Acute Optic Neuritis
Acute optic neuritis refers broadly to inflammatory conditions affecting the optic nerve. These include infectious and immune-mediated diseases of the optic nerve, as well as demyelinating diseases of the central nervous system; it may therefore also be called inflammatory optic neuropathy. In TCM, this condition falls within the category of “sudden blindness due to disorders of the ocular system” (目系暴盲).
TCM Pattern Differentiation and Formula Reference
|Common Symptoms
Clinical description:
A sudden drop in vision; a dull ache behind the eye or a feeling of pressure and pain in the eye. Funduscopic examination may show a congested, swollen optic disc with indistinct margins; dilated, tortuous retinal veins that appear purplish-red; edema, exudates, or hemorrhages around the optic disc; or no funduscopic abnormalities. Systemic symptoms may include a distended feeling in the head, tinnitus, pain in the flanks, and a bitter taste in the mouth. The tongue is red with a yellow coating, and the pulse is wiry and rapid.
In plain language:
- Vision suddenly becomes much worse, with objects appearing far blurrier.
- A dull ache or pressure-like pain is felt behind the eye.
- The optic disc at the back of the eye is congested and swollen, with indistinct margins.
- The retinal veins are dilated and tortuous, and look purplish-red.
- There may be swelling, exudates, and hemorrhages around the optic nerve, or no obvious abnormalities on examination.
- A feeling of fullness in the head accompanied by tinnitus.
- Pain along the ribs and a bitter taste in the mouth.
- The tongue appears somewhat red.
- The tongue coating is yellow.
- The pulse feels tense and somewhat rapid.
|Treatment Approach
Clinical description:
Clear the Liver and drain heat; cool the blood and dispel blood stasis.
In plain language:
- In TCM terms, reduce Liver heat to ease internal-heat discomforts such as red eyes, a bitter taste in the mouth, flank fullness, and irritability.
- Cool the blood to ease facial flushing, restlessness, and a sensation of heat.
- Promote blood flow and address stasis to ease stabbing or distending pain and purplish discoloration.
|Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
A rapid decline in vision, sometimes progressing to blindness, with pressure-like pain in the eye or pain on eye movement. Funduscopic examination may show a congested, swollen optic disc with indistinct margins; dilated, tortuous retinal veins that appear purplish-red; edema, exudates, or hemorrhages around the optic disc; or no funduscopic abnormalities. Other symptoms may include low mood, irregular menstruation, frequent sighing, chest and flank pain, dizziness, a distending sensation in the eyes, a bitter taste in the mouth, and a dry throat. The tongue is dark red with a thin white coating, and the pulse is wiry and thready.
In plain language:
- Vision suddenly drops sharply and, in severe cases, may be completely lost.
- The eye feels pressured and painful, or hurts when moved.
- The optic disc at the back of the eye is congested and swollen, with indistinct margins.
- The retinal veins are dilated and tortuous, and look purplish-red.
- There may be swelling, exudates, and hemorrhages around the optic nerve, or no obvious abnormalities on examination.
- Low or suppressed mood, with a tendency to sigh.
- Irregular menstrual cycles or flow.
- Discomfort or pain in the chest and ribs.
- Dizziness and a feeling of pressure in the eyes.
- A bitter taste in the mouth and a dry throat.
- The tongue appears somewhat dark red.
- The tongue coating is thin and white.
- The pulse feels tense and thready.
|Treatment Approach
Clinical description:
Soothe the Liver and relieve constraint; regulate qi and invigorate blood.
In plain language:
- Relieve constrained Liver qi to ease fullness and tightness in the chest and flanks, frequent sighing, and low mood.
- Help qi flow smoothly to ease abdominal bloating, belching, and feelings of blockage or tightness.
- Promote blood flow and address stasis to ease stabbing or distending pain and purplish discoloration.
|Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
A sudden drop in vision; a dull ache behind the eye or a feeling of pressure and pain in the eye. Funduscopic examination may show a congested, swollen optic disc with indistinct margins; dilated, tortuous retinal veins that appear purplish-red; edema, exudates, or hemorrhages around the optic disc; or no funduscopic abnormalities. Systemic symptoms may include dizziness, heat in the palms, soles, and chest, flushed cheeks and lips, and dry mouth. The tongue is red with a scanty coating, and the pulse is thready and rapid.
In plain language:
- Vision suddenly declines, and objects appear very blurry.
- A dull ache or pressure-like pain behind the eye.
- The optic disc at the back of the eye is congested and swollen, with indistinct margins.
- The veins at the back of the eye appear enlarged and winding, with a purplish-red color.
- There may be swelling, exudates, and hemorrhages around the optic nerve, or no obvious abnormalities on examination.
- Dizziness or lightheadedness.
- A restless feeling of heat in the palms, soles, and chest.
- Flushed cheeks and reddish lips.
- Dry mouth and a desire to drink.
- The tongue appears somewhat red.
- The tongue coating is very scanty or almost absent.
- The pulse feels thready and rapid.
|Treatment Approach
Clinical description:
Nourish yin and reduce fire; invigorate blood and dispel blood stasis.
In plain language:
- In TCM terms, replenish fluids and provide internal nourishment while reducing internal heat, to ease dry mouth and throat, tidal fever, night sweats, restlessness, and a tendency to feel hot.
- Promote the smooth flow of blood and address stasis to ease stabbing or distending pain and purplish discoloration, supporting smoother circulation.
|Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Long-standing illness and physical weakness, substantial blood loss, or onset during the postpartum breastfeeding period, with blurred vision. Other signs may include a pale, dull, or sallow complexion; pale nails and lips; shortness of breath, little desire to speak, fatigue, and lack of energy. The tongue is pale with a thin white coating, and the pulse is thready and weak.
In plain language:
- Blurred vision after a long illness with physical weakness, significant blood loss, or onset during the postpartum breastfeeding period.
- The complexion is pale and dull, or yellowish and lacking color.
- The nails and lips appear pale.
- Shortness of breath, little desire to speak, easy fatigue, and low energy.
- The tongue appears somewhat pale.
- The tongue coating is thin and white.
- The pulse feels thready and weak.
|Treatment Approach
Clinical description:
Tonify qi and nourish blood; unblock the vessels and open the orifices.
In plain language:
- Support energy and stamina to ease shortness of breath, weakness, dizziness, and palpitations.
- Support blood nourishment to address a pale complexion and cold hands and feet.
- Promote circulation through the vessels to gradually ease numbness, stiffness, and stabbing pain.
- Support alertness and responsiveness, and clarity of vision and hearing.
|Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
References
- Jin Ming. Annotations to the Guidelines for Clinical Diagnosis and Treatment in Traditional Chinese Medicine: Ophthalmic Diseases [M]. Beijing: China Press of Traditional Chinese Medicine, 2015: 107–108.
- Jin Ming. Clinical Rational Use of Chinese Patent Medicines for Common Diseases: Ophthalmology [M]. Beijing: Huaxia Publishing House, 2015: 120–158.
- Ouyang Yun, Cao Shuxia, Zhang Jian. Experience with the clinical application of Long Dan Xie Gan Tang in ophthalmology [J]. Journal of Liaoning University of Traditional Chinese Medicine, 2009, 11(10): 122–123.
- Liu Hong. Clinical observation of integrated traditional Chinese and Western medicine treatment for 74 cases of optic neuritis [J]. Chinese Journal of Ophthalmology in Chinese Medicine, 2012(5): 346.