bubble_chart Concept

Farsightedness is the ability to feel the pulse with fingertips, which allows for farsightedness but not myopia, or the clarity of distant vision compared to near vision.

This condition is referred to as "farsightedness" in Suwen Bingji Qiyi Baomingji, Zhengzhi Zhunsheng‧Seven Orifices Gate" as "farsightedness", Mujing Dacheng simply calls it "far".

By the late Qing Dynasty, "Compendium of Ophthalmology" clearly pointed out that farsightedness is usually not a disease in daily life, but arises due to illness. If it is congenital, it is beyond the reach of acupuncture and medicine, and is not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Insufficiency of Yin Essence︰Can see far but not near, prolonged viewing causes eyeball aching pain, dizziness, tinnitus, soreness and weakness in the waist and knees, dry mouth and throat, and in severe cases, seminal emission and night sweats, loose teeth. The tongue is red with scant coating, and the pulse is thin and rapid. Mostly caused by excessive sexual activity, irregular eating, physical overstrain, excessive grief and crying, leading to damage to yin essence, which fails to ascend and nourish the eye orifices and gather light, hence blurred near vision. Yang fire flares outward, so far vision remains clear. Cishi Nanzhi said: "The ability to see far is due to the presence of fire. The inability to see near is due to the lack of water, and the treatment should focus on tonifying the kidneys." The kidneys govern the storage of essence; when yin essence is deficient, interior heat wreaks havoc, leading to vexing heat in the chest, palms, and soles, dry mouth and throat, seminal emission, and night sweats. The tongue is red with scant coating, and the pulse is thin and rapid. Treatment should focus on nourishing water and replenishing essence, using Six-Ingredient Rehmannia Pill, plus Schisandra Fruit and oyster shell. For eyeball aching pain, add Sichuan Lovage Rhizome, Chinese Angelica, and Chastetree Fruit. Alternatively, use Earth Essence Pill.
2. Yin Deficiency︰Farsightedness, inability to sustain vision for long, with faint redness at the outer canthus of both eyes. Dizziness, tinnitus, soreness in the waist, weak legs, tidal fever, flushed cheeks, feverish sensation in the palms and soles, frequent night sweats, a deep red tongue texture, and a fine, wiry, rapid pulse. This is often caused by insufficient water (yin) failing to control fire, leading to the reckless flaring of deficient fire. Symptoms include faint redness in the white of the eye at the canthus, dryness and discomfort in the eyes, often worsening with fatigue, overthinking, or insomnia. Accompanied by low-grade fever in the afternoon, flushed cheeks, dry mouth and throat, and frequent night sweats—signs of yin deficiency with effulgent fire. Treatment should focus on nourishing yin and reducing fire, using formulas such as Anemarrhena and Phellodendron Rehmannia Decoction or modified Yin-Nourishing and Fire-Reducing Decoction.
3. Deficiency of Both Qi and Blood︰The vision is clearer for distant objects than for near ones, with intolerance to prolonged viewing. Prolonged viewing causes aching pain in both eyes, which may even extend to the orbits and forehead. The complexion is pale, accompanied by severe palpitations, dizziness, insomnia, shortness of breath, mental fatigue, and poor appetite. The tongue is pale with scant coating, and the pulse is thin and weak. This condition is mostly caused by qi deficiency and blood insufficiency, leading to scattered and disordered vision. The main manifestations include clearer vision for distant objects than for near ones, but the ability to sustain focus is poor. If forced to view for extended periods, aching pain occurs in the eyeballs and supraorbital ridge. Additional symptoms include a pale complexion, shortness of breath, reluctance to speak, a pale tongue with scant coating, etc. The treatment principle is to tonify and replenish qi and blood, using formulas such as Eight Precious Ingredients Decoction or modified Bupleurum Ginseng Atractylodes Macrocephala Decoction.
4. Deficiency of Both Yin and Yang︰Diminished visual acuity, with mental confusion when viewing near objects but slightly clearer vision for distant objects. Accompanied by cold limbs, pale tongue with white coating, and deep, thin pulse. Often caused by deficient yang qi, preventing the divine light from projecting outward to illuminate distant objects, resulting in blurred distance vision. Depleted yin essence prevents the gathering of radiance, leading to mental confusion when viewing near objects. However, distance vision is slightly better than near vision. Commonly accompanied by cold limbs, pale tongue with white coating, and deep, thin pulse. Treatment should focus on supporting yang and nourishing yin, consolidating essential qi, using the Quanzhen Qi-Tonifying Decoction.

Generally speaking, yin deficiency farsightedness, yin deficiency with effulgent fire farsightedness, and farsightedness due to deficiency of both qi and blood are more common in young adults. Appropriate treatments can be adopted based on the symptoms. As for deficiency of both yin and yang, it is a sign of aging and should be managed with care to slow its progression.

bubble_chart Documentation

1. Jingyue Quanshu．Eyes: "Dongyuan said that farsightedness is due to insufficient yang qi and excess yin qi, which is a deficiency of qi and an abundance of blood. The abundance of blood indicates excess yin fire, and the deficiency of qi indicates weakness of qi, which is a sign of aging. Myopia is due to excess yang qi and insufficient yin qi, which is a deficiency of blood and an abundance of qi. The deficiency of blood and abundance of qi both indicate excess fire and insufficient original qi. Fire is the thief of original qi."
2. Wang Haizang said: The ability to see far is due to the presence of fire, and the inability to see near is due to the absence of water, and Dongyuan's Earth Essence Pill should be used. The ability to see near is due to the presence of water, and the inability to see far is due to the absence of fire, and Dongyuan'sMind-Stabilizing Pillshould be used.
3. I think that the views of these two scholars are contradictory. Dongyuan considers the inability to see near as a deficiency of yang and the inability to see far as a deficiency of yin. Haizang attributes farsightedness to the presence of fire and absence of water, and myopia to the presence of water and absence of fire. How can their statements be so antagonistic? Is there no distinction between right and wrong? Liu Zonghou said: Yang qi is like the sun and fire. Yin qi is like metal and water. Ancient scholars said that metal and water are bright inside and dark outside, while the sun and fire are bright outside and dark inside, which is a principle of the Yi Jing. Therefore, those who are bright inside are good at seeing near, and those who are bright outside are good at seeing far. Therefore, those who cannot see far must have yin overcoming yang, and those who cannot see near must have yang overcoming yin. From this perspective, Haizang is right and Dongyuan is wrong. In my opinion, we should only talk about deficiencies and not about excesses. Therefore, those who cannot see far have insufficient yang qi, and those who cannot see near have insufficient yin qi. Isn't this very clear? If Dongyuan considers excess yin qi and excess yang qi as fire, then those who can see are all suffering from fire disease. Haizang says that the ability to see near is due to the presence of water, and the ability to see far is due to the presence of fire, then what should be blamed is also a disease. I cannot fully agree with such discussions."