1. What is the name of this disease based on? What is the prognosis?

2. What are the signs and symptoms of pathogenic heat damaging qi and yin on her second visit?

3. What guidelines should we use when selecting medicinals? What should be done to prevent its recurrence?

1. This disease is named by clustered punctate nebulae on the cornea. At the onset, it is marked by tiny doted nebulae on the cornea. Light green doted nebulae on the cornea can only be seen with fluorescein staining under the slit-lamp. Over time, these star nebulae can become connected developing into dendritic, map-like or discshaped opacities. This disease has a long duration and tends to be recurrent. Once it recurs, the disease is aggravated. However, it doesn’t fester or perforate. If untreated, it can be developed into petaloid nebula with a sunken center (ulcerative keratitis) or congealed-fat nebula (purulent keratitis).

2. Afer treatment, pain, photophobia and tearing were signifcantly relieved. Her eyesight improved. Nevertheless, there was still slight yellow urine and a slightly rapid pulse indicated that pathogenic heat was not completely cleared. Other signs and symptoms included dryness and visual fatigue, dry mouth with no biter taste, a red tongue with scant liquid, which were the signs of pathogenic heat impairing qi and yin. So the treatment principles are to boost qi, nourish yin, clear heat and improve vision.

3. This disease originates from the cornea, which belongs to the liver. Therefore, medicinals that enter the liver channel, clear liver heat, scatter wind, remove nebula and improve vision are chosen. In most cases, this disease atacks people with a decreased body resistance, who are susceptible to a cold and fever. Therefore, it is suggested that they increase outdoor exercise to strengthen their constitution. When the local disease is kept under control, medicinals that enrich yin and boost qi can be used to enhance upright qi and improve the immunity to prevent its recurrence.