Retinal Hemorrhage
视网膜出血 · shì wǎng mó chū xuè+3 other namesHide other names
Also known as: Retinal Haemorrhage, Hemorrhage In The Retina, Retinal Bleeding
Not every retinal bleed is the same condition. The sudden, stress-triggered bleed with a throbbing headache and the slow, chronic ooze with fatigue and dry eyes are two different patterns - and each needs its own treatment. Most patients see noticeable absorption of blood and stabilization of vision within four to eight weeks of herbs and acupuncture, with further improvement as the underlying constitution is rebuilt.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe retinal hemorrhage. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
Retinal hemorrhage isn't a single condition in TCM - it's a family of distinct patterns, each with its own cause and its own treatment. Some bleeds happen because the body's Qi is too weak to hold blood inside the vessels. Others happen because heat or rising Liver Yang pushes blood out with too much force. The same Western diagnosis of a retinal bleed might stem from a completely different internal imbalance, which is why TCM doesn't treat the bleed in isolation - it treats the person behind the bleed.
Retinal hemorrhage means bleeding within the light-sensitive tissue at the back of the eye. It can cause sudden vision changes - floaters, blurred vision, dark patches, or even complete vision loss if the macula is involved. Common causes include diabetes, high blood pressure, retinal vein occlusion, trauma, and age-related macular degeneration. Diagnosis is made through a dilated eye exam and imaging like optical coherence tomography or fluorescein angiography, which show the location, size, and likely source of the bleed.
Conventional treatments
Treatment depends on the cause and severity. Small hemorrhages may be watched as the body reabsorbs them over weeks. More serious cases - especially those threatening central vision - are treated with anti-VEGF injections to stop abnormal vessel growth, laser photocoagulation to seal leaking vessels, or vitrectomy surgery to remove blood from the vitreous. Managing the underlying condition, such as controlling blood sugar or blood pressure, is a cornerstone of prevention.
Where conventional treatment falls short
Conventional treatments focus on stopping active bleeding and preventing further vessel damage, but they don't address the systemic imbalances that made the vessels fragile in the first place. Recurrence is common because the underlying terrain - whether it's chronic inflammation, vascular fragility, or poor blood quality - remains unchanged. Anti-VEGF injections require repeated clinic visits and carry risks of infection and increased eye pressure. Many patients wonder if there is a way to strengthen their vessels and reduce the likelihood of another bleed, which is precisely where TCM's constitutional approach offers a different path.
How TCM understands retinal hemorrhage
TCM sees the eye as intimately connected to the Liver, Kidneys, and Spleen. The Liver opens into the eyes and stores Blood; if Liver Yin is too weak to anchor its Yang, that unmoored Yang can surge upward with heat and force blood out of the retinal vessels. This is why sudden bleeds often follow anger or stress - the Liver's energy rises abruptly and overflows.
The Kidneys store the essence that nourishes all tissues, including the delicate eye vessels. When Kidney Yin runs low, a dry, false heat rises upward, making vessels brittle and prone to slow, oozing bleeds. At the same time, the Spleen is responsible for holding blood inside the vessels. If Spleen Qi is weak - often from poor diet, overwork, or chronic illness - blood can seep out wherever vessels are fragile, causing chronic low-grade bleeding.
Blood stagnation is another key mechanism. When Qi becomes stuck, often from emotional frustration, it can't push blood smoothly through the tiny eye collaterals. The blood congeals, pressure builds, and a vessel ruptures. Each of these mechanisms - heat, deficiency, stagnation - produces a different kind of bleed and a different constellation of body-wide symptoms, which is why TCM practitioners ask about everything from thirst and sleep to bowel habits and menstrual cycles when assessing a retinal hemorrhage.
「血灌瞳人者，因血热妄行，溢于瞳内，视物不见，如隔云雾。」
"When blood pours into the pupil, it is due to reckless movement of blood from heat, overflowing into the pupil, causing vision to be obscured as if looking through clouds."
How a TCM practitioner diagnoses retinal hemorrhage
Inside the consultation
A TCM practitioner starts by asking how the vision change felt when it began - was it sudden or gradual, painless or sharp? The timing, quality, and any accompanying bodily sensations are the first clues that point toward one pattern rather than another.
If the bleeding is accompanied by persistent fatigue, dry eyes, thirst, and a sense of general depletion, the picture often matches Qi and Yin Deficiency. The tongue may appear pale and slightly dry, and the pulse feels weak and thready, reflecting the body’s inability to hold blood and nourish the vessels.
When the onset is abrupt and linked to anger, stress, or a throbbing headache - along with dizziness, a flushed face, and irritability - Liver Yang Rising is likely. The tongue is red with a thin yellow coat, and the pulse is wiry and forceful, showing that rising heat is pushing blood out of the retinal vessels.
A slow, gradual blurring with dry eyes, soreness in the low back and knees, and ringing in the ears points toward Kidney and Liver Yin Deficiency. Here the tongue is red with a scanty coat, and the pulse is thready and rapid. The fragile eye collaterals are not being nourished, making them prone to leak.
If those deficiency signs are joined by a feeling of heat in the palms and soles, night sweats, and a malar flush, the diagnosis shifts to Kidney Yin Deficiency with Empty-Heat Blazing. The tongue is red with little or no coating, and the pulse is rapid and thready, indicating that empty fire is scorching the vessels.
Sharp, fixed eye pain or a history of trauma suggests Qi and Blood Stagnation. The tongue may show dark purple spots, and the pulse feels wiry or choppy. In this pattern, physical blockage rather than weakness is the main culprit, causing vessel rupture from stasis.
Chronic, recurrent bleeding with a pale complexion, poor appetite, and loose stools points to Spleen not controlling Blood. The tongue is pale and puffy, and the pulse is weak. The Spleen’s Qi is too depleted to keep blood inside the vessels, so it leaks into the retina.
TCM Patterns for Retinal Hemorrhage
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same retinal hemorrhage can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is very common to see yourself in more than one pattern. For instance, long-standing Qi and Yin Deficiency can eventually weaken the Spleen, and Kidney Yin Deficiency can easily generate Empty-Heat. These patterns are stages along a continuum, not rigid boxes.
To narrow things down, pay attention to what feels strongest. If your energy is low and you feel cold or depleted, a deficiency pattern is likely dominant. If you feel hot, agitated, or your symptoms flare with stress, heat or Yang rising is more central. Sharp, fixed pain points toward stagnation rather than pure weakness.
Because retinal bleeding can be serious and the patterns overlap, a professional tongue and pulse diagnosis is extremely helpful. A practitioner can spot subtle signs - like a pale tongue with a red tip, or a wiry pulse that is also weak - that reveal a mixed picture and guide a safe, effective treatment.
If you experience a sudden loss of vision, a dark curtain across your sight, or severe eye pain, seek immediate care. Even with milder symptoms, a TCM practitioner can help you understand the underlying pattern and prevent recurrence, so do not rely on self-assessment alone for eye health.
Qi and Yin Deficiency
Liver Yang Rising
Qi And Blood Stagnation
Spleen not controlling Blood
Treatment
Four ways to address retinal hemorrhage in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for retinal hemorrhage
6 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A classical three-herb formula used to restore vitality when both Qi and body fluids have been depleted. It addresses fatigue, shortness of breath, excessive sweating, dry throat, and weak pulse caused by heat exhaustion, chronic illness, or prolonged coughing that has weakened the Lungs. In modern practice, it is also widely used as supportive treatment for heart conditions including heart failure and irregular heartbeat.
A classical formula that nourishes the Liver and Kidneys to support eye health and clear vision. It is used for blurred vision, dry eyes, sensitivity to light, excessive tearing in wind, dizziness, and ringing in the ears caused by Liver and Kidney Yin deficiency. Built on the famous Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) with the addition of goji berry and chrysanthemum flower for their vision-supporting properties.
A modern formula designed to calm an overactive Liver and settle internal Wind, used for headaches, dizziness, and insomnia caused by rising Liver Yang. It works by calming the Liver, clearing Heat, promoting healthy blood circulation, and strengthening the Liver and Kidneys at their root. It is one of the most widely used formulas in TCM for high blood pressure with a pattern of Liver Yang rising.
A classical formula that nourishes the body's cooling Yin fluids while clearing excess internal heat. It is commonly used for symptoms such as hot flashes, night sweats, tinnitus, sore throat, dry mouth, and low back aching that arise when the Kidneys become depleted and the body overheats from within. It builds on the famous Liu Wei Di Huang Wan (Six Ingredient Rehmannia Pill) with two additional cooling herbs.
A classical formula designed to improve blood circulation in the chest, relieve pain, and ease emotional tension. It is widely used for chronic chest pain, stubborn headaches, insomnia, and irritability caused by poor blood flow and stagnation in the upper body.
A classical formula that strengthens the Spleen and nourishes the Heart to address fatigue, poor appetite, insomnia, forgetfulness, palpitations, and anxiety caused by weakness of both the Heart and Spleen. It is also widely used for bleeding disorders such as heavy or prolonged menstrual periods, easy bruising, or blood in the stool that result from the Spleen being too weak to keep blood in its proper channels.
Acute bleeds from excess patterns like Liver Yang Rising often respond within 2-4 weeks of daily herbs and weekly acupuncture. Chronic oozing bleeds from deficiency patterns - Qi and Yin Deficiency, Spleen not controlling Blood, or Kidney and Liver Yin Deficiency - typically require 3-6 months of consistent treatment to rebuild the body's reserves and prevent recurrence. Vision improvement is usually gradual and steady rather than dramatic overnight.
Treatment principles
Across all patterns, TCM treatment of retinal hemorrhage works on two fronts: stopping active bleeding and resolving existing blood stasis, while simultaneously correcting the underlying deficiency or excess that caused the vessel to rupture. In the acute stage, the priority is to cool the blood, stop bleeding, and gently move stasis. In the chronic stage, the focus shifts to nourishing Yin, boosting Qi, and strengthening the Spleen and Kidneys to prevent recurrence.
This two-phase approach is a hallmark of TCM's advantage. Herbal formulas are adjusted as the bleed evolves - from hemostatic herbs like San Qi and Pu Huang in the early days to more nourishing and blood-moving herbs like Gou Qi Zi and Dan Shen later. Acupuncture points are chosen both locally around the eye to improve microcirculation and distally on the body to treat the root pattern, whether that's Liver Yang rising, Spleen Qi sinking, or Kidney Yin deficiency.
What to expect from treatment
Treatment typically starts with weekly acupuncture sessions and a daily herbal decoction or granules. In the first few weeks, the goal is to stabilize the bleed and begin absorption. Most patients notice that their vision stops worsening and the dark spot or blur gradually lightens. Over the next 2-3 months, as the underlying pattern is corrected, the blood continues to clear and visual acuity improves.
For deficiency patterns, treatment may extend to 4-6 months to fully rebuild the body's reserves. Acupuncture frequency may reduce to biweekly or monthly for maintenance once the bleed has resolved.
General dietary guidance
In general, retinal hemorrhage patients benefit from a diet that is cooling, nourishing, and easy to digest. Favor foods that support the Liver and Kidneys: goji berries, chrysanthemum tea, black sesame, walnuts, dark leafy greens, and small amounts of high-quality protein like fish or eggs. Avoid hot, spicy, and greasy foods that can generate heat and damage Yin.
Alcohol and smoking are particularly harmful as they directly injure the Liver and Kidneys and promote vascular fragility. Warm, cooked meals like congee and soups are ideal for supporting the Spleen and ensuring that Qi is strong enough to hold blood in the vessels.
Combining TCM with conventional treatment
TCM can safely complement conventional retinal hemorrhage treatment. Many patients receive herbs and acupuncture alongside anti-VEGF injections or laser therapy.
It is critical to inform both your ophthalmologist and your TCM practitioner about all treatments you are receiving. Certain herbs - especially Dan Shen, Chuan Xiong, and Hong Hua - have mild blood-thinning properties and should be used with caution if you are on anticoagulant or antiplatelet medications. Your TCM practitioner can modify the formula accordingly. Do not stop any prescribed eye drops or medications without consulting your doctor. Always bring a complete medication list to your TCM consultation.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
-
Sudden, complete loss of vision in one eye — This may indicate a massive hemorrhage, retinal detachment, or central artery occlusion - all of which require immediate emergency care.
-
A dark curtain or shadow moving across your field of vision — This is a classic sign of retinal detachment, which is a medical emergency. Prompt surgery can often save sight.
-
Sudden shower of new floaters, especially if accompanied by flashes of light — This can signal a retinal tear or detachment. The flashes are caused by the vitreous pulling on the retina.
-
Severe eye pain, especially with nausea or vomiting — Acute angle-closure glaucoma can cause sudden, intense pain and rapid vision loss. It requires immediate pressure-lowering treatment.
-
Vision loss after a head or eye injury — Trauma can cause internal eye damage that may not be visible externally. An urgent eye exam is necessary.
Audience-specific guidance — open what applies to you
During pregnancy, retinal hemorrhage may be linked to preeclampsia or gestational hypertension, and TCM treatment must prioritize fetal safety. Patterns like Liver Yang Rising or Qi and Blood Stagnation are common, but strong blood-moving herbs such as Chuan Xiong, Hong Hua, and Dan Shen in large doses are contraindicated because they can stimulate uterine contractions.
Instead, gentle nourishing herbs like Sang Ji Sheng and Gou Qi Zi are preferred, and small amounts of San Qi powder may be used to stop bleeding without moving blood too aggressively.
Acupuncture points that are traditionally avoided in pregnancy-such as Hegu LI-4 and Sanyinjiao SP-6-should not be used. Safer alternatives include Zusanli ST-36 and Taixi KI-3. Any treatment plan must be coordinated with obstetric care, and immediate referral is necessary if blood pressure rises dangerously.
After childbirth, blood deficiency often becomes more prominent, so formulas that nourish Blood and Yin, like Qi Ju Di Huang Wan, are suitable. Strong blood-moving herbs are still best avoided as their active compounds can pass into breast milk and potentially affect the infant. San Qi powder is generally considered safe and can be used to help absorb residual hemorrhage.
Acupuncture is a safe option during breastfeeding, and points such as Zusanli ST-36 and Taixi KI-3 can gently support Qi and Blood. If the mother is fatigued from nursing, the Spleen not controlling Blood pattern may emerge, and Gui Pi Tang can be adapted with caution.
Retinal hemorrhage in children is rare and usually results from trauma, blood disorders, or severe systemic illness. When it does occur, patterns such as Spleen not controlling Blood or Qi and Blood Stagnation may be present. Herbal dosages must be significantly reduced-often to one-quarter or one-third of the adult dose-and strong blood-moving herbs are generally avoided. Pediatric tuina and gentle acupressure can be safer alternatives to acupuncture.
Because children cannot always describe their symptoms, diagnosis relies heavily on observation of the tongue, pulse, and overall behavior. Any sign of retinal bleeding in a child warrants urgent medical investigation, and TCM treatment should be an adjunct to conventional care.
In older adults, retinal hemorrhage almost always arises from deficiency patterns-most commonly Kidney and Liver Yin Deficiency or Qi and Yin Deficiency. The retinal vessels are fragile due to long-term dryness and lack of nourishment. Treatment should be gentle and gradual, using nourishing formulas like Qi Ju Di Huang Wan or Sheng Mai San, with lower herb dosages (typically two-thirds of the standard adult dose) to avoid overwhelming a weakened digestive system.
Polypharmacy is a significant concern, so practitioners must carefully check for interactions with blood thinners, antihypertensives, and diabetes medications. Acupuncture is often well tolerated and can be an effective primary therapy. Strong blood-moving herbs like Hong Hua should be used sparingly, if at all, to prevent bleeding elsewhere.
Evidence & references
Research on TCM for retinal hemorrhage is most robust in the context of diabetic retinopathy, where several systematic reviews and randomized controlled trials have shown that Chinese herbal medicine, when added to conventional treatment, can improve visual acuity and promote absorption of retinal hemorrhages. Formulas like Qi Ju Di Huang Wan and Xue Fu Zhu Yu Tang are among the most studied. However, many trials are small and conducted in China, with limited blinding, which reduces the strength of the evidence.
Acupuncture for retinal hemorrhage has been explored in case series and small RCTs, particularly for retinal vein occlusion and diabetic retinopathy. Results suggest that acupuncture may improve retinal microcirculation and reduce macular edema, but high-quality, large-scale studies are still needed. Overall, TCM appears promising as an adjunctive therapy, but patients should not rely on it as a sole treatment for acute, severe bleeds.
Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「目衄者，肝火上炎，迫血妄行，溢于络外。」
"Eye bleeding occurs when Liver Fire flames upward, forcing blood to move recklessly and overflow outside the vessels."
Yin Hai Jing Wei (Essentials of Ophthalmology)
Blood Diseases of the Eye
Frequently asked questions
Common questions about using Traditional Chinese Medicine for retinal hemorrhage.
Yes, many TCM formulas and acupuncture points are specifically chosen to move stagnant blood and promote its absorption. Herbs like San Qi (notoginseng) and Dan Shen (salvia) are famous for dissolving blood stasis without causing further bleeding. Acupuncture around the eye and on distal points like Sanyinjiao can improve local circulation and speed up the clearance of blood from the retina. Patients often notice their vision starting to clear within a few weeks of consistent treatment.
In most cases, yes - but you must tell both your TCM practitioner and your prescribing doctor about all medications and supplements you are taking. Some Blood-moving herbs, such as Dan Shen and Chuan Xiong, can have mild antiplatelet effects, which may add to the effects of anticoagulant or antiplatelet drugs like warfarin, aspirin, or clopidogrel. Your TCM practitioner can adjust the formula to avoid interactions and will monitor you closely. Never stop or adjust your blood pressure medication without consulting your doctor.
Most patients begin to notice a gradual lightening of the dark spot or improvement in clarity within 4-6 weeks of starting herbs and acupuncture. The blood absorption happens slowly, and the speed depends on the size and location of the bleed, as well as your overall health. Acute, smaller bleeds tend to clear faster. Chronic, recurrent bleeds with underlying deficiency patterns take longer - often 3-6 months - because the treatment is also working to rebuild the vessel integrity and prevent future episodes.
TCM's goal is not just to clear this bleed but to correct the underlying imbalance that made your retinal vessels vulnerable in the first place. By strengthening Qi, nourishing Yin, and removing stasis, the treatment aims to reduce the likelihood of recurrence. Many patients find that once their constitution is rebuilt through a full course of herbs and acupuncture, their eyes feel more resilient and they experience fewer vascular events. Maintenance with periodic check-ups and seasonal herbal adjustments can help sustain this.
Favor foods that nourish the Liver and Kidneys and help move blood gently: goji berries, chrysanthemum tea, dark leafy greens, black sesame, mulberries, and small amounts of cooked liver. Avoid spicy, greasy, and fried foods, as well as alcohol and smoking, which generate heat and damage Yin. Warm, easily digested meals like congee support the Spleen's ability to hold blood in the vessels. Your TCM practitioner will give you more specific guidance based on your pattern, but these general principles apply to most retinal hemorrhage patients.
Acupuncture points around the eye, such as Jingming (BL-1) and Qiuhou (EX-HN-7), are needled very gently by trained practitioners. The needles are extremely fine and are inserted just under the skin or into the orbital tissue with great care - it is not painful and does not touch the eyeball itself. Most patients feel a mild sensation of pressure or distention, and many find the experience deeply relaxing. The majority of needles are placed on the body - on the legs, arms, and back - to address the internal pattern causing the bleed.
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