1. Clinical Definition & Etiology
Myopia is a common ametropia presenting with normal external ocular appearance, impaired distance vision and intact near vision. Classified under traditional East Asian medicine as near-sight disorder, this condition is primarily caused by axial elongation of the eyeball.
The development of axial lengthening is closely linked to genetic predisposition, physical constitution, and daily visual environments. Adolescents are the high-risk group, with major risk factors including improper eye use: reading or writing at a distance less than 20 cm, watching television or playing electronic games within 1 meter, prolonged reading, drawing or writing in dim lighting, and poor daily eye care habits.
Excessive strain on the eye’s accommodation and convergence systems elevates intraocular pressure persistently. Long-term pressure changes gradually stretch the ocular axis and induce myopia, which is widely referred to as school myopia among children and teenagers.
2. Diagnostic Criteria & Clinical Manifestations
The hallmark clinical signs are functional reduction of distant visual acuity, preserved near visual function, and no visible external ocular lesions. Visual impairment correlates directly with the degree of myopia, graded by diopter (D) as follows:
- Mild myopia: Less than 3 diopters
- Moderate myopia: 3 to 6 diopters
- High myopia: More than 6 diopters
Patients with high myopia often habitually narrow the palpebral fissure when viewing distant objects. Partial closure of the upper and lower eyelids blocks peripheral light and restricts light entry to the central cornea, which optimizes retinal imaging and temporarily improves blurred distance vision.
Moderate and high myopia patients frequently develop muscular asthenopia, triggered by incoordination between ocular convergence and accommodation. Individuals with severe myopia or significant anisometropia are also at higher risk of exotropia.
Fundus Ocular Changes
Pathological fundus lesions are typical in high myopia, including temporal crescent of the optic disc and tessellated fundus. Progressive conditions may lead to retinal degeneration, macular hemorrhage, vitreous opacification and retinal detachment. These complications further aggravate visual loss and visual field defects.
3. Standard Acupuncture Intervention
All acupoints follow WHO Standard Acupuncture Point Nomenclature. Needle specifications, insertion depth and manipulation comply with international clinical acupuncture standards.
Note: Traditional Chinese “cun” is converted to millimeters (mm) per WHO measurement standards.
3.1 Acupoint Selection & Needling Technique
- BL 1 (Jingming) – Bilateral
- Location: Depression slightly superior to the medial canthus.
- Instrument: 2 pieces of size 30 filiform needles, 38 mm in length.
- Procedure: Perform standard skin disinfection. Gently displace the eyeball upward and outward, then insert the needle perpendicularly to a depth of approximately 35.6 mm.
- Sensation: Distending and aching sensation around the orbital cavity and intraocular region.
- ST 1 (Chengqi) – Bilateral
- Location: Between the inferior orbital rim and eyeball, directly below the pupil with eyes in primary gaze.
- Instrument: 2 pieces of size 30 filiform needles, 38 mm in length.
- Procedure: Perform standard skin disinfection. Gently lift the eyeball upward, then insert the needle perpendicularly to a depth of approximately 35.6 mm.
- Sensation: Distending pain within the orbital cavity.
- EX-HN 14 (Shangming) – Bilateral
- Location: Midpoint of the eyebrow, between the superior orbital rim and eyeball.
- Instrument: 2 pieces of size 30 filiform needles, 38 mm in length.
- Procedure: Perform standard skin disinfection. Gently displace the eyeball downward, then insert the needle perpendicularly to a depth of approximately 35.6 mm.
- Sensation: Fullness and distending heaviness inside the orbit.
- GB 20 (Fengchi) – Bilateral
- Location: Bilateral depression at the junction of the upper trapezius and sternocleidomastoid muscles, level with GV 16.
- Instrument: 2 pieces of size 30 filiform needles, 50 mm in length.
- Procedure: Perform standard skin disinfection. Direct the needle toward the vertebral column and insert perpendicularly to a depth of approximately 45.7 mm.
- Sensation: Local distending pain, or radiating soreness extending to the ipsilateral occiput.
3.2 Treatment Protocol
Patients remain in a seated position throughout the session. Needles are inserted to the specified depth and retained for 40 minutes. A gentle twirling manipulation is applied once during retention.
- Treatment frequency: One session every other day
- Treatment course: 10 sessions per full course
- Interval: A 3-day rest period between consecutive courses
4. Clinical Outcomes & Recommendations
Acupuncture delivers the most prominent therapeutic effect for mild myopia. Most patients with baseline visual acuity above 0.6 (4.8 on logarithmic scale) can achieve visual acuity of approximately 1.0 (5.0 on logarithmic scale) after 3 full treatment courses.
Moderate myopia also responds to acupuncture, though longer treatment cycles are required. Visual acuity may decline gradually after treatment discontinuation, yet the overall visual function remains superior to untreated cases.
For patients with high myopia and organic fundus lesions, the therapeutic effect is limited. Long-term efficacy maintenance is critical for this population. Strict correction of unhealthy eye use habits is mandatory to sustain clinical improvements and prevent recurrence.