I. What is fundus The eye is one of the most sophisticated and complex human organs in terms of structure, consisting of the eyeball and appendages. As the name implies, the eyeball is a spherical object. What people can normally see with the naked eye is the front section, such as the black eye, the white of the eye, and other structures, while the part that cannot be seen behind is the fundus. We look at the structure of the eye, the front part of the eye has the cornea, crystal, etc., behind the vitreous, retina, choroid and blood vessels, optic nerve, macula, etc. We artificially call the cornea and lens of the eye the anterior segment, the vitreous, retina, choroid, optic nerve, etc. called the posterior segment of the eye, that is, what we usually call the fundus, these parts of the lesion is called fundus disease. The eye is a very important sensory organ in the human body, used to receive external light stimulation, and then with the help of optic nerve conduction, the impulse of light is transmitted to the brain center and cause vision. The structure of the human eye can be likened to a camera. The cornea is the most surface of the black eye, the pupil surrounded by the iris is similar to the aperture of a camera; and the iris is connected to the ciliary body and choroid, which is invisible from the front of the eye, similar to the dark box of a camera; the lens is equivalent to the lens of a camera, behind the pupil. The retina is equivalent to the film of a camera and is at the very bottom of the eye. The vitreous humor is between the lens and the retina. Light must be projected through the transparent cornea, lens, and vitreous to the retina in order to be imaged on the retina and for people to see objects. Therefore, local inflammation of the eye, trauma, vascular abnormalities, changes in blood rheology or hemodynamics, tumors, and systemic diseases, including cardiovascular diseases, endocrine diseases (diabetes, hyperthyroidism), urologic diseases (nephritis, nephrotic syndrome), hematologic diseases (aplastic anemia, leukemia, thrombocytopenic purpura), collagenous connective tissue diseases (rheumatism, rheumatoid, systemic The fundus can be caused by a variety of diseases, including rheumatism, rheumatoid, systemic lupus erythematosus, viral diseases, tuberculosis, leukoaraiosis, ankylosing spondylitis, skin diseases, and diseases of the genetic system. Fundus disease accounts for a large proportion of ophthalmic diseases, and is a common, frequent and difficult clinical disease in ophthalmology. There are many types of fundus diseases. The more common ones are diabetes, hypertension, atherosclerotic retinopathy, retinal arteriolar/venous obstruction, vitreous hemorrhage, macular degeneration, central retinal chorioretinitis, retinal perivasculitis, uveitis, optic neuritis, optic nerve atrophy, retinitis pigmentosa and other inflammatory, hemorrhagic or ischemic fundus diseases. Epidemiological data show that the prevalence of atherosclerosis in people over 60 years of age in China is as high as 80%, the prevalence of diabetes is about 2%, and the incidence of complications of diabetic retinopathy is about 35% to 50%, which is one of the four major blinding eye diseases today. If the history of diabetes is more than 20 years, 99% of type I diabetic patients and 60% of type II diabetic patients suffer from diabetic retinopathy. With the change of people’s living conditions and dietary structure and the trend of aging population, the incidence of hemorrhagic/ischemic fundus disease caused by various reasons such as hypertension, atherosclerosis and diabetes is on the rise in China. Clinical manifestations and diagnosis of fundus diseases As mentioned above, there are many types of fundus diseases with complex causes and various clinical manifestations. However, the ocular manifestation of most fundus diseases is the normal appearance of the eye but visual dysfunction, which can have different degrees of vision loss or night blindness, visual field defects, black shadows in front of the eyes, flashing sensation, visual distortion or small size, etc. In severe cases, only manual or light sensation may exist, or even blindness, which directly affects the quality of life and work ability. Hemorrhage, exudation, edema, atrophy, hyperpigmentation, proliferation and mechanization, neovascularization, retinal or choroidal detachment and other signs may appear in the fundus of the eye. In addition to local manifestations of the eye, associated systemic manifestations such as diabetes, hypertension, hyperlipidemia, hyperthyroidism, rheumatoid arthritis, rheumatoid, Leukocerebrovascular syndrome, multiple sclerosis, ankylosing spondylitis, hematologic diseases, nephropathy, and other systemic diseases may be seen. The diagnosis of fundus disease requires routine tests such as visual function tests, slit lamp and fundoscopy, and if necessary, fundus fluorescence imaging, visual field meter, ocular electrophysiology, ocular ultrasound and CT/magnetic resonance, as well as blood tests and other ancillary tests. Therefore, when people find that their eyes have some of the above symptoms, they should go to the ophthalmology department of a regular hospital in time to avoid misdiagnosis or miss the best time for treatment. Western medicine is limited to symptomatic treatment and treatment of the primary cause of fundus disease. For example, patients with diabetic or hypertensive retinopathy, retinal vein occlusion, retinal perivasculitis and other fundus hemorrhages are first required to rest in bed, avoid activities and mental tension, and do a good job of controlling blood pressure and blood sugar. In the early stage, hemostatic agents are used as the main treatment, and fibrinolytic agents and anti-platelet aggregation agents are used after the hemorrhage is stopped to promote the absorption of the stagnant blood, and laser photocoagulation and botoxical treatment are taken when necessary for cases with neovascularization or proliferative lesions and other complications. However, they are far from ideal for restoring vision. For ischemic fundus disease, such as ischemic optic neuropathy, retinal artery blockage, etc., we can only treat the primary cause symptomatically, such as anti-inflammatory, lipid-lowering, vasodilatation, nerve nutrition or surgical treatment, which is limited by the timing and indications of treatment, the long-term effect is poor, and the effect on improving visual function is not ideal. Optic nerve atrophy and retinitis pigmentosa used to be considered incurable by Western medicine. In recent years, some people are exploring the feasibility of retinal transplantation and electronic eye technology, which are still in the experimental research stage. For uveitis, optic neuritis, retinitis and other fundus diseases related to infection and autoimmunity, non-specific therapies such as local pupil dilatation, hormonal or non-hormonal anti-inflammatory agent eye spot treatment, and systemic application of hormones, immunosuppressants, antibiotics treatment are mostly used, which have certain clinical efficacy but also bring many serious side effects. In particular, uveitis, which is not only one of the most frequent eye diseases and important blinding eye diseases in the northern region, but also tricky to treat and difficult to heal, is often treated with corticosteroid drugs, which can achieve certain efficacy, but there is a hormonal “rebound” after stopping the drug, resulting in recurrent disease characteristics, and long-term application will produce more obvious side effects, such as Hormonal glaucoma and cataract, hypokalemia and hypertension, stress ulcers, adrenal cortical dysfunction… etc. are some of the complications of long-term application. Therefore, it has become an important topic of research in the field of TCM ophthalmology to try to find effective methods for the treatment of difficult fundus diseases from the perspective of TCM to make up for the shortcomings of Western medicine drug therapy. V. Methods and advantages of TCM in treating fundus diseases The basic characteristics of TCM are holistic concept and evidence-based treatment, and TCM ophthalmology is an important treasure in the treasury of TCM, and fundus diseases belong to the category of “pupillary diseases” in TCM ophthalmology. The modern ophthalmology of TCM has taken advantage of the strengths and weaknesses of modern ophthalmology to diagnose more clearly and treat more specifically. The improvement of modern ophthalmology examination and diagnosis technology has led to a change in the clinical thinking pattern of TCM ophthalmology and enriched the clinical treatment methods. The dual diagnosis mode of diagnosis and identification, which is widely used in Chinese medicine today, incorporates the focal changes of fundus lesions into the scope of identification, so that fundus lesions can be seen under the fundoscope or other instruments as if they were external eye diseases, and retinal edema, exudation, hemorrhage, and vascular morphological changes and even functional status can be seen at a glance. According to the relationship between the eye and the internal organs, meridians, qi and blood, the patient’s body condition, and individual differences, the corresponding treatment rules and methods can be formulated according to the individual, local and seasonal conditions, “treating the symptoms when it is urgent”, “treating the root when it is slow”, or “treating both the symptoms and the root when it is slow”. “We use Chinese medicine, external application, acupuncture (eye, ear, head and body acupuncture), massage and physical therapy to clear heat and detoxify, dispel wind and dampness, dredge liver and qi, stop bleeding and stasis, open the meridians, soften hardness and disperse knots, benefit qi and nourish blood, nourish liver and kidney, nourish yin and lower fire, and open the orifices and brighten the eyes. It also has the functions of tonifying the orifices and brightening the eyes. The treatment of evidence-based therapy includes two aspects: supporting the righteousness and eliminating the evil and adjusting the state of the body, which is a comprehensive treatment method; the treatment method for the cause and the main link of the disease is specific treatment; the treatment for the patient’s pain is symptomatic treatment, and these three complement each other, playing a complementary role and combination effect, correcting the toxic side effects of other drugs or therapies, and achieving the best comprehensive therapeutic effect. Clinical practice proves that TCM treatment of hemorrhagic fundus has the advantages of stopping bleeding without leaving stasis, removing stasis without injuring the righteousness, delaying the formation of proliferative lesions, reducing the damage of laser treatment to the fundus, and avoiding the recurrence of bleeding; acupuncture combined with TCM treatment of ischemic fundus is unique, with the advantages of anti-inflammatory, sedative, antispasmodic, tonifying qi and nourishing blood, adjusting yin and yang, activating blood circulation and removing stasis, regulating immune function, improving microcirculation, enhancing It has specific clinical significance in maintaining and improving visual acuity, expanding the range of visual field, improving the condition, and stopping disease progression. For inflammatory fundus diseases, TCM therapies not only have precise antibacterial and anti-inflammatory and antiviral effects, but also have similar effects to hormones, immunomodulators and immunosuppressants, which can reduce the dosage of these western drugs and their toxic side effects. In summary, Chinese medicine has unique advantages in the treatment of fundus disease, and the combination of Chinese and Western medicine can effectively make up for the shortcomings of Western medicine treatment and improve the comprehensive clinical efficacy of fundus disease.