Myopia and amblyopia in children

Many trials of acupuncture and related methods for short sight in children add them to another treatment, such as atropine eye drops or health education, and compare the combination with that treatment alone. The one Cochrane review on the question, Wei and colleagues in 2011, found two eligible trials and drew no conclusion. Since then, a 2026 trial of 680 children in Ophthalmology compared electrical stimulation applied through the skin at points around the eye with a sham version of the same device and reported fewer new cases of myopia over 48 weeks. For amblyopia, a weaker eye whose vision does not reach normal even with glasses, two trials by Dennis Lam’s group at the Chinese University of Hong Kong in 2010 and 2011 compared acupuncture with patching and with spectacles alone. Cochrane registered a review of acupuncture for amblyopia and withdrew the protocol in 2017 before any review was published. This page reports those sources, the reviews that pooled Chinese trials, and the position of the International Myopia Institute and the American Academy of Ophthalmology.

What the trials measure

Myopia, short sight, most often comes from an eyeball that is too long, so that light focuses in front of the retina, as the 2011 Cochrane review explains. Trials that try to slow it measure two things. Refraction is the lens power, in dioptres (D), needed to correct the eye, taken after drops that relax focusing (cycloplegic refraction); a more negative number means more myopia, and the review defined progression as a change of 1 D. Axial length is the length of the eyeball in millimetres. Many Chinese trials report a third outcome, unaided visual acuity or a “total effective rate”: the share of children each trial judged improved on its own criteria.

Amblyopia is a loss of best-corrected visual acuity, usually in one eye, that comes from abnormal processing of images in the developing brain rather than from damage to the eye, in the definition of the American Academy of Ophthalmology’s Amblyopia Preferred Practice Pattern. In the anisometropic form, unequal focusing errors leave one eye’s image blurred. Trials report best-corrected visual acuity in lines on a letter chart or in logMAR units, where a lower number is better. The same document notes that glasses alone improve the amblyopic eye by two or more lines in at least two thirds of children aged 3 to 7 with untreated anisometropic amblyopia, so a trial that starts glasses and acupuncture together needs a glasses-only arm to show what acupuncture added.

Reviews

The two trials in the Cochrane review both added ear stimulation to another treatment. Three of 26 children dropped out of the ear-stimulation arm of one because of pain, and children in both reported mild pain, heat or swelling while pressing. The authors asked for trials against placebo, of at least six months’ treatment, with axial length followed for a year. A Europe PMC search on 11 October 2026 found no update of the review.

In the Sangvatanakul review, from Thammasat University in Thailand, 9 of the 12 studies were published in Chinese, and allocation concealment and blinding were generally judged unclear. In the Tan review, from Hunan University of Chinese Medicine, all participants were Chinese and every trial raised concerns about blinding; the adverse events it describes include fear of needles, dizziness and bleeding after needling at points around the eye. Cochrane’s amblyopia protocol, by Liu and colleagues at Hunan and the Chinese University of Hong Kong, was withdrawn on 7 August 2017.

Cochrane’s living network meta-analysis of myopia control, by Lawrenson and colleagues, last searched in February 2024 and included 104 trials and 17,509 children. Its scope is optical, drug, light and behavioural treatments, and it does not include acupuncture.

Myopia trials

• Ear stimulation with atropine, Taiwan, 2008. A trial by Liang and colleagues randomised 71 children to 0.25% atropine, 0.5% atropine, or 0.25% atropine with stimulation of ear points. Myopia progressed by 0.38 D a year with 0.25% atropine alone and 0.21 D with the ear points added, close to the 0.15 D with the stronger drop. Axial length did not differ between the three groups.
• Ear stimulation with low-dose atropine, Shanghai, 2021 and 2023. Kong and colleagues at the Shanghai Research Institute of Acupuncture and Meridian and Fudan University randomised 104 children aged 7 to 12 to nightly 0.01% atropine alone or with magnetic beads taped over seven ear points for 6 months. Assessors did not know the allocation, and there was no sham plaster. At 6 months refraction had changed by −0.25 D with the ear points and −0.38 D without, a difference the authors called “clinically negligible, yet statistically significant”; axial length and choroidal thickness did not differ. At 12 months, 6 months after the beads came off, the difference was 0.16 D, and axial length had grown 0.31 against 0.37 mm (P = 0.05).
• Ear seeds and press needles for pseudomyopia, 2024. A multicentre trial by Hou and colleagues randomised 269 children with pseudomyopia, which the authors treat as a stage that can precede true myopia, to health education alone or with ear seeds at the liver, spleen, heart and eye points and embedded needles at BL02 (Cuanzhu), XH04 (Yuyao) and ST02 (Sibai), for two 6-week courses. Axial length grew less in the treated group through 24 weeks of follow-up, and no adverse reactions were reported. The control group had no sham procedure.
• Electrical stimulation around the eye against sham, 2025 and 2026. A trial at the Shandong University of Traditional Chinese Medicine randomised 170 children aged 6 to 12 with premyopia, eyes close to but not yet myopic, to 20 weeks of transcutaneous electrical stimulation through skin pads at BL02, XH04, TB23 (Sizhukong), XH05 (Taiyang), ST02 and BL01 (Jingming), or to the same device with no current. Over 28 weeks of follow-up, 20.0% of the stimulated group and 34.7% of the sham group became myopic. The multicentre trial that followed, by Jiang, Bi and colleagues at centres across China and published in Ophthalmology, randomised 680 children with premyopia, a refraction between +0.75 and −0.50 D, to stimulation or sham, applied at home under parental supervision at least three times a week for 24 weeks through masks fitted to each child, and followed them for 24 more. At 48 weeks 29.0% of the stimulated children and 38.1% of the sham group had become myopic (difference 9.1 percentage points, 95% CI 1.6 to 16.6). Refraction changed by −0.47 against −0.75 D and axial length by 0.21 against 0.36 mm. No treatment-related adverse events were reported.

Amblyopia trials

• Against patching, 2010. A single-centre trial by Jing Zhao, Dennis Lam and colleagues randomised 88 children aged 7 to 12 with anisometropic amblyopia, who had worn their glasses for at least 16 weeks, to 2 hours a day of patching over the stronger eye or to five acupuncture sessions a week. At 15 weeks acuity in the weaker eye had improved by 1.83 lines with patching and 2.27 with acupuncture, and amblyopia had resolved in 16.7% and 41.5%. Letters to the journal questioned the design, one under the title “Unfair comparison of in-office acupuncture vs at-home patching for amblyopia”: patching was done at home and acupuncture in a clinic.
• Added to spectacles, 2011. The same group’s crossover trial randomised 83 children aged 3 to 6 with untreated anisometropic amblyopia to spectacles alone or spectacles with acupuncture for 15 weeks, then swapped the groups for 15 more. At 15 weeks acuity had improved by 2.2 lines with spectacles alone and 2.9 with acupuncture added (difference 0.77 lines, 95% CI 0.29 to 1.3). By 30 weeks, after both groups had received acupuncture, the share of children who responded or whose amblyopia resolved was similar. No severe adverse effect was reported.

Neither amblyopia trial used sham acupuncture. Acupuncture for children covers needling in this age group, and Ear acupuncture describes the seeds, beads and plasters most of the myopia trials used.

What guidelines say

The International Myopia Institute’s 2025 report on interventions for controlling the onset and progression of myopia, by Bullimore and colleagues in Investigative Ophthalmology and Visual Science, does not mention acupuncture, acupressure or ear stimulation. The 2026 sham-controlled trial was published after it.

The Amblyopia Preferred Practice Pattern, published by the American Academy of Ophthalmology in 2022 and amended in February 2024, lists optical correction, patching, atropine, Bangerter filters and digital therapies as treatments and does not mention acupuncture. Clinical guidelines sets out other bodies’ positions on acupuncture.

What the reviews could not settle

No review has pooled the sham-controlled trials of myopia, and the two that exist come from one group in Shandong and test prevention in children not yet myopic, not slowing myopia that has started. The ear-stimulation trials added beads or seeds to atropine without a sham plaster, and their differences in refraction, 0.13 to 0.17 D, came with no consistent difference in axial length. The pooled reviews of ear stimulation counted visual acuity or response rates, which children’s focusing can change without any change in the eye’s length. Follow-up after treatment stopped was 28 weeks at most. For amblyopia, the two trials by Lam’s group have no sham arm and no independent repeat; the reviews of 2013 and 2025 pooled composite response rates, and the 2025 review’s trials added acupuncture to conventional treatments that improve acuity on their own. Sham acupuncture sets out what a sham control can and cannot rule out, and Dry eye disease covers needling around the eye.

AcuiQ’s myopia, juvenile myopia, amblyopia and anisometropic amblyopia pages list the protocols individual studies prescribed, each with its citation.