Treating Chronic Open-Angle Glaucoma with Acupuncture, Chinese Medicine & Functional Medicine

Over the last 25 years, I have specialized in TCM Ophthalmology and Ophthalmic Acupuncture.  I have made quite a few significant clinical observations through diagnostic testing, treatment, and direct feedback from my patients.  In my clinical practice, I incorporate TCM ophthalmology and Functional Medical Ophthalmology.  

Functional medicine uses methods to measure how weak (yin) or stressed (yang) the body’s organs, glands, and systems may be.  Among these include blood sugar, adrenals, thyroid, pituitary, oxidative stress, inflammation hydration, ATP-energy production, and contributing metabolic-hormonal issues.  Both TCM and Functional Medicine look to uncover patterns of disharmony.  The idea is to uncover deeper patterns and underlying pathologies that contribute to the patients’ symptoms and conventional biomedical diagnosis of glaucoma.

Chronic open-angle glaucoma is a very common condition affecting about 3 million Americans.  In my experience, it can be successfully treated with nutrition, acupuncture & Chinese medicine.  In chronic open-angle glaucoma, the intraocular pressure (IOP) gradually increases because the eye’s drainage canals have gradually become congested.  This build-up of fluid in the eyes can eventually damage the retina and optic nerve.   Early glaucoma can be easily detected with regular eye exams.  A “tonometer” will measure IOP and a vision field test will detect any peripheral vision loss.  

In the early stages, the person will usually be unaware of increasing IOP.  Often, by the time open-angle glaucoma progresses, some vision loss may be present whereas conventional medicine will usually recommend eye drops.  The drops are used to lower the IOP to keep the eye pressure down.  The objective of the medication is to lower the IOP as to not cause damage to the optic nerve or retina as to preserve the vision.  Many patients using these eye drops report that the drops burn and irritate their eyes, causing blurry vision and irritated eyes.  

Conventional medicine is limited in their treatment of glaucoma where they only work to control eye pressure (IOP), It’s been observed that in some cases the side-effects of the IOP-lowering medication may actually accelerate progressive vision loss in some cases.  That said, these IOP meds (for the most part) have been effective in lowering eye pressure and that is certainly one causative factor that needs to be controlled.  But is that enough?

The TCM classics say that in most cases chronic open-angle glaucoma falls under the liver-kidney yin deficiency with liver yang rising.   In my experience, this is most often the correct treatment for acute closed-angle glaucoma, NOT chronic open-angle glaucoma, or normal-tension glaucoma.  Of course, we always want to do our TCM assessment for pattern dysfunction (tongue, pulse, four-pillar, etc.) to be certain of the dominant pattern.   I have personally found that patterns vary widely from patient to patient.  

Through using the principles of Chinese medicine, we can determine the origins and underlying pattern that drive most diseases.  The TCM condition(s) of vision loss should first be distinguished with Yin-Yang theory.  Looking at the Taiji Yin-Yang symbol we can learn a lot about the nature of vision loss and how to treat it.  Conditions like glaucoma and diabetic retinopathy will usually manifest with peripheral vision loss.  The Yin aspect of the Taiji symbol mimics a loss of peripheral vision (dark outer and bright inner); therefore, the condition must be yin dominant and yang deficient.  

In contrast, cases like macular degeneration where the central vision is lost, the opposite condition is present.  There is brightness on the periphery and darkness in the center.  This means that the condition must be of a yang nature with yin deficiency.  

Please take a minute to observe this as it is a very simple yet important consideration for understanding the TCM pathogenesis of central and peripheral vision loss.  Once this has been determined, you can do your other TCM exams to determine the channels and organs that are being most affected.  

yin yang

In terms of treatment, I will tend to treat the UB, ST, and GB channels.  This GB being a yang channel delivers the Yang-Qi from the liver to the upper body and eyes.  The UB is the yang channel of the water element that delivers the Yang-Qi of the kidney to the upper body and eyes.  Stomach channel points are also important to deliver the spleen nutritive Yang-Qi to the eyes.  

A basic point prescription for Gall Bladder & Kidney weakness is: 

- GB-1 (local), GB- 20 (move Qi to the eyes), GB-21 (move Qi in GB), GB-30 (move Qi in GB), GB-37 (special eye point), GB-40 (source) GB-43 (tonification)

- UB-2 (local), UB-64 (source), UB-67 (tonification)

- St-2 (local), St-36 (horray), St-41 (tonification)

Extra Glaucoma points:

- Extra Glaucoma #1: I cun superior to SJ-23, and one finger-width lateral.  In the tender spot, needle posterior until a strong “de-Qi” sensation is obtained.

- Extra Glaucoma #2: ½ cun anterior to St-5; needle superior in the tender area as to obtain a strong “de-Qi” sensation.  

Eye Exercises to Reduce IOP: 

Using the middle finger apply pressure below the eyeball, pressing in and up for 10 seconds, then rest for 10 seconds.  Do this 3 times in a row 3 times each day.

As far as Chinese herb formulas go, for this pattern I usually combine and slightly modify two traditional formulas: Dan Zhi Shao Yao Wan and Zhou Jin Wan.  The therapeutic goal is to regulate the Liver Qi (and gall bladder) and boost Kidney function.  Sometimes I will add Er Chen Tang to help clear a path for the clear-yang to ascend to the eyes if there appears to be dampness present.

Moxa is also a great adjunctive therapy for glaucoma patients presenting with this kind of deficiency pattern.  Use moxa on St-36, CV-12, UB-20, UB- 19, UB-22, and UB-23.   Massaging peppermint and/or lavender oil into the GB and UB meridians can also be another effective way of activating the Yang-Qi in the channels.

In terms of functional medicine, I have found that chronic open-angle glaucoma is due to autonomic nervous system (ANS) deregulation and autoimmune pathologies. Diminished ATP cellular output (also Qi and yang deficiency).  High doses of cod-liver oil (5000-8000 IU/day) can help patients with open-angle glaucoma.   Other supplements like Ginko Biloba and l-taurine have also been shown to support the optic nerve. 

In summary, conventional biomedicine is limited to treating eye pressure with medications and surgical procedures.  Most of the time, they work and other times they do not.   So, we let the conventional glaucoma specialists manage the eye pressure where our strategy is on preserving the health, function, and structural integrity of the optic nerve.   In my experience, this integrative approach yields the best possible clinical outcomes for patients dealing with glaucoma. 


Andy RosenfarbDr. Andy Rosenfarb, founder and clinical director of Acupuncture Health Associates in Westfield, NJ, is a world-renowned expert in the field of Chinese Medical Opthalmology. Since 1997, he has been leading the field in integrated treatment methods that combine Traditional Chinese Medicine, Naturopathic Medicine, and new cutting-edge therapies to help people suffering from debilitating eye diseases to maintain and improve their eyesight.  Dr. Rosenfarb earned his Master’s in Traditional Chinese Medicine from Pacific College of Oriental Medicine and his Doctor of Naturopathy from Canyon College. He continued his post-graduate education at Zhejiang College of Chinese Medicine in Hangzhou, China.
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