Glaucoma damages the optic nerve, the bundle of fibres that carries signals from the eye to the brain, and a 2025 review lists it among the major causes of irreversible vision loss. The American Academy of Ophthalmology’s 2025 guideline for primary open-angle glaucoma states that clinical trials have shown lowering intraocular pressure (IOP), the fluid pressure inside the eye, measured in millimetres of mercury (mm Hg), slows the disease, and that eye drops, laser and surgery all lower it. Acupuncture trials for glaucoma mostly measure IOP for minutes to weeks after needling. Cochrane’s review, updated in 2020, found three small trials and judged their evidence of very low certainty, and the European Glaucoma Society’s 2025 guidelines state that there is no evidence acupuncture has a role in glaucoma management.
The Cochrane review
Simon Law, a glaucoma specialist at the Jules Stein Eye Institute in Los Angeles, and Tianjing Li at Johns Hopkins first published the review in 2007. The 2013 update included one completed trial, of ear acupressure, and set aside seven Chinese-language trials for later assessment. For the 2020 update, Law, Lin Wang and Li searched English and Chinese databases to November 2018 and found 18 potentially eligible trials. They wrote to the authors of the 12 that gave an email address to ask how participants had been randomised; two confirmed, ten did not reply, and those ten were excluded. The review included three completed trials, from Taiwan and the United States, with 137 participants between them, and one ongoing trial. One of the three was run by Law.
The three trials tested different things: pressing ear points against pressing sham ear points, electrical stimulation through skin pads against a control, and needling at points around the eye against points elsewhere. All three were at high risk of bias in at least one domain, and the review graded every outcome very low certainty under GRADE, the system Cochrane uses to rate how far a result can be trusted, citing that risk of bias, differences between the trials, and imprecision. The trials provided no evidence of an effect on visual field, the extent of side vision that glaucoma erodes, or on visual acuity. The review’s plain language summary says acupuncture may have a very small effect on eye pressure. The authors concluded that no reliable conclusion could be drawn to support acupuncture for glaucoma, and that trials comparing acupuncture alone with standard glaucoma treatment or with placebo are unlikely to be ethically justified where a standard of care is established. They suggested trials of acupuncture added to standard treatment against that treatment alone.
Trials
The trials below are the three Cochrane included, then those published since its search. None compared acupuncture with pressure-lowering treatment; two added it to drops or usual treatment and compared the result with those alone.
| Trial | People | Treatment and control | Reported |
|---|---|---|---|
| Her 2010, Taiwan | 33 with glaucoma or raised eye pressure | Tapping and massage at three ear points twice daily for 4 weeks, against tapping at three sham ear points | IOP lower than sham at 4 weeks; no difference at 8 weeks, four weeks after stopping, when IOP had returned to its starting level |
| Yeh 2016, Taiwan | 82 with glaucoma or raised eye pressure | One 20-minute session of skin-pad electrical stimulation at BL61 (Pucan) and BL62 (Shenmai), against no stimulation | IOP fell more than in controls over the following hour |
| Law 2015, Los Angeles | 22 with stable primary open-angle glaucoma; 11 finished | Crossover: 12 sessions at eye-related points and 12 at points unrelated to the eye | No change in daytime IOP, acuity, visual field or optic nerve measurements after either series |
| Leszczynska 2018, Dresden | 56 with primary open-angle glaucoma | One session at eye-specific points, against points not specific to the eye | Pulsatile blood flow in the eye rose from 5.6 to 6.7 microlitres a minute with eye-specific points; no change in IOP in either group 10 minutes later |
| Chen 2020, Taiwan | 45 on one or no pressure-lowering drug | Four 20-minute sessions over 2 weeks of needling or electroacupuncture at BL01 (Jingming) and Qiuhou (EX-HN7), both on the rim of the eye socket, against herbal seeds laid on the skin at the same points | IOP fell more with needling than with seeds 60 minutes after each session and across the 2 weeks |
| Chen 2023, Beijing | 70 with optic atrophy after glaucoma | Basic Western medical treatment, with or without needling at points including GV20 (Baihui), ST01 (Chengqi), GB20 (Fengchi) and ST36 (Zusanli), twice weekly for 3 months | No difference in IOP or visual field; better acuity at 6-month follow-up and a thicker nerve fibre layer with needling |
| Chen 2026, Taiwan | 40 with normal-tension glaucoma | Weekly needling at BL01 and EX-HN7 for 24 weeks, against seeds at the same points | Visual field declined more slowly than with seeds; no treatment-related adverse events |
| Sun 2026, Beijing | 78 with primary open-angle glaucoma | Pressure-lowering drops, with or without weekly needling at tender points within a circle centred on GV20 for 4 weeks | Within the needled group, 24-hour IOP fell from its starting level; acuity and optic disc blood flow did not differ between groups |
Normal-tension glaucoma, in the 2026 Taiwanese trial, damages the optic nerve while eye pressure stays in the normal range. The retinal nerve fibre layer is the layer of nerve fibres at the back of the eye, which thins as glaucoma progresses and is measured by scan. Cochrane describes the 2016 control group as a sham procedure, while the trial’s own abstract says the controls received no stimulation. The 2026 trial reported acuity, nerve fibre layer and IOP gains against each group’s own starting values, and compared the two groups only on visual field; its authors call for larger double-blind multicentre trials. The 2026 Beijing trial likewise reported its IOP fall within the needled group rather than against drops alone. A Taiwanese trial of 50 people of eye-point needling against minimal needling at points away from the eye, registered as NCT05753137, began recruiting in June 2023.
Later reviews
Two reviews since Cochrane have pooled or graded glaucoma trials, each within a wider review of eye diseases. Chen and colleagues in Taiwan published a 2025 meta-analysis of 21 studies of acupuncture for glaucoma, age-related macular degeneration, optic atrophy and retinitis pigmentosa. In its pooled data, IOP was 0.86 mm Hg lower with acupuncture, a difference that was not statistically significant (P = 0.11), and visual acuity did not differ; the trials against sham also showed no significant difference. The review did not report GRADE certainty in its abstract. Bautista-Hernández and colleagues in Oaxaca, Mexico, published a 2026 systematic review, searched to February 2025, that included seven glaucoma studies without pooling them. It rated six of the seven at high risk of bias, with problems in randomisation and outcome measurement, graded the glaucoma evidence low certainty, and concluded that there is no conclusive evidence acupuncture is an effective therapy for these eye diseases. Five of the seven glaucoma studies did not report whether adverse events were assessed.
A 2023 narrative review by Christopher Marando and Teresa Chen of the glaucoma service at Massachusetts Eye and Ear in Boston states that there is no evidence acupuncture alters the progression of glaucoma or causes a sustained fall in IOP.
Eye pressure after needling, and other harms
The Los Angeles crossover trial measured IOP before and after each session. Mean IOP rose from 12.9 to 13.6 mm Hg after eye-point sessions (P = 0.019) and from 13.0 to 13.5 mm Hg after the others, a change that was not significant. Of the 22 volunteers, three were withdrawn: two for needle sensitivity and one whose IOP rose by 8 mm Hg in the other eye. The authors concluded that acupuncture may raise IOP temporarily right after a session. The 2020 Taiwanese trial also recorded higher IOP immediately after each session than before it, in all three groups and most with electroacupuncture, which had gone 30 minutes later; it reported no bleeding or bruising at the points around the eye.
Glaucoma prescriptions often use points on the rim of the eye socket, such as BL01 and ST01. A 2023 review of case reports by Lee and colleagues in Korea collected 14 reports, covering 15 eyes, of serious eye injury after acupuncture around the eye, published between 1982 and 2020. Dry eye disease describes those cases and the bruising reported in dry eye trials.
What guidelines say
The European Glaucoma Society’s 6th edition guidelines, published in 2025, answer the question of whether neuroprotective agents or alternative treatments are recommended: there is no evidence that acupuncture, cannabinoids or alternative treatments have a role in glaucoma management. The society rates that recommendation strong, on low-level evidence.
The American Academy of Ophthalmology’s Primary Open-Angle Glaucoma Preferred Practice Pattern, approved in September 2025 and current, replaced the version approved in September 2020. Neither version mentions acupuncture. Both state there is no conclusive evidence that herbal medicines or nutritional supplements help glaucoma, and both set a reasonable first goal of lowering IOP by 20% to 30% from where it started.
NICE’s glaucoma guideline, NG81, published in November 2017, last updated in January 2022 and reviewed in March 2025, does not mention acupuncture or complementary therapy. It recommends laser treatment (selective laser trabeculoplasty) as the first treatment for newly diagnosed open-angle glaucoma that is not advanced, and surgery for advanced glaucoma.
What the reviews could not settle
Most trials measured IOP within an hour of a session or over a few weeks, while glaucoma is followed over years, and the outcome that matters to a patient is whether side vision is kept. Only the 2026 Taiwanese trial of 40 people compared visual field decline between groups, over 24 weeks. The trials that report a fall in IOP and those that report none differ in technique, points, control and the type of glaucoma enrolled, and the 2026 review judged that mix of diagnoses a source of heterogeneity. The trials measured and reported harms unevenly. None of the trials on this page tested acupuncture in place of pressure-lowering treatment, and the Cochrane authors judged that a trial of acupuncture alone against standard treatment is unlikely to be ethically justified. Sham acupuncture sets out what different sham controls can and cannot rule out, and Reading an acupuncture trial covers outcome choice and follow-up.
AcuiQ’s glaucoma page lists the protocols individual studies prescribed, each with its citation. Myopia and amblyopia in children covers trials of needling at points around the eye in children.