Have you ever felt as if your vision were separated by a thin veil, with both near and far objects appearing as though covered by a fog? This sensation of "blurred vision, like a layer of fog before the eyes" is not uncommon in TCM clinical practice. However, the causes of blurring vary greatly. Before rushing to find a remedy, it may be helpful to go through the following self-assessment checklist to see which tendency applies to you:
1. Is the blurring worse upon waking, with slight relief after rubbing or blinking your eyes?
2. After prolonged eye use, does the blurring worsen, accompanied by dryness, soreness, and distension?
3. Is the blurring more pronounced on cloudy, rainy days or in damp environments?
4. Is it accompanied by dizziness, tinnitus, and soreness and weakness of the lower back and knees?
5. Does the blurring suddenly worsen after emotional fluctuations or fatigue?
If 2–3 of these apply to you, your "foggy sensation" may not simply be due to eye overuse, but rather a signal from your body's internal balance. How does TCM view this issue? Let us start with the triggers and peel back the layers like an onion.
Triggers and Disease Location: Where Does This "Fog" Come From?
The Huangdi Neijing states: "The essential qi of the five zang and six fu organs all ascends and pours into the eyes to form visual essence." Clear vision depends on the nourishment of organ essential qi ascending to the eyes. If you experience "blurred vision, like a layer of fog before the eyes," the first question to determine is: Is it a deficiency of essence and blood, unable to nourish the eyes? Or is it dampness, turbidity, phlegm, and stasis blocking the pathway through which essential qi ascends?
Clinically, there are three common triggers: first, prolonged late nights and excessive eye use, which deplete liver blood; second, irregular diet with excessive rich and greasy foods, leading to spleen deficiency and dampness generation; third, aging and bodily decline with kidney essence depletion. If the blurring is accompanied by dry, red eyes, it may lean toward liver blood insufficiency; if accompanied by heavy eyelids and a muzzy head, it may lean toward dampness and turbidity clouding the orifices. However, both may coexist—deficiency complicated by excess—which is particularly common in people who work at desks for long hours and lack exercise.
In TCM theory, the eyes connect with multiple meridians. For example, Jingming (Bright Eyes), also known as the tear hole, belongs to the Foot Taiyang Bladder Meridian and is located in the depression slightly above the inner canthus of the eye. The Bladder Meridian originates at the inner canthus and is closely related to the brain and eyes. The Zhenjiu Jiayijing records that "for unclear vision, Jingming governs it," making it a representative acupoint for eye-related issues. Related to this is Taichong, which belongs to the Foot Jueyin Liver Meridian and is the Yuan-Source point of the Liver Meridian, located in the depression anterior to the junction of the first and second metatarsal bones on the dorsum of the foot. The liver opens into the eyes, and Taichong is where the qi and blood of the Liver Meridian converge, closely related to the function of liver blood nourishing the ocular orifices.
Disease Nature and Trend: "Deficiency" or "Excess"—Completely Different Directions
In TCM pattern differentiation, the greatest pitfall is a "one-size-fits-all" approach. The same "blurred vision, like a layer of fog before the eyes" may, if it belongs to a deficiency pattern, have an essential nature of "insufficiency"—a depletion of liver blood, kidney essence, or qi and blood. Such individuals often present with a lusterless complexion, fatigue, insomnia, and soreness and weakness of the lower back and knees. The disease trend is slow, like a candle gradually burning out, with the blurring worsening progressively.
However, if it belongs to an excess pattern, the essential nature is "surplus"—dampness and turbidity, phlegm and fluids, or liver fire harassing upward. Such individuals may have a thick, greasy tongue coating, sticky stools, and irritability. The disease trend may be acute or chronic; sometimes after a single sleepless night or a bout of overeating, the blurring suddenly worsens.
Clinically, it is necessary first to distinguish whether deficiency or excess predominates, as the directions of regulation differ. If a deficiency pattern is mistakenly treated with clearing and draining, the condition may worsen with increasing deficiency; if an excess pattern is mistakenly treated with tonification, it is like adding fuel to the fire. This is why TCM emphasizes "treating the same disease with different methods"—the same chief complaint may have entirely different pathomechanisms behind it.
Prognosis and Care: How to Let the "Fog" Slowly Dissipate?
The Shanghan Lun states: "Observe the pulse and symptoms, know what transgression has occurred, and treat accordingly." The core of this classic lies in "treating accordingly"—adjusting the approach based on the specific manifestations at hand. For "blurred vision, like a layer of fog before the eyes," the direction of care must also vary from person to person.
If the tendency is toward liver blood insufficiency, one may appropriately consume dark-colored foods such as mulberry, goji berries, and black sesame, which are helpful for nourishing liver blood. However, note that these foods are warm and moist in nature; if one already has a thick, greasy tongue coating and loose stools, they should not be consumed in excess, lest they promote dampness.
If the tendency is toward dampness and turbidity clouding the orifices, the focus of care should be on strengthening the spleen and eliminating dampness. Some light, bland foods such as coix seed, poria, and dried tangerine peel can serve as dietary adjuncts. But similarly, if accompanied by obvious dry mouth, sore throat, and constipation, it may not be simple dampness and turbidity, and these should be used with caution.
From the perspective of meridians, the spleen and stomach are closely related to the transformation and transportation of dampness and turbidity. Zusanli, also known as Xialing, belongs to the Foot Yangming Stomach Meridian and is the He-Sea point of the Stomach Meridian and the lower He-Sea point of the Stomach. It is located on the anterior-lateral aspect of the lower leg, 3 cun below Dubi (ST35), one finger-breadth lateral to the anterior crest of the tibia. The spleen and stomach are the foundation of the acquired constitution and the source of qi and blood production; when the spleen and stomach transform and transport normally, water and dampness can be properly distributed. The name "Sanli" (three li) refers to its ability to regulate the deficiency and damage of the Triple Burner, making it an important acupoint for regulating spleen and stomach function.
The most critical point: any food or method must be determined by a licensed TCM practitioner based on pattern differentiation according to individual constitution. Blindly following "eye-protection recipes" or "liver-clearing, vision-brightening teas" may prove counterproductive.
Reflection Rather Than Answers: Which Type Does Your "Fog" Belong To?
Returning to the initial self-assessment checklist, after comparing, do you have a clearer understanding of your own situation? But the beauty of TCM lies in that it never gives standard answers—it guides you to observe your body's changes. If "blurred vision, like a layer of fog before the eyes" persists and is accompanied by other discomforts, it is advisable to consult a formal medical institution, where a licensed TCM practitioner can determine deficiency, excess, cold, and heat through the four diagnostic methods of inspection, auscultation and olfaction, inquiry, and palpation.
Perhaps this layer of "fog" is not merely an eye problem, but your body reminding you: it is time to stop and listen to your inner voice.
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Frequently Asked Questions
Q: Are blurred vision and "floaters" the same thing?
A: Not exactly. Floaters refer to small dark shadows drifting in the visual field, like flying insects; whereas "blurred vision, like a layer of fog before the eyes" is more like an overall hazy sensation across the visual field. The two have overlapping pathomechanisms, but TCM pattern differentiation emphasizes different aspects—floaters are mostly related to liver-kidney yin deficiency and phlegm-dampness with stasis obstruction, while the "foggy sensation" may lean more toward essence-blood insufficiency or dampness-turbidity clouding the orifices.
Q: Why do some people use warming tonification while others use clearing and draining for the same blurring?
A: This is precisely the manifestation of TCM's "treating the same disease with different methods." Different causes of blurring naturally call for different treatments. For example, blurring caused by liver blood depletion responds to warming tonification to nourish blood; blurring caused by liver fire harassing upward requires clearing and draining to descend the fire. The key lies in pattern differentiation, not in the symptom itself.
Q: What type does blurring caused by prolonged phone use belong to?
A: Prolonged eye use depletes liver blood, usually leaning toward a deficiency pattern, presenting with dryness, soreness and distension, and worsening in the afternoon. However, if accompanied by irregular diet and lack of exercise, dampness and turbidity may also be present, forming a mixed deficiency-excess pattern. In such cases, neither pure tonification nor pure clearing and draining alone will be effective; a comprehensive assessment by a licensed TCM practitioner is needed.
Q: Are there simple TCM methods for daily eye care?
A: TCM emphasizes "treating disease before it arises." Daily care focuses on regular rest, moderate eye use, and a balanced diet. For example, every 45 minutes of eye use, gaze into the distance for a moment to relax the eye muscles; in terms of diet, pay attention to combining coarse and fine grains and avoid excessive spicy and greasy foods. However, these are general recommendations; specific plans still need to be tailored to individual constitution, and it is not advisable to adopt specific foods or methods on your own.