A total of 319 RCTs on acupuncture and moxibustion for dry eye disease were systematically reviewed.
Liver-kidney yin deficiency syndrome was the most common TCM syndrome type involved (54.55%).
Methodological quality of existing RCTs is generally low, indicating a need for improved study design and standardized outcome measures.
Guideline-Based Recommendations
Diagnosis
Clinical diagnosis of dry eye disease based on symptoms such as dryness, foreign body sensation, photophobia, blurred vision, and visual fatigue.
Use of TCM syndrome differentiation, especially identifying liver-kidney yin deficiency syndrome.
Management
Acupuncture and moxibustion as adjunct or alternative therapies to conventional treatments like artificial tears.
Consider combination therapies involving acupuncture/moxibustion with other TCM or Western medicine treatments.
Monitoring & Follow-up
Assessment of ocular surface health indicators, TCM symptom scores, and clinical efficacy outcomes.
Regular evaluation of tear film break-up time and Schirmer test results.
Risks
Artificial tears may cause tear film instability and corneal damage due to preservatives.
Current evidence quality is low; clinicians should interpret findings cautiously and monitor patient response carefully.
Patient & Prescribing Data
Patients with dry eye disease, particularly those with TCM liver-kidney yin deficiency syndrome
Acupuncture and moxibustion show potential benefits in improving ocular surface health and symptom relief, but higher-quality RCTs are needed to confirm efficacy and safety.
Clinical Best Practices
Strict adherence to randomization and methodological rigor in clinical trials to improve evidence quality.
Standardized use of TCM syndrome differentiation in diagnosis and outcome assessment.
Integration of acupuncture and moxibustion with conventional therapies tailored to patient syndrome types.
Use of validated ocular surface and symptom assessment tools to monitor treatment response.
Dr. Theriot discusses the differences between natural tear film and artificial tears—and why the change in moniker to "lubricating drops" is appropriate.
