Dry Eye: What Acupuncture Changes, and What It Does Not

Dry eye is one of those conditions that sounds minor until you have it. Gritty eyes by mid-afternoon, blurring that clears when you blink hard, watering that makes no sense for something called dry, a burning that makes screens tiring and driving at night unpleasant. Drops help, and for a lot of people drops are not quite enough.

There is a solid body of research on acupuncture for dry eye, and the most consistent finding in it is the one that matters day to day: people’s eyes feel better.

What makes an eye dry?

The tear film has three components: an oily outer layer from the meibomian glands along the lid margins, a watery middle layer from the lacrimal glands, and a mucin layer that lets the whole thing spread across the eye. Dry eye follows when there is not enough tear production, when the film evaporates too fast, or both. Evaporative dry eye, usually from meibomian gland dysfunction, is the more common form.

Blink rate matters more than most people realise. Concentrated visual work roughly halves it, and an incomplete blink leaves the lower cornea exposed. Age, hormonal change around menopause, some medications, contact lenses and previous laser surgery all contribute.

What the trials found

The most useful single trial for our purposes was published in Clinical Ophthalmology in 2019: double-blinded and sham-controlled, with the sham using needles placed away from known meridians. Symptom scores on the Ocular Surface Disease Index fell from 34 to 16 with true acupuncture, against a much smaller change with the sham, and the advantage for real acupuncture was still there six months after treatment (p=0.04).

A multicentre Korean trial published in PLOS ONE in 2012 compared acupuncture against artificial tears in 150 people. Both groups improved during treatment, and at follow-up eight weeks after treatment had ended the acupuncture group showed the greater improvement in symptoms and in tear break-up time, a benefit that outlasted the treatment itself.

A sham-controlled trial of 90 people with dry eye after cataract surgery found better tear film stability, symptom scores and meibum quality in the acupuncture group at the end of treatment.

What the larger reviews add

A 2021 meta-analysis of 21 trials covering 1,542 eyes found acupuncture outperforming artificial tears alone on tear break-up time, Schirmer’s test, corneal staining and symptom scores, and found acupuncture combined with artificial tears better than tears alone.

A 2026 evidence map of 319 randomised trials concluded that acupuncture and moxibustion show advantages in dry eye disease.

What the trials point to most consistently is symptom relief: how the eyes actually feel through a working day, which is what people come in for. In the larger reviews the tear-film measures improve as well.

Where Chinese medicine looks

The Liver is said to open into the eyes and Liver-Blood to nourish them, so dryness, grittiness and visual tiredness are read first through that relationship. Maciocia notes that dryness of the eyes is one of the main signs distinguishing Liver-Yin deficiency from Liver-Blood deficiency, the two otherwise being close, and that the Liver and Kidneys share a common root, so a deficiency in one often draws in the other. Where dry eyes appear together with lower backache, tinnitus, dizziness and night sweating, the reading shifts to Kidney-Yin failing to moisten the eyes.

In practice that means the questions asked at assessment range well beyond the eye itself: sleep, menstrual history or menopause, screen hours, medications, and how much of the day is spent in air conditioning.

Screens, air-conditioning and Brisbane offices

This is a condition where the environment does much of the work.

Brisbane spends a lot of the year in air conditioning, and conditioned air is dry air moving across the face. A ceiling fan aimed at the bed will do the same thing for eight hours a night. Car vents pointed at the windscreen bounce air straight back into the eyes. Add a working day of screens at half your usual blink rate and a glare-heavy drive home, and the eye never gets a chance to recover.

The changes worth making are dull and they work: redirect the vents and the fan, lower the monitor so the lids cover more of the eye, take deliberate breaks from close work, and use the drops before the burning starts rather than after. Warm compresses and lid hygiene matter where the meibomian glands are involved, and we show you how at the first visit.

Do those things, and let treatment work on the pattern underneath them.

What treatment around the eyes actually involves

Most people asking about this are quietly worried about needles near the eye, so it is worth being direct.

Points around the orbit are used, on the brow and beneath the eye on the bony rim, along with points on the hands, forearms and lower legs that relate to the Liver and Kidney channels. Needling near the eye is shallow and the needles are very fine. Bruising is the common side effect, as those trials reported, and the skin there shows it more than anywhere else on the body. If you have something on next week where a bruise would bother you, say so and we will work differently.

Laser acupuncture is available for anyone who would rather avoid needles near the face altogether.

When it is not straightforward dry eye

These need an optometrist or eye clinic promptly:

• Moderate or severe eye pain
• Light sensitivity that is new or marked
• Marked redness, particularly in one eye only
• Reduced or blurred vision that does not clear with blinking
• Symptoms related to contact lens wear, which need same-day assessment
• Discharge, or an eye that is stuck shut in the morning
• Dry eyes together with a persistently dry mouth and joint pains, which may point to Sjögren’s syndrome and needs proper investigation

Dry eye that has not settled after four weeks of drops is worth a proper assessment, and it is usually the point at which people come to us.

Questions we get asked

Do I stop using my drops?

Keep using them. Drops look after the surface of the eye; acupuncture works on why it is drying out. The two do different jobs.

Will this fix the cause?

Treatment is aimed at the pattern behind the dryness as well as the symptoms, alongside the lid care and drops that look after the surface directly.

I have had laser eye surgery and now my eyes are dry. Is this different?

It is a recognised consequence of refractive surgery, and it responds to the same approach. We work alongside your surgeon or optometrist.

Does it help the headaches that come with it?

Often the neck and head tension that accompanies long screen days responds well, and people notice that before they notice anything about the eyes.

References

Dhaliwal DK, Zhou S, Samudre SS, Lo NJ, Rhee MK. Acupuncture and dry eye: current perspectives. A double-blinded randomized controlled trial and review of the literature. Clinical Ophthalmology. 2019;13:731-740. doi:10.2147/OPTH.S175321

Kim TH, Kang JW, Kim KH, et al. Acupuncture for the treatment of dry eye: a multicenter randomised controlled trial with active comparison intervention (artificial teardrops). PLOS ONE. 2012;7(5):e36638. doi:10.1371/journal.pone.0036638

Kong X, Long J, Liu H, Ding Q, Jin H, Zou Y. Randomized, sham-controlled trial of acupuncture for post-cataract surgery dry eye disease. Complementary Therapies in Clinical Practice. 2022;49:101680. doi:10.1016/j.ctcp.2022.101680

Na JH, Jung JH, Park JG, Song PH, Song CH. Therapeutic effects of acupuncture in typical dry eye: a systematic review and meta-analysis. Acta Ophthalmologica. 2021;99(5):489-498. doi:10.1111/aos.14651

Liu Q, Yang X, Hong Y, Wang T, Han S. Evidence map for randomized controlled trials of treatment of acupuncture and moxibustion for dry eye disease. Frontiers in Medicine. 2026;13:1829981. doi:10.3389/fmed.2026.1829981

Findlay Q, Reid K. Dry eye disease: when to treat and when to refer. Australian Prescriber. 2018;41:160-163. doi:10.18773/austprescr.2018.048

Maciocia G. The Practice of Chinese Medicine: The Treatment of Diseases with Acupuncture and Chinese Herbs. 2nd ed. Edinburgh: Elsevier; 2008.

Individual responses vary, and an assessment is what determines whether treatment is suitable for you. Dr Francesco Pennisi practises at Balmoral and Alexandra Hills. Phone (07) 3820 2887, or book online.