Research Progress on the Treatment of Myopia in Traditional Chinese Medicine based on the Theory “The Liver Opens into the Eyes”

Abstract

In Traditional Chinese Medicine, myopia is classified as “inability to see distant objects” or “inability of the eyes to see far.” Its core pathogenesis lies in qi stagnation and blood stasis, as well as deficiency of qi and blood, which obstruct the nourishment of the ocular orifices by qi and blood, resulting in insufficient nourishment of the ocular collaterals and a dimmed visual acuity. Based on the theory that “the liver opens its orifice to the eyes”—where liver blood nourishes the ocular orifices and liver qi ascends to the eyes—this concept exhibits a high degree of intrinsic consistency with the pathogenic mechanism of myopia characterized by “qi stagnation and blood stasis, as well as deficiency of qi and blood.” From the perspective of modern pathophysiology, the upregulation of hypoxia-inducible factor-1α (HIF-1α) and the downregulation of transforming growth factor-β (TGF-β) have been identified as key mechanisms in the progression of myopia. Guided by the theory that “the liver opens into the eyes,” TCM interventions primarily follow two major therapeutic principles: regulating the liver and harmonizing qi, and nourishing blood to soothe the liver. Clinical and experimental studies have shown that this therapeutic approach can improve choroidal blood supply, alleviate scleral hypoxia, and slow the increase in axial length, demonstrating a comprehensive, multi-target effect. This article systematically traces the origins and development of the theory that “the liver opens into the eyes” and reviews the progress of TCM research on myopia treatment guided by this theory, with the aim of providing theoretical references and evidence-based support for the development of standardized integrated Chinese and Western medicine strategies for myopia prevention and control.