Allergic reactions caused by local contact of certain allergens with the eyelid are contact dermatitis, which is an allergic or irritating irritant reaction of the eyelid skin to the causative agent or chemical. Allergy-induced contact dermatitis is an immune reaction of the eyelid skin to the allergy, with itching being the main cause; irritation-induced contact dermatitis is a non-immune reaction of the skin to the chemical. It is characterized by a burning or irritation sensation. Etiology (1) Allergic reactions: Drugs are common allergens: including antibiotics, antivirals, surface anesthetics, atropine, mercury, iodine, trichothecene, sulfonamides, etc., and various chemicals that the eyelid skin is exposed to, such as eyeglass frames, cosmetics, hair dyes, aerosols, etc. (2) Local chronic irritation: chronic conjunctivitis, chronic dacryocystitis, lid ectropion, etc. The eyelid skin is inflamed by long-term chronic irritation from tears or secretions. Clinical manifestations: itching or burning sensation of the eyelid skin. In the acute phase, the eyelids are red and swollen with lesions that take various forms, including erythema, papules, blisters, exudation, and soon vesicles and crusts, with rough and scabbed and flaky skin. Some may be accompanied by conjunctival congestion, edema, and light punctate staining of the cornea. The subacute phase is slow and often prolonged, but after the acute and subacute phases are not healed, the skin of the eyelids becomes chronic, rough and mossy, often accompanied by desquamation. Treatment (1) Remove the cause. Discontinue medications immediately. Avoid exposure to external irritants. If multiple drugs are being used at the same time and it is not certain which drug is causing the allergy, discontinue the suspected drug if possible. Chronic dacryocystitis, lid ectropion, etc. should be treated surgically. (2) In the acute stage, saline or 3% boric acid solution can be used as a cold compress 4 to 6 times/day. Itching attacks are often related to the increase in temperature, and cold compresses with wet towels can lower the body surface temperature and reduce congestion for the purpose of relieving itching. (3) After the control of acute inflammation, the skin involved rough, flaky people can use glucocorticoid eye ointment or hydrocortisone butyrate ointment to rub the affected area, 2 to 3 times, with 3 to 5 days, should not be used for a long time. (4) For those with combined allergic conjunctivitis, antihistamine eye drops: 0.1% Olopatadine eye drops or Imodium fumarate eye drops. (5) For severe eyelid itching, oral antihistamines such as Benadryl, Pulverizine, and Emedastine can be used. Chinese medicine treatment This is an ophthalmologic disease in which the eyelid skin is red, swollen and painful, with papules and small blisters, followed by ulceration. It belongs to the category of wind and red sores in Chinese medicine. The name of this disease is derived from the book “Secret Ophthalmology Longmu Lun? The name of the disease originates from the “Treatise on Wind and Red Sores and External Disorders”. (1) Wind-heat in the spleen: red, swollen, itchy, burning, blistering skin on the eyelids; or accompanied by fever; red tongue with thin yellow coating and floating pulse. Treatment: Removing wind and clearing the spleen. (2) Wind-damp-heat poisoning: eyelid redness, swelling, pain, blistering, itching, or even breaking and flowing water, erosion; or with chest tightness and dullness. The tongue is red with a yellowish coating, and the pulse is slippery. Treatment: Expel wind and eliminate dampness, and remove fire and detoxification. (3) Blood deficiency and wind: rough skin on eyelids, itchy and flaky eyes, dry and scratchy, recurrent attacks, dizziness, light red tongue with thin white fur, thin pulse. Treatment: Nourish blood to dispel wind, moisten dryness and relieve itching. The formula: Jing Fang Siwu Tang plus or minus: Angelica sinensis 10g red peony 10g raw licorice 10g Chuanxiong 3g Xuan Shen 10g thornbush 10g Fang Feng 10g cicada 6g Tribulus terrestris 10g licorice 3g. If the eyes are itchy and dandruffy, add Sclerococcus sinensis and Qiang Wu to dispel wind and relieve itching. Topical application of Chinese herbs (1) for those with more wet and rotten skin oozing from the eyelids. 10g of Diyu or 10g of Huanglian, decoction, cold wet compress. (2) Radix et Rhizoma Dioscoreae 10g, Ginseng 10g, Serpentine 10g, Horsetail 10g, decoction, cold and wet compress. Experience of famous doctors Edited by Xiao Guoshi. Xiao Guoshi’s Academic Experience in Ophthalmology. Beijing. Chinese medicine treats this disease mostly from wind-heat or damp-heat, and ancient physicians prefer to use Nei Shu Huang Lian Tang or Jing Fang Defeat Poison San with an addition, to remove wind-heat and clear damp-heat, then the swelling and itching can be stopped. The author’s observation is that this disease is mostly caused by internal heat, and can be treated with the option of adding and subtracting heat-dissipating and disinfecting drinks (Note: Burdock, Qiangwu, Scutellaria, Chuanlian, Peppermint, Fenghuang, and Lianxiao), and adding dahurica dahurica, Manzanita, Jin Yinhua, Zingiber officinale, and bitter ginseng to dispel wind-dampness and clear heat and detoxify toxins. If the eyelid is swollen and itchy, you can add dahurica, tribulus terrestris, cicada, phyllanthus and ochre to dispel wind and anti-allergy. For allergic ophthalmopathy and eyelid cryptomeria dermatitis, the treatment is mostly based on wind-heat or heat toxicity, or the use of Jing Fang Defeat Poison San (Note: Thornbush Spike, Fang Feng, Qiang Wu, Dushu, Qian Hu, Chai Hu, Citrus Aurantium, Mandarin, Poria, Chuanxiong, Ginseng, Licorice, Peppermint or Ginger) or Pu Ji Disinfectant Drink (Note: Huang Lian, Scutellaria, Chen Pi, Licorice, Xuan Shen, Chai Hu, Mandarin, Lian Qiao, Pan Lan Gen, Mab, Niu Zi, Peppermint, Stiffy, Sheng Ma) Add reduction to treat. If the wind-heat is cleared and the heat toxin is resolved, the swelling and itching of the eyelids can be stopped. If the eyelid is severely wet and rotten, it can be treated with Fangfengtongsheng San (Note: Fangfeng, Bai Shao, Ephedra, Sheng Shiyang, Slippery Rock, Chuanxiong, Rhubarb, Forsythia, Licorice, Angelica, Peppermint, Mangosteen, Radix Platycodon grandiflorus, Thornbush, Gardenia, Atractylodes, Scutellaria), which can be healed with several doses.