation of fluids,
dry eyes because dampness or phlegm is obstructing the flow of fluids to the eyes
excessive production of tears,
"bags" underneath the eyes, In Western Medicine, they are a symptom of Bright's disease
the aqueous humour may become sticky leading to "open-angle" glaucoma
Thick phlegm may lead to drusen
The Lungs
dry eyes from Lung Yin Xu
excessive tears from Lung Qi Xu
excessive tears from long-term sadness
excessive tears when wind-cold invades the lung - and many other conditions related to
either the lungs or to the Wei Qi.
The lungs also affect the fluid circulation inside the eye, so that there is a Lung pattern of
glaucoma.
tear production on going from hot to cold
corneal erosion and corneal ulcer, both of which have as one of their syndromes Lung Yin
Xu. Both these conditions are similar to an equivalent skin disease - corneal erosion
being like flaking eczema and corneal ulcer being similar to an ulcer or rash on the skin.
Grief
Kidneys
Last, but not least in our discussion of the eye problems come the Kidneys. They are of
such importance for the eyes that they come first equal with the Liver. In particular we can
see:
The Retina and Optic Nerve
...are anatomically part of the brain, and as such are ruled by the Kidneys.
The Aqueous Humour
When the Kidneys are deficient, it is easy for fluid imbalances to occur in the eyes. In
particular one may see:
glaucoma (open angle) when the pressure builds up in the eye due to Kidney deficiency
the Lens
...could be said to be ruled by the Kidneys. In particular one sees:
progressive hardening of the lens in old age, leading to presbyopia
cataract, which frequently comes from Kidney Yin deficiency.
The 'glitter', or the force of the Shen is ruled by the Kidneys.
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Eye diseases
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Eye diseases
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Cranial nerves
These nerves come out of the cranium near the point Fengchi Gb-20 which explains its
effectiveness in so many eye disorders.
Extraocular muscles
inferior, superior, lateral and medial rectus,
inferior and superior oblique muscle
Clinical Ophthalmology a synopsis, J.J.Kanski, Butterworth-Heinemann
Lots of lovely pictures
Outline of Ophthalmology, Coakes and Sellors, Buttersorth-Heinemann
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Eye diseases
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Shen
The 7 Emotions
Foods which directly affect the Eyes
Garlic
Onions
Eggs
Alcohol
Liver
Blueberries (Myrtle)
Carrots
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Mercury poisoning
Can lead to
1. Accumulation of phlegm
2. Progressive degeneration of the nerves
3. Dysfunction of the excretory function of the
kidneys
Effect on the eyes
Mercury can be behind all problems to do with fluids. In
particular:
Glaucoma, especially when the intra-ocular pressure is
not especially high.
Chronic sore eyes, especially when there is a
continuous discharge
Corneal erosion.
Retinal degeneration
Phosphorous
The symptoms relating to the eyes are mainly those you
would expect from Yin deficiency:
Over-sensitivity to light - has to wear sunglasses,
even at night.
Dry, red eyes
Cataract
Glaucoma
Various sorts of retinal damage.
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Eye diseases
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Principles of Treatment
we see the following imbalances:
1.
2.
3.
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Eye diseases
Local points
Jingming Bl-1
1 to 1.5 cun, perpendicularly
All eye problems
Zanzhu Bl-2
3 to 5 fen perpendicular; or 0.5 to 1 cun towards Jingming Bl-1
Yangbai Gb-14
Sore eyes, twitching of eyelid, itching eyelids.
Sibai St-2
0.2 to 0.3 cun
Red eyes, corneal opacity.
Sizhukong SJ-23
Transversely, 0.5 to 1 cun
Red eyes, ingrowing eyelashes.
Qiu hou
1 to 2 cun, first slightly downwards, then slightly upwards.
Myopia, inflammation or atrophy of the optic nerve, glaucoma, retinitis pigmentosa,
convergent squint
Near points
Taiyang
all eye diseases, red and swollen eyes, sty.
Touwei St-8
Blurred vision, pain in the eyes, excessive tears, spasm of eyelid
0.5 to 1 cun, upwards or downwards.
Fengchi Gb-20
Straight insertion 1 to 1.5 cun; or 2 to 3 cun towards opposite eye.
All eye diseases
Glaucoma #1
1 cun above SJ-23
Yifeng SJ-17 ("Shielding" wind)
2 to 2.5 cun, towards the nearest eye.
All eye problems, especially corneal opacity.
Er jian (apex of the ear)
Bleed or 5 moxa cones
Painful eyes, corneal opacity
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Distal points
Back Shu points:
Ganshu Bl-18
Pishu Bl-20
Shenshu Bl-23
Yangguang Gb-38
Yanglao Si-6
blurred vision, "green blindness" (moxa
Xingjian Liv-2
Taichong Liv-3
Hegu Li-4
Guangming Gb-37
Zusanli St-36
Yemen Sj-2
Red eyes
Neiting St-44
Dreamy
Glazed look in eyes
Skin oily or excessively dry
Skin on body is rough (like sandpaper)
Swollen lymph nodes (and tonsils)
Occasional drops in energy
Food intolerance
In younger people
Timid, cautious, indecisive
Does not use full potential
Lumbar back weak
Wrinkled and decrepit (In older people)
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Eye diseases
Microcurrent stimulation
Rules for microcurrent:
Increase the intensity gradually until a slight pricking sensation is felt, then reduce slightly
so that there is no sensation. Best results are obtained when the stimulation is just under
the threshold of perception.
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Watering Eyes
Aetiology & Pathology
Wind-heat
Symptoms and signs
Eyes are red, sore and watering, possibly with purulent discharge.
Onset is sudden
Liver Qi stagnation
Symptoms and signs
May appear to be very angry or tense, but more often has irritability alternating with
great charm.
Red tongue
Wiry pulse
In spite of spring being the worst time, the patient does not seem to be very angry
Pale face
Quiet voice
Frequent infections
Weak pulse
Additionally these patients may have signs of a lot of mucus, such as
Nasal discharge
Cough
Slippery pulse
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Heart Fire
Symptoms and signs
Face red
Eyes red
Restlessness
Insomnia
Stiff back
Ache in occiput.
Blood insufficient
Symptoms and signs
Face gray
Tired
Tongue pale
Sore back
Weak knees
Arthritis
Poor memory
low in vitality
no interest in life
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Liver Qi stagnation
Heart fire
Phlegm patterns
Dry eyes
Liver blood insufficient
This more or less corresponds to the Western pattern of anaemia.
Liver and Kidney weak
This pattern is common in old age. There is general weakness, but specially Yin Xu, nor
Yang Xu.
Kidney Yin Xu
The common time for this pattern to emerge in western patients is the menopause. They
may not show the malar flush conventionally associated with Yin Xu, but there are often
many other characteristic symptoms and signs. Another situation is those undergoing
radiation therapy, where the burning radiation has consumed Kidney Yin.
Full heat
These are the people who run hot all the time. They may be seen in short trousers or
cotton dress in the middle of winter. Typically they have a red face, and a full, rapid pulse
and a red tongue. Sometimes, especially in older people, the face is not so red, but is more
yellow. This happens when the Qi is somewhat weaker, and also when the heat is trapped
inside.
Liver Yang rising
Typical symptoms include irritability and even outbursts of anger, red or purple tongue with
a dirty coat, wiry pulse. Generally these people exude an atmosphere of frustration and
pent-up energy. In China, this pattern is usually accompanied by hypochondriac pain. This
symptom does appear in Western patients, but not always.
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Eye diseases
Spleen Qi Xu
Typical symptoms include poor digestion, tiredness, lack of concentration, a tendency to
worry, weak pulse. These people may exude a defeated attitude. In China this pattern is
usually accompanied by loose stools, but in the West, irregular stools are more common,
possibly loose stools alternating with several days of constipation.
Thick phlegm
This pattern is rarely mentioned in Chinese texts, but is common in the West. Its root cause
is often the combination of many immunisations and suppressed fevers. Common
symptoms include congested lymph system, dry or dusty skin, or even flaking eczema.
Lung weakness
We prefer to use the term Lung weakness rather than Yin or Yang Xu because this is how it
often presents in the West. Typically there may be a history of Lung illness, such as
chronic cough, or asthma when young, which at present does not manifest as a lung
condition, but which is nevertheless the major imbalance, and needs to be treated for a
successful outcome
Special diagnostic pulse:
The bean bone pulse is a sure indication that there is lung weakness, even if there are no
other symptoms. Normally the pulse can be felt in the first position on the right it
represents the lungs, and on the left the heart. But examining the pulse closer to the wrist,
the pulse becomes fainter, so that by the time the practitioner is pressing on the patients
wrist bone, little or no pulse can be felt. However in the bean bone pulse, the pulse can be
clearly felt for up to a centimetre beyond the crease of the wrist. On the right it represents
damage to the right lung, and on the left damage to the left lung. The length and strength
of the pulse in this position are an indication of the depth of damage to the lungs.
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Corneal erosion
Common symptoms
localized opacity
nearby redness and excess blood vessels
photophobia
watering eyes
pain similar to that felt with a foreign body
or
Fierce pain in eyes
irritable iritis (because toxins reach the iris)
Spleen and Kidney weakness (or Spleen and Kidney yang deficiency)
sclera has a muddy look
patient is tired
weak knees
sore or weak back
pasty complexion
tongue may be pale, possibly with red at the edges
soggy and weak pulse
Liver and Gallbladder heat
bloodshot eyes
possibly a red face, but more often in the West, the face is pale
male patients may have blue color along the jawline
tense and irritable
tendency to high blood pressure
wiry pulse
purple tongue
Wind-heat
very red, very sore, itchy eyes
possibly watery eyes
sudden onset
signs of an attack of wind-heat
possible fever
possible thirst
pulse is floating and rapid
tongue has thin coating and red tip
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Lung yin deficiency
white face with malar flush
night sweats
thin build
history of Lung problems
possible history of excessive use of steroids for treating asthma
overstimulated
pulse is fine and rapid
tongue is thin, red at tip or red all over, and maybe peeled
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Patterns
Liver and Kidney weak (xu-ruo)
Heart Ying weak
Spleen and Kidney Yang Xu
Stagnation of qi and blood
Accumulation of phlegm
Damp-heat
Lung Qi / Organ weakened
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Eye diseases
Advice
Other treatments
Microcurrent stimulation
Daily electrical stimulation of the points around the eye with a microcurrent stimulator has
been shown to be beneficial.
Dry type is characterised by drusen and possibly growth of blood vessels
Wet type is characterised by retinal oedema, retinal bleeding
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Retinal bleeding
Blood heat
Red face
Red tongue
Rapid pulse
Spleen does not hold blood
Overweight (in the West)
Bloating after meals
Food intolerances
Varicose veins
Weak heart and vessels
Easily tired
Palpitations
Other Heart signs
Pale or purple tongue
Irregular pulse
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Eye diseases
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Kidney weak
Spleen Qi deficiency
Gray face
Tendency to overweight
Difficulties over food diet does not seem to help
May overeat
Pale tongue, possibly coated, or possibly with stringy saliva
Pulse slippery
Gray face
Tendency to eczema/dry flaky skin
Food intolerance/allergies
Tendency to stone formation
Pale tongue, possibly coated, or possibly with stringy saliva
Pulse slippery or wiry
Lung Qi Xu
Bean-bone pulse is a pulse that can be felt on the radial artery just distal to the wrist line. In a healthy person it should
not be possible to feel this pulse. Its presence indicates injury to the lung organ, for example by whooping cough when
young or tuberculosis.
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Eye diseases
Cataract
Cataracts occur because there is too much heat in the system. One should not be misled
by the symptom of feeling cold. Often patients feel cold because they are weak or tired, or
because the heat inside does not reach the surface. The very fact of cataract points
towards heat of some kind.
Syndrome
Aetiology
Symptoms
Tongue
Pulse
White face,
history of lung
problems,
dreamy
expression
Chronic lung
condition, lung
illness early in
life, overwork,
exhaustion
We have used the term 'weak heat' in preference to the term Yin Xu, as Western patients
often do not exhibit the typical symptoms of Yin Xu of night sweats, and five centres hot.
There nearest they may get is often that they have to sleep with their feet uncovered, even
in winter.
New causes:
Exposure to chemicals in youth
Other treatment:
Cineraria maritima eye drops (Dr. Reckeweg)
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Short Sight
First of all treat stress
The treatment of stress in children is not really medical work, but is more in the sphere of
counseling.
Then treat any Qi imbalance:
Prescription for Spleen Qi Xu
St-36 Zusanli
Sp-6 Sanyinjiao
Prescription for Lingering Pathogenic Factor
Once the Spleen deficiency has been overcome, there may still be a Lingering Pathogenic
Factor. A typical treatment for this would be
Bailao (Extra)
Bl-18 Ganshu
Bl-20 Pishu
Bringing qi to the eyes
Undoubtedly the best way is for the child to do the self-massage techniques described,
because these can be done three times a day.
There are other ways - straight acupuncture, electric plum blossom needle, microcurrent
stimulation.
Prescription of points to bring qi to the eyes
Zanzhu Bl-2
Yuyao (Extra)
Tongziliao SJ-23
Yangbai St-2
Fengchi Gb-20
Hegu Li-4
Neiguan Pc-6 (optional)
Ideally these points are treated every day for 10 days, with a rest of 5 days. In practice,
they need to be treated three times a week minimum. If you treat less often than this, it is
not worth doing at all, and just involves everyone in frustration and expense.
Self checking
. . . is important
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Eye diseases
Advice to parents
Squint
Crossed eyes which appear in childhood must be treated in childhood. In fact the condition
must be treated before the age of 8 years at the very latest if there is to be any hope of
success. This is because there is always one dominant eye, and the other eye, the lazy
eye gradually falls into disuse. If this eye is not used at all through the 7 to 8 year
transition, it becomes blind.
Causes of squint
Mechanical defects
1. Shortened muscle
2. Paralysed muscle
Diagnosing squint
For Caucasian children this is usually quite easy, but when diagnosing young babies, and
Orientals it is easy to make a mistake, because there is a fold of skin which makes it look
as though the eye is not central, even though it really is.
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some signs or red on the face, such as red cheeks or red lips
maybe red tongue or red tip to the tongue
irritable, restless.
Overexcitement
The key symptoms and signs are:
child is born with good eyes, and then develops a squint
squint is worse when overtired or overexcited
often red cheeks
lower back is often weak
child is shy at first, then playful and overexcited
tongue may be red, or may be pale
pulse rate varies with excitement.
Paralysis
There are a lot of similarities between this pattern and the second one, LPF, for the simple
reason that they are both the result of a fever. In this pattern the fever has gone deeper
and caused the paralysis. So one often sees exactly the same symptoms, the only
difference being in the movement of the eyes.
However, one does sometimes see an alternative pattern, that of qi xu; in which case one
will see the following symptoms and signs;
pale face
tired, floppy
poor appetite
sleeps a lot
dull spirit in the eyes.
Conjunctivitis
Other treatments:
Eye drops: Euphrasia (Weleda) Calendula (Weleda) Euphrasia and Vaccinium (Vizulize)
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Eye diseases
CASE NUMBER 1
Mr N Aged 78 years
Appearance:. Square face, engaging smile, Well preserved. Face colour is red. both eyes
slightly watery.
Behaviour:. Seems to be in a hurry every time he comes. Likes to take control. Wants to
know everything about sterilization and safety procedures.
Main complaint: Blocked tear duct, It has been there on and off for two years. He has
been offered surgery, but is unwilling to go down that route, because of health risks. (A
close friend died recently on the operating table)
Don't turn over until you have answered the first few questions
What are the possible syndromes for blocked tear duct, and for high blood pressure?
Blocked tear duct
What results would you expect from treatment, and how soon?
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Eye diseases
CASE NUMBER 2
Mrs. J aged 58
Appearance: Dull coloured face, slightly yellow, significantly overweight: pasty complexion
Behaviour: rather heavy footed
Main complaint: Corneal erosion, especially the left eye. On waking the eye is painful and
watery, feels like grit in the eye, pain may last for an hour or two before subsiding. Recently
has had actual erosion, with fierce pain. This may occur in the middle of the night.
Eyes are often blurred, in spite of spectacles (cannot wear contacts)
Eyes feel tired all the time.
Digestion: some indigestion with flatulence, worse when rushing around too fast
Sleep: used to sleep very well, until this happened. Now often wakes at 3.30 to 4.00am
Energy: is OK.
Appetite: OK
Life. Happily married, but fed up with work, and is looking forward to retiring in a year and a
half. Her hobby is writing books (she has published about 20)
Pulse: 72 slippery-soggy, quite strong, except both 3rd positions
Tongue: slightly pointed, red a tip, slight rough coat.
What are the syndromes for corneal erosion?
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CASE NUMBER 3
Master O Aged 16 years
Appearance:. Tall, well built, pale face, droopy posture
Behaviour: Quiet, dull voice.
Main complaint: Retinitis pigmentosa, Diagnosed one month ago after 2 year history of
increasing night blindness. Field vision test at routine appt. alerted the
optician to peripheral vision loss and he made referral. Hospital has said there
is no tx. for the condition however through internet search they have found
that Vitamin A is prescribed for this condition in the US. Mum has found
medical herbalist who is prescribing it to them along with chromium, gingko
and omega oils which he is already taking for migraines.
What results would you expect from treatment, and how soon?
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Eye diseases
Head & Body Severe migraines which can last up to 3 days. Started 2-3 yrs ago. Triggered
by exercise, especially bad when he had an important match to play. Rather
sketchy about exact symptoms, no real visual disturbances, couldnt say
whether they were one sided or not, just like a very bad headache- some
nausea. Migraines ceased after tx. by herbalist.
Food & taste
Wont really eat fruit or vegetables, likes the usual teen diet but Mum
tries to keep him on track with home cooked stuff. He thinks he has a good
appetite but Mum begs to differ. Also eats a lot of chocolate at least one
medium bar of galaxy milk chocolate a day, sometimes more, plus minstrels.
Hates the taste of salt & vinegar.
Drink & thirst Drinks very little, doesnt feel thirsty, often forgets to drink unless prompted.
This runs in family, Mum is the same but has trained herself to drink more.
Doesnt drink at night but wakes up v. thirsty and drinks a lot first thing in the
morning. Drinks mainly milk or water.
Sleep
Life
Lives with Mum, Dad brother and sister. Sister has autism. School is ok,
works hard at school but not much work at home. Likes maths & sports.
Immunisations
Had a bad reaction to first triple vaccine but I couldnt get Mum to say
exactly what the reaction was. When the time came for the next one, GP split
them up and gave whooping cough separately. Mum is quite suspicious of
vaccinations since younger child developed autism.
Occiput
GB 20
Liv 14
Taiyang pt. Face
Lumbar
Areas directly over each kidney felt squashy (esp. on L side) but everywhere
else felt stiff like a board.
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Other Impressions Has always been very physical and sporty. As a child he was always
ahead of physical milestones. Apparently a bit of a risk taker as a child
bordering on the hyperactive.
Considering how sporty he is supposed to be, his frame, posture and energy
dont give a sense of being particularly robust or sturdy. Posture looks more
like a teenager who sits in his room watching TV or playing guitar. Quite
gangly, like someone who has grown too fast and body cant quite keep up.
Mum alludes to ill health generally in the family and gets a bit defensive when
I question him around Fear. She thinks I think he is anxious. She leaps in to
say that he is the most normal of us all- in fact when the rest of us are all
getting anxious about things, he is the one who holds us all together and
keeps our feet on the ground. I cant help wondering whether he feels under
pressure to be responsible for the whole family in this way. Perhaps Im way
off the mark but something felt a bit weird, there was a dynamic that felt tense
at that point.
Pulse
Tongue
Floating on all positions, also slippery on the right side. * radial artery on RHS
is on dorsal surface of arm.
Normal colour, no coat, quite wet.
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Eye diseases
CASE NUMBER 4
Mrs. D Aged 57 years
Appearance:. Tall, well built, pale face, a distinguished and fine nose, red lips
Behaviour: Quiet, measured tones in her voice.
Main complaint: Macular degeneration, It is in its early stages, and she can still read
quite small print, though she is noticing things going fuzzy.
Also she has a chronic cough. This has been going on for nearly a year. In the summer it
gets a bit better, and in the winter a bit worse. The cough is worse when she lies down at
night, though it is there in the day too. When she coughs she brings up some thick green
phlegm.
What are the possible syndromes for macular degeneration and for chronic cough?
Macular degeneration
Chronic cough
What results would you expect from treatment, and how soon?
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Eye diseases
CASE NUMBER 5
Miss T Aged 26
Appearance Smiling face, red cheeks slightly yellowish skin, slightly green around the
mouth
Behaviour: Easy to get on with. Charming.
Main complaint: Glaucoma, for one year. It started with headaches and sparks in front of
the eyes, especially early in the morning, just after waking. Since the diagnosis she has
been putting drops in her eyes morning and night. These are effective in keeping the
pressure down in her eyes, and so she does not see any sparks. But she still gets lots of
headaches.
Don't turn over until you have answered the first few questions
What are the possible syndromes for glaucoma?
What results would you expect from treatment, and how soon?
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Eye diseases
CASE NUMBER 6
Miss T Aged 6 years
Appearance: Pale face with red hair, Some pink in her cheeks. Her left eye turns in
markedly, and is obviously not used. She has crusts under her nose.
Behaviour: rather shy. Quiet.
Main complaint: Squint, for three years. Three years ago she had a bad attack of
bronchitis, with very high fever, and the eye has not been well since then. According to
tests at the eye hospital, there is actually some use in the left eye, and she does
occasionally use it.
Also she has a chronic cough. Every winter she gets three or four really bad coughs, and
has to take antibiotics each time. Even during the summer she sounds a bit chesty.
Don't turn over until you have answered the first few questions
What are the possible syndromes for squint?
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Case Number 7
Mr.J aged 54 yrs
Main complaint: Retinal bleeding, and retinal
arterial occlusion.
The left eye has now very little vision, after
arterial occlusion. The vision was suddenly
impaired by arterial occlusion. Laser
treatment was unsuccessful and made him
totally blind in this eye. There is fairly good
vision in the right eye, but there has also
been bleeding there, and the vision is hazy,
and is getting worse. He is understandably
reluctant to have further laser treatment.
Appearance. On first few visits, colour was
somewhat yellow, in later visits it is showing
red.
Digestion
He has always had slight heartburn, but since last Christmas the stomach has been very
painful. It has been diagnosed as acid reflux and inflamed oesophagus. He has always
had a lot of burping. All this better if he takes tablets.
Limbs in good condition, generally. Some arthritis in knee from an old injury. He is a
carpenter and works mainly constructing roofs.
More about vision: is hazy, worse in morning, worse in darkness. Has lost some of upper
field of vision. Inspection of picture of retina shows where there are blood clots and also
where it has escaped.
Pulse a bit slow. LH a bit deep and slightly muddy, a bit weaker in He.
RH a bit slippery, more full in lung position, and very much so distal to the cun position, on
the wrist bone, which is the 'special lung pulse'. Not especially full in the stomach position.
Tongue: Colour good, a little pale, large cracks.
BP was reported to be 150/88
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CASE NUMBER 8
Mrs W Aged 67 years
Appearance: Slightly overweight, wrinkly face, yellowish.
Behaviour: Moves rather heavily, groans from time to time.
Main complaint: Fierce pain in L eye, for five days. Ten days ago she had an operation
for detached retina. Healing was going well until five days ago, on Friday afternoon.
On the next day she phoned the hospital where the surgery was performed, opnly to find
that the surgeon had just gone on holiday.
Other symptoms and signs
Confesses to being a worrier. I worry about not having anything to worry about
Often bloated after meals. Has to be careful about what she eats.
Knees very swollen. Give her trouble in cold and damp weather
Tongue pale
Pulse: tight in all positions
What would you do?
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Case Number 9
Miss S Aged 15 years
Appearance: Pale face, attractive look. Shiny skin on the face, with mild acne
Behaviour: polite; does not feel comfortable sitting up straight prefers to slouch
Main complaint: Coats syndrome: Coats disease is a serious condition of the eye,
where the small arteries enlarge, and start to leak. There is also exudation i.e. the
formation of a whitish yellowish substance over the retina. If untreated, this leads gradually
to blindness, at first locally, then, as the condition worsens, it can lead to glaucoma and
retinal detachment. It can be present as leukoria (a wide appearance of the pupil).
Aetiology unknown. Usually, only one eye affected. Treatment: sometimes laser
coagulation.
She has been noticing some loss of vision in the upper R quadrant, which has slowly
increased over the past year.
She has always problems with her throat, high tension of the muscles in the neck,
Don't turn over until you have answered the following questions
What are the conditions (in Chinese medicine) which give rise to blood leaking out of the
vessels?
What are the conditions which give rise to greasy deposits?
Now turn over and answer the following questions.
What imbalances do you think there are?
What is the significance of the cracking noise from the jaw?
What is the significance of the rough skin?
Why do you think the problem occurs in teenage?
Do you think you can help?
If so, how long will it take before you see any improvement?
Julian Scott
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Eye diseases
Julian Scott
Eye diseases
Page 47
CASE NUMBER 10
Mr. G aged 68 was still very active, and although he had officially retired, he was, if
anything busier than before. He had had glaucoma since his early 40's, which had been
treated with drops. Unfortunately, as time went on, his body became more and more
accustomed to the drops, and they more or less stopped working. Consequently, about 20
years ago he had a trabeculotomy. However, even this did not produce lasting relief. The
pressure continued to rise.
By the time he came to me, there was damage in both eyes, severe in the left eye, so much
so that he was obliged to give up his driving licence. He still had (just about) enough sight
to continue what he was doing, but it was deteriorating.
Appearance: tall, thin, wiry body; thinning white hair, slightly purple face; bright eyes,
enthusiastic
Examination: energy in back was weak; tender at SJ-17 Yifeng point, especially on the left;
slightly tender at Gb-20 Fengchi
Past history: 2 years ago was diagnosed as having high cholesterol. Otherwise nothing
abnormal, except last year had a period of bad diarrhoea. He had to get out of bed in the
morning to pass stools. This is better now.
Pulse: Left side: wiry, tending to long, though stronger in 3rd position
Right side: more slippery than wiry, stronger in 3rd position
Speed: when he first came in it was 60, but the speed gradually slowed to 54
Tongue: a bit red, surface is slightly rough, some sticky saliva on tongue
What do you think is the main pattern?
What treatments would you give?
Will they work? If so, how soon?
What would you expect to happen?
Julian Scott
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Eye diseases
CASE NUMBER 11
Ms A
Aged 43
Why do you think a person of this age and this state of health has a degenerative disease?
Julian Scott
Eye diseases
Page 49
Julian Scott