TCM Treatment for Red, Swollen, Painful Eyes and Insomnia

1. Red, swollen and painful eyes are common in liver fire, wind-heat invasion, damp-heat accumulation, yin deficiency and hyperactivity of fire. If accompanied by insomnia, it is usually related to hyperactivity of heart and liver fire and disharmony between heart and kidney. Treatment should be carried out from the perspectives of clearing liver and purging fire, dispersing wind and heat, nourishing yin and calming the mind.

   1. Acupuncture treatment

   (1) Clear the liver and reduce fire, relieve eye redness and pain

   Taiyang (EX-HN5) - Clear heat and reduce swelling, relieve eye pain

   Zanzhu (BL2) - Relieve eye discomfort, relieve eye redness and swelling

   Tongziliao (GB1) - Soothe the liver and improve eyesight, relieve eye inflammation

   Fengchi (GB20) - Dispel wind and heat, improve eye blood circulation

   Hegu (LI4) - Clear heat and detoxify, improve eye congestion and pain

   (2) Calm the mind and soothe the nerves, improve insomnia

   Shenmen (HT7) - Calm the mind and improve sleep quality

   Sanyinjiao (SP6) - Harmonize the liver, spleen, and kidneys, promote sleep

   Anmian (EX-HN22) - Specially used to improve insomnia and relieve anxiety

   Baihui (DU20) - Regulate Qi, soothe the mind and help sleep

   (3) Nourish the liver and kidneys, relieve Yin deficiency and excessive fire

   Taichong (LR3) - Soothe the liver and regulate Qi, relieve eye congestion and liver fire inflammation

   Zhaohai (KI6) - Nourish Yin and reduce fire, relieve dry eyes and insomnia

   Yintang (EX-HN3) - Calm the mind, relieve stress and anxiety, and improve sleep

   Note: Acupuncture method

   Operation method:

   For insomnia-related acupoints (Shenmen, Anmian, Baihui), stimulation should be light

   For liver fire and eye inflammation acupoints (Taiyang, Fengchi, Hegu, Taichong), slightly heavier manipulation can be used

   Needle retention time: 20-30 minutes, recommended 2-3 times a week, once a day in the acute stage

   Auxiliary therapy:

   Electroacupuncture: Hegu (LI4) + Taichong (LR3), enhance the effect of activating blood and clearing heat

   Cupping: Dazhui (DU14), Feishu (BL13) Cupping helps reduce fire and inflammation

   Auricular acupoints: Select liver, heart, and Shenmen acupoints to relieve emotional tension

   2. Chinese Herbs Treatments

   (1) Liver fire (heat attacks the upper body, red and swollen eyes)

   Symptoms: red and swollen eyes, pain, burning sensation, blurred vision, bitter mouth, irritability, headache, dizziness, insomnia, red tongue with yellow fur, and rapid pulse.

   Treatment: Clear the liver and purge fire, soothe the nerves and help sleep

   Chinese Prescription: LongdanXiegan Decoction with modifications

   Herbs:

   Longdancao/Gentiana 10g (clear liver fire)

   Huangqin/Scutellaria 12g (clear heat and detoxify)

   Zhizi/Gardenia 10g (clear triple burner fire)

   Zexie/Alisma 12g (purge liver and gallbladder dampness and heat)

   Che qian zi/Plantago 12g (diuretic and dampness-inducing)

   Mu tong/Akebia 9g (clear heat and relieve stranguria)

   Dang gui/Angelica 10g (nourishes blood and activates blood circulation)

   Shengdihuang/Rehmannia glutinosa 12g (cools blood and nourishes yin)

   Gancao/Licorice 6g (harmonizes medicinal properties)

   Additions and subtractions:

   Severe eye swelling → add Juhua/chrysanthemum 10g, Juemingzi/cassia seed 12g, etc.

   Red and stinging eyes → add Sangye/mulberry leaf10g, Xiaku cao/Prunella vulgaris 12g, etc.

   Dry mouth and throat → add Maidong/Ophiopogon12g, Xuan shen/Scrophularia 10g, etc.

   Insomnia and irritability → add Suanzaoren/Ziziphus jujuba seeds 15g, Baihe/lily bulbs 12g, etc.

   (2) Wind-heat attacking the eyes (exogenous wind-heat, red and swollen eyes)

   Symptoms: red and swollen eyes, pain, tears, fear of wind, slight fever, dry and sore throat, thirst, red tongue with thin yellow fur, and floating and rapid pulse.

   Treatment: dispel wind and heat, detoxify and improve eyesight

   Chinese Prescription: Yinqiao powder with modifications

   Herbs:

   Jinyinhua/Honeysuckle 12g (clears heat and detoxifies)

   Lianqiao/Forsythia suspensa 12g (dissipates heat and detoxifies)

   Sangye/Mulberry leaf 10g (dispels wind and heat)

   JuHua/Chrysanthemum 10g (clears liver and improves eyesight)

   BoHe/Mint 6g (disperses wind and dissipates heat)

   Niubangzi/Burdock seed 10g (clears heat and relieves sore throat)

   Juegeng/Platycodon 6g (expels lung qi and dissipates evil)

   Gancao/Licorice 6g (harmonizes medicinal properties)

   Additions and subtractions:

   Excessive tearing → add Fangfeng/Saposhnikovia divaricata 10g, Bai zhi/Angelica dahurica 10g, etc.

   Red and painful eyes → add Xiakucao/Prunella vulgaris 12g, Jue ming zi/Cassia seed 12g, etc.

   Insomnia and dreaminess → add 12g of Hehuanpi/Albizzia julibrissin bark, 15g of Yejiaoteng/Polygonum multiflorum, etc.

   (3) Liver and kidney yin deficiency (virtual fire ascending, dry eyes and sore eyes)

   Symptoms: dry and sore eyes, slightly red eyes, no obvious pain, blurred vision, fear of light, dizziness and tinnitus, sore waist and knees, insomnia, fever in the five parts of the body, night sweats, red tongue with little coating, and thin pulse

   Treatment method: nourish the liver and kidney, nourish yin and clear heat

   Chinese Prescription: QijuDihuang Pill with modifications

   Herbs:

   12g of Gouqizi/wolfberry (nourishes the liver and kidney)

   10g of Juhua/chrysanthemum (clears the liver and improves eyesight)

   15g of Shengdihuang/raw rehmannia (nourishes yin and clears heat)

   10g of Shanzhuyu/cornus officinalis (nourishes the liver and kidney)

   12g of Shanyao/yam (strengthens the spleen and replenishes qi)

   10g of Mudanpi/peony bark (clears virtual heat)

   12g of Zexie/oriental zedoaria (clears dampness and turbidity)

   12g of Fuling/poria (strengthens the spleen and eliminates dampness)

   Additions and subtractions:

   Sore eyes and fear of light → add Juemingzi/Cassia seed 12g, Nv zhen zi/Ligustrum lucidum 10g, etc.

   Dizziness and tinnitus → add Shudihuang/Rehmannia glutinosa 12g, He shouwu/Polygonum multiflorum 10g, etc.

   Insomnia → add Suanzaoren/Ziziphus jujuba seed 15g, Baihe/Lilium 12g, etc.

   3. External treatment

   Red,swollen,hot and painful eyes:use Juhua/chrysanthemum, Pugongying/dandelion, Sang ye/mulberry leaf decoction to wash eyes

   Dry and uncomfortable eyes: drop Gouqijuhua/wolfberry chrysanthemum water, 2-3 times a day

   Local wet compress:decoction of Huangbai/Phellodendron chinense, Pugongying/dandelion,Yejuhua/wild chrysanthemum,warm compress eyes.

   4. Lifestyle conditioning

   (1) Diet conditioning

   Avoid spicy, greasy, fried foods, and avoid helping fire to generate heat

   Eat appropriate amounts of liver-clearing and eye-improving foods, such as chrysanthemum tea, wolfberry, cassia seed, mung bean.

   Yin-nourishing foods: black sesame, lily, yam, lotus seed

   (2) Work and rest conditioning

   Keep a regular schedule and avoid staying up late, which can damage the liver and aggravate red eyes and insomnia

   Reduce long-term use of the eyes and do eye exercises

   Relax and reduce anxiety. Irritability can easily aggravate insomnia and eye symptoms

   Summary

   Acute red and swollen eyes, strong fire → choose Longdan Xiegan Decoction

   Exogenous wind-heat, red and painful eyes and tears → choose Yinqiao Powder

   Dry eyes, dull pain, yin deficiency and fire → choose Qiju Dihuang Pills

   For severe insomnia → use sour jujube seeds, cassia bark, and lily to nourish the heart and calm the mind

   Clinical cases are common in patients with liver and kidney yin deficiency, and it is common to drink alcohol to consume yin and damage the liver. If you have such symptoms, it is recommended to see a professional Chinese medicine practitioner and adjust the specific medication.