Presbyopia is a common age-related condition characterized by a loss of the eye’s ability to focus on close objects.
According to 2023 data from the American Optometric Association, nearly 90 percent of people over the age of 45 are affected by presbyopia.
Clinical observations also point to an earlier onset. An increasing number of people between the ages of 35 and 40 are beginning to experience symptoms such as blurred near vision, slower focusing, and reduced visual clarity in low-light environments.
High-Risk Habits for Presbyopia From a TCM Perspective
More than 1,300 years ago, the Tang dynasty physician Sun Simiao documented everyday habits that could harm eye health in his work “Essential Prescriptions Worth a Thousand in Gold for Emergencies” (“Beiji Qianjin Yaofang”), some of which still hold true in modern everyday life.
Prolonged and Excessive Use of the Eyes
Sun identified “prolonged writing and meticulous craftsmanship” as high-risk behaviors that can accelerate the development of presbyopia. In practical terms, these behaviors refer to occupations or activities that require sustained near vision and fine visual focus, which can easily lead to eye overuse.
From a traditional Chinese medicine (TCM) perspective, eye overuse is explained by the principle that “prolonged visual strain depletes the blood.” In essence, continuous and intensive use of the eyes gradually depletes the nourishing substances that support eye function, impairing the body’s ability to repair and restore the eyes.
In modern life, prolonged use of computers and smartphones has created a similar pattern, with most people experiencing some degree of visual strain from excessive screen time.
Eye Usage in Inadequate Lighting
Classical descriptions, such as “reading fine text at night” or “reading by moonlight,” closely mirror modern practices, such as using a smartphone in bed with the lights off. Forcing the eyes to function in poor lighting conditions accelerates the depletion of qi (vital energy) and blood, which nourish the eyes.
From a conventional medical perspective, darkness causes excessive pupil dilation and sustained tension in the eye muscles, thereby increasing the risk of fatigue, dryness, and difficulty focusing.
A 2018 study found that asthenopia symptoms, such as eye strain or fatigue, were more pronounced when using a smartphone in dark environments than during daytime use.
Chronic Mental or Emotional Stress
In addition to visual habits, mental and emotional well-being also play an important role in eye health. In TCM, prolonged emotional distress—such as persistent low mood or frequent crying—is believed to have a detrimental effect on eye health.
A 2018 review indicated that chronic stress can disrupt endocrine function and lead to autonomic nervous system imbalance and vascular dysfunction, which may negatively affect both the eyes and the brain. At the same time, declining vision can further increase psychological stress, creating a vicious cycle.
Excessive Recreational or Entertainment Activities
Unhealthy lifestyle habits can also harm eye health. Sun specifically cautioned against excessive indulgence in recreational activities—such as gambling or board games—that people in the past engaged in and interfered with adequate rest.
In modern times, this is comparable to staying up late to binge-watch television series or to play video games throughout the night.
Beyond visual fatigue, prolonged immersion in highly stimulating entertainment places additional strain on the body. Energy that would otherwise be directed toward repairing and restoring the eyes is instead consumed by sustained excitement and fatigue.
Unhealthy Dietary Habits
Sun also emphasized the influence of diet on visual health, particularly excessive alcohol consumption and the frequent intake of spicy or highly stimulating foods. In modern lifestyles, this can extend to habitual drinking of iced beverages and fried foods.
Such dietary patterns may deplete the body’s fluids and nourishing substances while promoting internal heat and dryness. As a result, the eyes may lose adequate nourishment and protection.
Excessive Sexual Activity
Another behavior considered harmful to eye health is excessive or unrestrained sexual activity. From a TCM perspective, this is believed to directly deplete the body’s fundamental energy reserves, known as kidney essence.
TCM holds that the kidney “opens into the eyes,” meaning kidney energy nourishes and sustains visual function. When kidney essence is strong, the eyes maintain flexibility and focusing ability. When it is depleted, vision weakens—particularly the ability to adjust focus.
From this perspective, presbyopia is understood as a sign of declining kidney essence, reflecting reduced visual adaptability rather than an isolated eye problem.
In the context of modern life, this concept extends beyond sexual behavior itself. Chronic sleep deprivation, excessive workload, and disrupted daily rhythms similarly place sustained strain on the body’s restorative reserves.
Underlying Mechanisms of Eye Disorders
In TCM, eye disorders are primarily associated with two functional systems: the liver and the kidneys, which regulate circulation, nourishment, and long-term vitality.
The liver governs the flow of qi and blood and is closely connected to vision, while the kidneys store the body’s core restorative energy and support visual stability with aging.
Eye problems are commonly associated with three patterns:
Kidney Yin Deficiency: Depletion of deep nourishing reserves due to chronic fatigue or sleep deprivation leads to dryness and reduced repair capacity. A 2022 study found irregular daily routines may worsen presbyopia.
Liver Blood Deficiency: Insufficient or unstable blood supply to the eyes, which have high metabolic demands. A 2021 review linked liver dysfunction to impaired vision through metabolic and inflammatory pathways.
Liver Qi Stagnation: Stress-related disruption of qi and blood circulation, which can indirectly affect eye health.
Natural Ways to Support Healthy Eye Aging
Healthy management of sleep, stress, and diet helps maintain good eyesight as we age.
1. Maintain a Regular Sleep Schedule
TCM holds that the period between 11 p.m. and 1 a.m. is a critical time for liver repair and regeneration. Going to bed before 11 p.m. is therefore considered beneficial for liver health.
Sleeping by 10:30 p.m. is recommended, while those who have difficulty falling asleep are advised to begin preparing for bed around 10 p.m.
2. Manage Emotional Stress
Practicing slow, deep, and rhythmic diaphragmatic breathing can help relax both the mind and body, allowing the nervous system to shift from a state of tension to one of relaxation. This, in turn, helps restore the smooth circulation of qi and blood, supporting their upward flow to the eyes.
From a conventional medical perspective, diaphragmatic breathing activates the parasympathetic nervous system and helps relieve tension in the ciliary muscles, thereby reducing eye fatigue.
3. Incorporate Foods That Nourish the Liver and Kidneys
In TCM, black-colored foods are commonly associated with nourishing the kidneys and replenishing the body’s deeper restorative energy. Green vegetables, meanwhile, are believed to support liver function and, in turn, help nourish the eyes.
Black-colored foods are often rich in anthocyanins, compounds known for their antioxidant properties.
An earlier animal study found that anthocyanins concentrated in the outer layer of black soybeans may help protect the retina.
Research has also shown that black sesame seeds contain a variety of bioactive nutrients associated with antioxidant activity and tissue repair.
A cell culture study demonstrated that mulberry extract can reduce oxidative injury in retinal cells, suggesting a protective effect on ocular tissues.
Other kidney-nourishing foods, such as Chinese yams and black fungus, are believed to support fluid balance in the body, thereby reducing dryness and fatigue while maintaining adequate moisture in the eyes.
Spinach is traditionally valued for nourishing the liver and blood. It is also rich in lutein and zeaxanthin, nutrients known to support macular health and help filter harmful blue light.
4. Cervical Spine and Eye Care Exercises
To improve blood circulation to the eyes, internal nourishment of the liver and kidneys should be complemented by cervical spine and eye care exercises.
Clinical experience suggests that many cases of visual decline and eye fatigue are not solely the result of age-related changes in the eyes themselves, but are often closely associated with impaired cervical circulation and insufficient blood supply to the eyes.
A 2025 article reported that postural abnormalities of the cervical spine may compress the carotid sheath, which protects key nerves and blood vessels supplying the head and eyes. Such compression may affect the optic nerves and blood flow, potentially contributing to elevated cerebrospinal fluid pressure and thereby increasing intraocular pressure.
However, the causal relationship between cervical spine conditions and eye disorders warrants further investigation and confirmation.
Regular practice of the complete nine cervical spine self-adjustment exercises is recommended. This routine is designed to improve cervical circulation through a structural, whole-system approach rather than isolated movements.
In particular, the first three exercises—longitudinal traction, horizontal traction, and back-of-the-head massage—primarily target the first and second cervical vertebrae. These regions are closely associated with the blood supply to the eyes. When circulation in this area is restricted, the effectiveness of other eye exercises may be limited.
Once circulation in the cervical region has been improved, adding the Shaolin Temple eye exercises and a 20-minute eye care routine can further relax the ciliary muscles and promote the circulation of blood, qi, and meridians (energy pathways) around the eyes.
Long-term, consistent practice is essential for eye care.
In one observational case, two 75-year-old women with marked presbyopia performed the eye exercises two to three times daily, for approximately 10 minutes per session, without additional interventions. After three months of consistent practice, both reported improvements in vision.
One participant, who had previously required +2.50 reading glasses, was able to read clearly without them following the intervention. While individual results may vary, these results suggest that presbyopia may not be entirely irreversible.
5. Warm Compresses and Blinking
To enhance blood circulation around the eyes, gently warming the eyes with the palms of the hands can be effective. This technique is part of the previously mentioned 20-Minute Eye Care Routine, and it can also be practiced on its own.
Commercial eye-warming devices may produce varying results depending on the individual. If the eyes feel dry or uncomfortable after heat application, it may indicate that the device is not suitable, as the eyes generally do not tolerate excessive heat well. Using the palms for warm compresses remains the simplest, gentlest, and most reliable approach.
Blinking is another natural way to promote circulation around the eyes and regulate tear production.
A 2021 study found that people with dry eye disease who practiced blinking exercises—approximately 25 cycles per day, with each blink held for about 10 seconds—experienced improvements in dry eye symptoms.
6. Ear Acupoints for Eye Health
Massaging specific ear acupoints can help regulate blood supply to the eyes and support visual function. In auricular therapy, certain reflex points on the ear are commonly associated with eye function. These include:
- Eye 2: Located in the depression near the outer edge of the concha cavity
- Eye Point: Located near the center of the earlobe, close to the typical site of ear piercing
Clinical acupuncture experience suggests that stimulation of these points may result in rapid improvements in visual clarity for some people. As such, ear acupoint massage can serve as a supportive daily self-care practice for people with presbyopia as well as for those who engage in prolonged visual tasks.
7. Gabor Patch Training
Presbyopia is not solely the result of age-related changes in the eyes—it is also related to the brain’s ability to process visual information.
Gabor patches are specialized visual patterns derived from the research of Nobel Prize-winning physicist Dennis Gabor. They are widely used in vision science for both studying visual processing and in visual training programs.
A 2016 study found that participants with presbyopia who underwent Gabor patch training for two to four months experienced significant improvements in near-vision acuity and reading speed. Notably, participants with more severe presbyopia showed greater degrees of improvement.
Under professional guidance, Gabor patch training is typically recommended for 10 to 20 minutes per session, three to four times per week, as a supportive eye-care practice.
Such training requires long-term consistency and is not intended to produce rapid visual recovery. It should be viewed as a complementary approach rather than a replacement for corrective lenses or standard ophthalmologic care.
Presbyopia may be common, but it need not be passively accepted as an inevitable decline. By adjusting daily habits, restoring balance to sleep and stress, nourishing the body, and practicing consistent eye and cervical care, we can support healthier visual aging and preserve clarity for years to come.
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