acupuncture procedure for treating myopia with dry eye

Standardizing Press Needle Treatment for Myopia with Dry Eye

Myopia is a refractive error; when the eye is in a relaxed state of adjustment, parallel light rays are focused in front of the retina after passing through the refractive retina, resulting in a clear image on the retina, which is called myopia. The main manifestations of this disease are clear vision of near objects and blurred vision of distant objects1. When the normal eye adjusts to a relaxed state, the parallel light rays from 5 m away pass through the refractive system of the eye, and the focus falls on the retina, forming a clear image. However, when a myopic patient sees a distant object 5 m away, the parallel light rays are focused in front of the retina after passing through the refractive system of the eyeball, so the vision will be blurred. If you look at a near object within 5 m, the parallel light rays will be focused on the retina after passing through the refractive system of the eyeball, and it will be clearer. Due to the rapid changes in the socio-economic environment in recent years, the widespread use of electronic screens, and the increase of refined eye use methods, the incidence of myopia has increased rapidly, and it is showing a trend of younger age, which has a serious impact on social health.
According to statistics, the number of myopic people in the world will reach nearly 5 billion in 2050. With the spread of computers and smartphones, coupled with the impact of the previous novel coronavirus outbreak, more and more myopic patients are beginning to have comorbid dry eye symptoms2. Nearly 400 million people in China suffer from dry eye, and the prevalence of dry eye in myopia is significantly higher than that in emmetropia and hyperopia, and the incidence of dry eye in myopic adolescents is about 20%. Tear deficiency and tear film instability are key factors that lead to dry eye, and changes in the cornea and increased eyelid space during eye elongation in myopia patients can cause uneven tear film distribution, resulting in decreased tear film stability, which increases the risk of dry eye.
Dry eye syndrome is characterized by an imbalance of tear film and eye discomfort. It is a chronic inflammatory reaction of corneal conjunctival dryness, which is mainly manifested by sensitivity to the external environment, insufficient tear fluid, and foreign eye sensation. It can lead to corneal conjunctival lesions and visual impairment, and then affect the quality of life and vision of patients3. The etiology of dry eye is complex; the main cause is the abnormal quality, quantity, and dynamics of tears, resulting in tear film instability or imbalance of ocular surface microenvironment. The specific onset of the disease is related to the patient&#39;s ocular surface tear film osmotic pressure changes, immune inflammatory response, tear film hyperoxidation, neuroparesthesia, and apoptosis, and the pathological process involves MAPK, NF-&#954;B, Wnt, TLR, PI3K/AKT, and other signaling pathways4,5.
Traditional Chinese medicine believes that the main pathogenesis of dry eye in myopia patients is liver and kidney insufficiency. In the Yellow Emperor&#39;s Neijing-Su Wen, it is recorded that &#34;the five internal organs and six internal organs are infiltrated into the eyes&#34;, which shows that the dysfunction of the internal organs, the insufficient production of the fluid to moisturize the eyes, or the poor infusion are important pathogeneses. Yinhai Subtlety clearly states: &#34;Tears are less responsible for the deficiency of liver and kidney&#34;-the main blood of the liver is the outer part of the eye, the liver blood is enough, and the liver qi is regulated, and the subtle substances are injected on the surface of the eye for tears. The main water of the kidney is the source of the fluid, and the kidney is sufficient, the kidney qi is full, and the source of the whole body is sufficient. The liver and kidney essence and blood are homologous and interconnected, so liver and kidney insufficiency is an important pathogenesis6. At present, the clinical treatment of dry eye is mainly based on artificial tears, vitamins, nerve growth factor, and thermal pulse therapy, which has good short-term effects, but the long-term effects are still limited. Traditional Chinese medicine treatment is mainly based on the internal administration of traditional Chinese medicine, acupuncture, hot compress fumigation, auricular pressure pills, etc. The durability of the curative effect is good, but the operation is more complicated, and the patient&#39;s compliance is not strong.
Press needle is a kind of intradermal acupuncture, which is widely used in clinical practice, mainly used for the treatment of facial paralysis, insomnia, dysmenorrhea, and other diseases, and has gradually expanded to ophthalmic diseases in recent years, with the characteristics of long-lasting effect, easy operation, low cost, and good patient compliance7. Specifically, a special small needle (0.2-0.3 cm long) is inserted and fixed in the acupoint area or subcutaneously for a long period of burial. There is no need to immediately produce a sense of air when burying the needle, and the air can be adjusted only after the needle is buried. This therapy combines the theory of acupoints and the skin theory of traditional Chinese medicine, adopts the ancient idea of &#34;staying still for a long time&#34;, combines the advantages of traditional acupuncture and thread embedding, and has a long period of continuous stimulation of the skin, to achieve the purpose of preventing and treating diseases.
Press needles can improve unaided distance vision, improve the state of visual fatigue, reduce refraction, and delay the axial growth of myopia patients, which has been confirmed by clinical studies8,9,10. Press needle can improve dry eye and is better than sodium hyaluronate eye drops alone in improving the stability of the tear film, tear secretion, and the degree of corneal epithelial damage in patients with dry eye11,12,13. The effect of press needle combined with auricular pressure beans, traditional Chinese medicine atomization fumigation, and massage in the treatment of dry eye is more significant, which may be related to the regulation of multiple signaling pathways such as MAPK, NF-kB, Wnt, TLR, and PI3K/AKT.
Based on the theory of acupoints and dermatozoa in traditional Chinese medicine, this study was treated with a press needle (Figure 1), aiming to improve the symptoms of dry eye, improve visual function, and quality of life. A press needle is a long-lasting, easy-to-operate, and inexpensive traditional Chinese medicine treatment. To sum up, it is necessary to propose a standard scheme on how to correctly operate acupuncture for the treatment of myopia with dry eye. This article explains how to properly use a press needle to treat dry eye in patients with myopia.

Author Spotlight: Exploring Press Needle Efficacy and Underlying Molecular Pathways

压针：干眼症近视患者的中医疗法

治疗干眼症近视的针灸手术

首先将患者平放在治疗床上仰卧位，然后摘下眼镜露出面部。让医生站在患者的右侧。要找到脸上的绚竹或 BL2，请找到眉毛内缘的凹陷。当患者直视向上，瞳孔处于笔直向上的位置时，取眉毛中间的点以定位 Yuyao，或 Ex-HN4。然后在眼睛呈方形且瞳孔垂直向下时，将 Sibai 或 ST2 定位在眶下孔的凹陷处。要开始针灸程序，请在每个穴位喷洒 75% 医用消毒酒精 2 至 3 次。然后用一次性医用消毒棉签擦拭该区域，从内到外，从上到下移动。接下来，检查压榨针以确认其保质期。打开包装，检查压针是否完整、无损坏、无变形。要在 BL2 穴位进行针灸，请用左手拇指和食指固定皮肤。然后，用右手用镊子拿起针带，保持针头无菌。将针尖对准穴位，以 45 度角进入皮肤。然后将针尖完全压入皮肤，并用左手固定胶带。现在轻轻按压针头 3 次，询问患者是否感到任何酸味、麻木感、肿胀、疼痛或其他刺激感。如果有任何感觉，请离开针头。如果没有感觉，请调整针的方向，直到感觉到感觉，然后离开针头。要取下针头，请用左手拇指和食指稳定皮肤。用右手的镊子拿起针带，将针头垂直于皮肤取下。取出后，用无菌棉签按压针孔，并用酒精棉签对局部区域进行消毒。拔出针头后，将患者留在治疗室 30 分钟后再离开。一个疗程后，在开始下一次治疗之前，根据 UCVA 图表评估肉眼视力和干眼评分的改善情况。治疗后患者 OSDI 评分显著低于治疗前患者，差异有统计学意义。治疗后左眼 UCVA 评分显着下降。然而，治疗前后右眼 UCVA 评分无显著差异。

acupuncture-procedure-for-treating-myopia-with-dry-eye

Research

JoVE Journal

Medicine

Acupuncture Procedure for Treating Myopia with Dry Eye

111 次观看. 首先将患者平放在治疗床上仰卧位，然后摘下眼镜露出面部。让医生站在患者的右侧。要找到脸上的绚竹或 BL2，请找到眉毛内缘的凹陷。当患者直视向上，瞳孔处于笔直向上的位置时，取眉毛中间的点以定位 Yuyao，或 Ex-HN4。然后在眼睛呈方形且瞳孔垂直向下时，将 Sibai 或 ST2 定位在眶下孔的凹陷处。要开始针灸程序，请在每个穴位喷洒 75% 医用消毒酒精 2 至 3 次。

视频: 治疗干眼症近视的针灸手术

Press Needle: A Traditional Chinese Medicine Therapy for Myopia Patients with Dry Eye

Most patients with myopia have dry eye, which has been shown to adversely affect ocular symptoms, myopia progression, and quality of life in patients with myopia. Needle prickling has been shown to be effective in providing symptom relief in patients with myopia and dry eye. Press needle is a long-lasting, easy-to-operate, and inexpensive traditional Chinese medicine treatment. The standard practice of needle insertion is very important for the treatment of myopia and dry eye. The specific steps include selecting the appropriate acupoints, piercing them with appropriate needles, and fixing them in the skin or subcutaneously at the acupoints, burying them for 2 days, resting for 1 day; the course of treatment lasts for 2 weeks. Specifically, the following indicators were assessed: uncorrected visual acuity and the ocular surface disease index. This article will explain how to standardize the operation of a press needle in the treatment of myopia and dry eye.

Here, we present a protocol to standardize the operation of acupuncture in the treatment of myopia with dry eye.

Most patients with myopia have dry eye, which has been shown to adversely affect ocular symptoms, myopia progression, and quality of life in patients with ...