What are the traditional Chinese medicine approaches for treating glaucoma?

While traditional Chinese medicine (TCM) has historically been used to manage symptoms associated with glaucoma—such as eye discomfort, blurred vision, or headaches—it is critical to emphasize that TCM does not lower intraocular pressure (IOP), which is the primary modifiable risk factor in glaucoma progression. Glaucoma is a group of optic neuropathies characterized by progressive retinal ganglion cell loss and irreversible visual field defects, most commonly driven by elevated IOP. Evidence-based, first-line treatments include topical hypotensive medications (e.g., prostaglandin analogs, beta-blockers, alpha-2 agonists), laser trabeculoplasty (e.g., selective laser trabeculoplasty), and surgical interventions (e.g., trabeculectomy, minimally invasive glaucoma surgery) when medical therapy is insufficient.

Some TCM approaches—such as acupuncture, herbal formulations (e.g., *Qi Ju Di Huang Wan* or *Xue Fu Zhu Yu Tang*), and qigong—have been explored in limited observational studies or small pilot trials for potential adjunctive effects on ocular blood flow, antioxidant activity, or neuroprotection. However, robust clinical evidence supporting their efficacy or safety in altering glaucoma outcomes is currently lacking. No TCM intervention has demonstrated reproducible IOP-lowering effects in randomized controlled trials meeting modern methodological standards.

Patients diagnosed with glaucoma must prioritize regular monitoring by an ophthalmologist—including tonometry, optic nerve imaging (e.g., optical coherence tomography), and automated perimetry—and adhere strictly to prescribed IOP-lowering therapy. Relying solely on TCM may delay effective treatment and increase the risk of permanent vision loss. If patients wish to integrate complementary approaches, they should do so only under the guidance of both a qualified ophthalmologist and a licensed TCM practitioner, with full transparency about all therapies being used.