Dry Eye Disease and Acupuncture
Dry eye disease (DED) is a common ocular surface disorder marked by inadequate tear quantity or quality. Two main types are recognized: aqueous-deficient dry eye (reduced lacrimal gland output, as seen in conditions like Sjögren’s syndrome) and evaporative dry eye (often related to meibomian gland dysfunction), though many patients have mixed disease. Symptoms include burning, grittiness, fluctuating vision, photophobia, eye fatigue, and sometimes paradoxical tearing. Daily activities such as reading, computer work, driving, and contact lens wear can be significantly affected. Standard therapies—artificial tears, lid hygiene and warm compresses, environmental adjustments, prescription drops like cyclosporine or lifitegrast, punctal plugs, and in-office procedures—help many but not all, and benefits can be modest or slow to develop. Understanding where acupuncture may fit can help patients and clinicians consider a complementary pathway. In traditional Chinese medicine (TCM), dry eye is often framed as a combination of Yin deficiency (commonly Liver and Kidney), internal heat or wind-heat affecting the eyes, and impaired fluid distribution by the Lung and Spleen. Acupuncture treatments typically aim to nourish Yin and blood, clear heat, and harmonize qi circulation to improve ocular lubrication and comfort. Protocols often include local points around the eye (such as BL1/Jingming, ST1/Chengqi, GB14/Yangbai, and Taiyang) combined with distal points to regulate systemic patterns (e.g., LI4/Hegu, LV3/Taichong, KI3/Taixi, SP6/Sanyinjiao, ST36/Zusanli). A course of care commonly targets symptom relief, improved tear film stability, and reduced ocular surface inflammation. Clinical evidence suggests acupuncture may improve symptoms and some objective signs compared with artificial tears or sham in the short term, including better tear break-up time (TBUT), Schirmer test values, and lower symptom scores (e.g., OSDI). Meta-analyses report positive effects but also note key
Updated April 4, 2026This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or medication regimen.
Medical Perspectives
Two Ways of Seeing Health
Western
scientific · clinical
Western medicine applies science, technology, and clinical experience to treat symptoms through testing, diagnosis, and targeted intervention.
Surgeons · Pharmaceuticals · Clinical trials · Diagnostics 
Eastern
traditional · alternative
Eastern medicine focuses on treating the body naturally by applying traditional knowledge practiced for thousands of years, emphasizing balance and whole-person wellness.
Acupuncture · Herbal medicine · Yoga · Meditation
Gold Bamboo presents both perspectives side-by-side so you can make informed decisions. We don't advocate for one over the other — your health choices are yours.
Two Ways of Seeing Health
Western
scientific · clinical
Western medicine applies science, technology, and clinical experience to treat symptoms through testing, diagnosis, and targeted intervention.
Eastern
traditional · alternative
Eastern medicine focuses on treating the body naturally by applying traditional knowledge practiced for thousands of years, emphasizing balance and whole-person wellness.
Gold Bamboo presents both perspectives side-by-side so you can make informed decisions. We don't advocate for one over the other — your health choices are yours.
Western Perspective
From a western clinical standpoint, acupuncture is viewed as an adjunctive option for dry eye disease (DED) when conventional therapies provide incomplete relief. Evidence from randomized trials and meta-analyses suggests short-term improvements in symptoms and tear film metrics, but study heterogeneity, small sample sizes, and blinding challenges temper confidence. It is not a first-line standard in major guidelines, yet may be reasonable for selected patients as part of multimodal care.
Key Insights
- DED includes aqueous-deficient and evaporative subtypes with inflammation and neural dysregulation playing central roles.
- Several RCTs and meta-analyses report improvements in OSDI scores, TBUT, and Schirmer values with acupuncture versus artificial tears or sham, though effect sizes vary.
- Methodological limitations include heterogeneous point protocols, variable session schedules, short follow-up, and risk of bias from inadequate masking.
- Biologic hypotheses include autonomic modulation of lacrimal secretion, anti-inflammatory effects (reduced tear cytokines), and neurosensory pathway modulation.
Treatments
- Conventional DED care: artificial tears, lid hygiene/warm compresses, environmental/behavioral adjustments
- Anti-inflammatory drops (e.g., cyclosporine, lifitegrast) and short courses of topical steroids when indicated
- Procedures for meibomian gland dysfunction and punctal occlusion when appropriate
- Adjunctive acupuncture for persistent symptoms under shared decision-making
Deep Dive
Dry eye disease (DED) is a multifactorial condition of the ocular surface characterized by tear film instability, hyperosmolarity, inflammation,... Dry eye disease (DED) is a multifactorial condition of the ocular surface characterized by tear film instability, hyperosmolarity, inflammation, and nociceptive change. Conventional care targets these factors through lubricants, eyelid hygiene and thermal therapy, environmental and behavioral strategies, and anti-inflammatory agents such as cyclosporine or lifitegrast; procedural interventions address meibomian gland dysfunction and tear drainage. Despite this toolbox, many patients report residual symptoms, prompting interest in complementary modalities like acupuncture. Randomized trials and meta-analyses suggest acupuncture can produce short-term improvements in validated symptom scores (e.g., OSDI), tear break-up time, and sometimes Schirmer values when compared with artificial tears or sham. However, methodological concerns limit certainty: protocols vary in point selection and frequency, masking is challenging, and sample sizes are often small with short follow-up. As such, major western guidelines do not endorse acupuncture as first-line therapy but consider it a potential adjunct within shared decision-making, especially for patients with persistent discomfort despite standard care. Proposed mechanisms span autonomic and inflammatory pathways. Acupuncture may increase parasympathetic output to the lacrimal functional unit, potentially improving aqueous secretion. It may also reduce proinflammatory cytokines on the ocular surface and influence neurosensory processing, which is relevant for patients with neuropathic-like ocular pain. Stabilization of the tear film, whether via improved glandular output or reduced blink-related instability, has been reported in some studies. These hypotheses remain under investigation; larger, well-controlled trials with standardized outcomes and longer follow-up are needed to define who benefits most and how durable the effects are. Clinically, acupuncture can be discussed as part of a multimodal regimen. Safety is generally favorable in trained hands, with minor bruising or transient soreness most common; needling near the orbit requires advanced skill. Best practice includes continuing indicated ophthalmic therapies while monitoring objective signs and patient-reported outcomes to gauge added value.
Sources
- Craig JP et al. TFOS DEWS II Definition and Classification. Ocul Surf. 2017.
- Jones L et al. TFOS DEWS II Management and Therapy. Ocul Surf. 2017.
- Lee MS, Shin BC, Choi TY, Ernst E. Acupuncture for treating dry eye: a systematic review. Acta Ophthalmol. 2011.
- Yang A et al. Acupuncture for dry eye: systematic review/meta-analysis of RCTs. Complement Ther Med. 2018.
- American Academy of Ophthalmology. Dry Eye Disease PPP. 2023.
Eastern Perspective
In TCM, the eye reflects the health of the Liver system and is nourished by Kidney Yin and essence. Dryness and visual discomfort commonly arise from Liver and Kidney Yin deficiency with heat, sometimes compounded by Spleen qi deficiency failing to transform fluids, or wind-heat disturbing the ocular surface. Acupuncture is used to nourish Yin and blood, clear heat, course wind, and restore the smooth flow of qi and fluids to the eyes.
Key Insights
- Pattern differentiation guides care: common patterns include Liver-Kidney Yin deficiency, wind-heat, and qi-blood insufficiency.
- Local and distal points are combined to address both ocular symptoms and systemic disharmony.
- Adjunctive methods (e.g., moxibustion in deficiency patterns) and lifestyle guidance (rest for the eyes, diet supporting Yin/fluids) are often included.
- Improvement is expected to unfold over weeks as systemic balance is restored rather than as an immediate topical effect.
Treatments
- Acupuncture points often used: BL1 (Jingming), ST1 (Chengqi), GB14 (Yangbai), Taiyang (Extra), LI4 (Hegu), LV3 (Taichong), KI3 (Taixi), SP6 (Sanyinjiao), ST36 (Zusanli), SJ23 (Sizhukong)
- Electroacupuncture in select cases to strengthen stimulation while avoiding direct ocular risk
- Moxibustion for cold-deficiency presentations (with care to avoid eye irritation)
- Herbal support (separately prescribed) such as Qi Ju Di Huang Wan or Ming Mu Di Huang Wan in Yin-deficient patterns
Deep Dive
Within traditional Chinese medicine (TCM), the eye is closely linked to the Liver, which stores blood and opens to the eyes, and to the Kidney, ... Within traditional Chinese medicine (TCM), the eye is closely linked to the Liver, which stores blood and opens to the eyes, and to the Kidney, which provides Yin and essence to nourish ocular tissues. Dryness, burning, and visual fatigue often indicate Liver–Kidney Yin deficiency with relative heat; wind-heat and Spleen or Lung dysfunction may also contribute to impaired fluid distribution. Treatment therefore aims not only at local symptom relief but at restoring systemic harmony to produce and circulate nourishing fluids to the eyes. A typical acupuncture plan combines periocular points, chosen to clear heat, brighten the eyes, and ease discomfort, with distal points that tonify Yin and blood and regulate qi. Common selections include BL1 (Jingming), ST1 (Chengqi), GB14 (Yangbai), and the extra point Taiyang locally, together with LI4 (Hegu) and LV3 (Taichong) to move qi and dispel wind-heat, and KI3 (Taixi), SP6 (Sanyinjiao), and ST36 (Zusanli) to support Kidney and Spleen and generate fluids. In deficiency patterns, gentle techniques and, in some cases, moxibustion may be used. Over a course of visits, the goals are to reduce heat and irritation, improve ocular comfort and moisture, and address systemic factors such as sleep, diet, and stress that further deplete Yin. TCM clinicians observe that improvements often build gradually over several weeks, with symptom relief preceding more stable tear film performance. For patients with post-surgical or screen-related eye strain, pattern differentiation might emphasize wind-heat and Liver qi constraint, while for autoimmune sicca (e.g., Sjögren’s) the focus leans toward nourishing Yin and gently regulating immunity in collaboration with biomedical care. Herbs may be considered separately when appropriate (for example, formulas like Qi Ju Di Huang Wan in Yin deficiency), though acupuncture alone is frequently applied when minimizing ocular surface exposure is preferred. Throughout, the TCM approach complements, rather than replaces, conventional ophthalmic treatment, with the shared aim of comfort, function, and protection of the ocular surface.
Sources
- Deadman P, Al-Khafaji M, Baker K. A Manual of Acupuncture. 2nd ed.
- Chinese Medicine Ophthalmology texts on Liver-Kidney Yin deficiency and ocular dryness.
- World Health Organization. Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials. 2002.
Evidence Ratings
Acupuncture improves dry eye symptoms (e.g., OSDI scores) more than artificial tears in the short term.
Yang A et al. Complement Ther Med. 2018; systematic review/meta-analysis.
Acupuncture increases tear film stability (TBUT) compared with control/sham in several RCTs.
Lee MS et al. Acta Ophthalmol. 2011; systematic review.
Objective tear secretion (Schirmer test) may increase after acupuncture, but findings are inconsistent across trials.
Mixed RCT results summarized in meta-analyses (Lee 2011; Yang 2018).
Acupuncture may reduce ocular surface inflammation as reflected by lower tear cytokines.
Small mechanistic studies measuring tear IL-1β/IL-6/TNF-α after acupuncture.
Acupuncture is generally safe with mostly minor, transient adverse effects when performed by trained practitioners.
MacPherson H et al. Acupunct Med. 2011; large safety cohort; White A et al. BMJ. 2001.
Major ophthalmology guidelines do not list acupuncture as first-line therapy for DED.
American Academy of Ophthalmology. Dry Eye Disease PPP. 2023; TFOS DEWS II. 2017.
Autonomic modulation of lacrimal gland function is a plausible mechanism for acupuncture’s effects in DED.
Preclinical and human physiologic studies of acupuncture’s effects on autonomic tone.
Sources
- Craig JP et al. TFOS DEWS II Definition and Classification. The Ocular Surface. 2017.
- Jones L et al. TFOS DEWS II Management and Therapy. The Ocular Surface. 2017.
- American Academy of Ophthalmology. Dry Eye Disease Preferred Practice Pattern. 2023.
- Lee MS, Shin BC, Choi TY, Ernst E. Acupuncture for treating dry eye: a systematic review. Acta Ophthalmol. 2011.
- Yang A et al. Acupuncture for dry eye: systematic review and meta-analysis of randomized trials. Complement Ther Med. 2018.
- MacPherson H et al. Adverse events following acupuncture: a prospective survey of 32,000 treatments. Acupunct Med. 2011.
- White A et al. Adverse events following acupuncture: prospective survey of 34,000 consultations. BMJ. 2001.
- TFOS DEWS II Pain and Sensation report; Belmonte C et al. The Ocular Surface. 2017.
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Health Disclaimer
This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or medication regimen.