The condition known in Traditional Chinese Medicine (TCM) as “Clouds and Mists Shifting Before the Eyes” (云雾移睛) is recognized in modern medicine as floaters.
The term “Yun Wu Yi Jing” (云雾移睛) was first documented during the Ming Dynasty, it refers to an eye disorder characterized by floating shadows in the vision.
Excerpt from Zheng Zhi Zhun Sheng:
“Shifting Clouded Vision refers to the peoples perceiving external forms such as flies, snakes, banners, butterflies, or cord loops floating and fluttering in the air. The color may be dark blue, black, pale white, or light yellow. These shadows shift with eye movement. This is due to damage to the ‘original palace’ (a metaphor for essential organs), depletion of vital fluids in the meridians, and stagnation of pure qi, resulting in internal obstruction. The root cause lies in the gallbladder and kidney. Black shadows signify gallbladder-kidney disorders; white suggests phlegm-heat damaging the lungs; yellow indicates harm to the pure qi of the spleen and stomach. The pupils are governed by innate yin essence, which gathers the essence of the five zang-organs. Damage to this inner essence causes such symptoms. Those who are constitutionally weak, women post-labor with excessive blood loss, or those who grieve excessively or brood on resentment are often affected. In children, chronic malnutrition, fever, malaria, or long-term eye inflammation can deplete vital fluids and also lead to this disease. As children cannot express themselves well, symptoms may not be noticed until they grow older, at which point the condition is often irreversible.”
At times, peoples report seeing floating shadows in front of their eyes, resembling mosquitoes, flags, butterflies, or cords, drifting erratically in the air. The color of these shadows may vary:
– Black: Indicates diseases of the gallbladder and kidneys
– White: Related to phlegm-heat damaging the lungs
– Yellow: Associated with issues of the spleen and stomach
Modern Medical Perspective
In Western medicine, this condition is known as floaters. Normally, light passes through the eye’s lens and vitreous body and is projected onto the retina. If debris are present in the vitreous humor, they cast shadows on the retina, which patients perceive as floating spots or strings.
Common causes include:
- – Inflammation of the retina
– Bleeding inside the eye
– Degeneration of the retina or vitreous body
– Aging-related vitreous liquefaction - Damp-Heat or Phlegm-Damp Accumulation, Turbid Qi Rising
Damp-Heat Accumulation: Blurred vision, black shadows floating like flies. Exam shows dot-like opacities in the vitreous. Other symptoms: heavy head, chest tightness, irritability, bitter taste in the mouth, yellow tongue coating, soft rapid pulse.Spleen Deficiency with Dampness: Blurred vision, black flower-like floaters. Pallor or sallow complexion, poor appetite, abundant phlegm, fatigue. Tongue is pale and tender, coating is white, the pulse is soft
- Yin Deficiency with Hyperactive Fire, Burning the Eye Collator
Black floaters, progressive or sudden vision loss. Exam shows dot-like, cotton-wool or clumped opacities, possibly hemorrhagic lesions in the retina. Other symptoms: dizziness, tinnitus, irritability, insomnia, dry mouth and throat, red tongue with little coating, wiry thin rapid pulse. - Liver Qi Stagnation, Qi and Blood Stasis
Floaters, decreased vision, vitreous opacity with retinal venous dilation or patchy hemorrhage. Emotional depression, chest tightness, bitter taste, yellow tongue coating or tongue with dark spots, wiry or choppy pulse. - Liver and Kidney Deficiency, Essence and Blood Depletion, Eye Orifice Malnourishment
Blurred vision, short-range vision better than long, floaters, vitreous body visibly unsettled with eye movement. Other symptoms: dizziness, tinnitus, lower back soreness, seminal leakage, dry mouth and throat, weak pulse.
Clinical Presentations:
1. History of eye inflammation: Perception of floating shadows like webs or flies, moving with eye motion. Vision may be mildly to severely impaired.
2. History of intraocular bleeding: Shadows float like clouds or fluttering flags.
3. Vitreous degeneration: Snowflake-like white specks or sparkling crystal deposits in the vitreous. Liquefied vitreous increases floaters’ movement with eye motion.
Traditional Chinese Medicine Treatment Options:
1. Herbal therapy based on pattern differentiation (e.g., clearing damp-heat, nourishing yin, activating blood).
2. Acupuncture, often using liver, gallbladder, bladder, kidney, lung, stomach, and large intestine meridians. Common points include Xingjian (LV2), Fengchi (GB20), Tianzhu (BL10).
3. External therapies: Iontophoresis cum herbal injections such as Danshen (Salvia), Sanqi (Notoginseng), Honghua (Safflower), and Chuanxiong (Ligusticum).
To prevent “Shifting Clouded Vision” or floaters:
1. Maintain emotional stability; avoid excessive stress.
2. Limit overuse of the eyes; take breaks when working visually.
3. Rest adequately; avoid staying up late.
4. Avoid sports or activities that may impact the eyes.
5. Seek medical advice promptly if the number or size of floaters increases within a short range of time.
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