The Universal Struggle With Myopia Through the Ages

Modern China faces a myopia epidemic, with 81% of high school students requiring corrective lenses by 2018. This phenomenon, however, is far from contemporary. Historical records reveal that ancient Chinese scholars—constantly poring over texts to prepare for imperial examinations—frequently suffered from vision impairment. The prevalence of nearsightedness in antiquity spawned both practical solutions and humorous anecdotes that offer fascinating insights into pre-modern life.

Ancient Humor and Hazards of Poor Vision

The Ming Dynasty joke collection Xiaolin Guangji preserves numerous comedic scenarios involving myopia. One particularly vivid tale describes a nearsighted man mistaking a nightsoil carrier for a shrimp paste vendor due to the pungent odor. After chasing the bewildered laborer and sampling the “merchandise” with disastrous results, the shortsighted character indignantly complains about the vendor withholding “premium goods.” Such stories, while exaggerated for comic effect, underscore the daily challenges faced by those with uncorrected vision in eras before optometry.

Traditional Chinese terminology referred to myopia as “cannot see far” (不能远视), accurately describing its primary symptom. Ancient physicians correctly identified excessive close work—studying tiny characters by candlelight, prolonged manuscript copying, or delicate craftsmanship—as contributing factors. The Huangdi Neijing, China’s foundational medical text from the Han Dynasty, already warned against “reading fine scripts by moonlight” as harmful to vision.

Misguided Theories and Curious Cures

Pre-modern explanations for myopia reveal the limitations of ancient medicine. Rather than understanding the physiological changes in eyeball shape, traditional Chinese medicine attributed myopia to “yang deficiency” (阳虚) of the kidneys. This led to unconventional prescriptions—the Qing Dynasty physician Lin Peiqin recommended kidney-tonifying formulas like Liuwei Dihuang Wan (六味地黄丸) or Bawei Wan (八味丸) for vision correction. While these remedies might address other ailments, their efficacy for myopia remained dubious at best.

Archaeological discoveries prove that magnification aids existed much earlier than previously assumed. The tomb of Eastern Han Dynasty prince Liu Jing yielded a crystal lens—possibly the earliest known Chinese magnifier. During the cosmopolitan Tang Dynasty (618-907 CE), imported glass “fire pearls” (火珠) from Central Asia served primarily for lighting fires, but their optical properties didn’t escape scholarly notice.

The Scholar’s Saving Grace: Magnification Devices

The Northern Song Dynasty (960-1127 CE) witnessed a breakthrough when judicial official Shi Hang used crystal lenses to examine legal documents, as recorded in the Xia Ri Ji. This innovation coincided with the expansion of the imperial examination system, which created an unprecedented demand for visual aids among book-weary scholars. By the Southern Song period, dedicated reading aids called “ai dai” (叆叇)—primitive spectacles with twin lenses mounted on wooden or horn frames—emerged. Zhao Xigu’s Dongtian Qinglu describes these nose-mounted devices (lacking modern earpieces) helping elders read fine print.

Western Innovation Meets Imperial Curiosity

The transition to modern-style spectacles occurred through cultural exchange. Italian eyewear manufacturing flourished by the 13th century, and Ming Dynasty painter Qiu Ying’s Scenes from the Southern Capital (c. 1540) depicts early adopters wearing European-style glasses. The Qing Dynasty saw explosive growth in spectacle use—the Yongzheng Emperor (r. 1722-1735) amassed hundreds of Western lenses, establishing a dedicated imperial workshop to produce replicas. These prized items became diplomatic gifts, with missionaries frequently presenting bespoke glasses to Chinese rulers.

Democratizing Vision: The Rise of Civilian Optics

By the Qianlong era (1735-1796), Guangzhou artisans mass-produced affordable crystal lenses using steel saws—though without understanding optical principles, they created lenses of random curvature for customers to trial. British diplomat George Macartney’s 1793 delegation observed this pragmatic approach: “They place differently ground lenses before the purchaser until he finds one helping his sight.” At five mace of silver (≈modern ¥500), these spectacles became accessible to common scholars and officials alike.

A delightful 18th-century anecdote illustrates this new normal: When a myopic prefect struggled to discern the emperor’s face during an audience, Qianlong good-naturedly inquired, “Have you no glasses?” The official promptly produced spectacles from his sleeve to properly behold his sovereign—showcasing both the ubiquity of eyewear and courtiers’ tact.

Alternative Solutions for the Visually Impaired

Before spectacles became widespread, resourceful scholars employed workarounds. Northern Song statesman Ouyang Xiu—likely severely myopic—employed readers as “human audiobooks,” having texts recited aloud when his vision failed. This practice, recorded in Ye Mengde’s Shilin Yanyu, represents an early form of accessibility accommodation for the educated elite.

Lasting Legacies of Ancient Vision Correction

The evolution from kidney tonics to ai dai frames reflects China’s pragmatic approach to technological adaptation. Today’s optometry clinics owe much to this incremental progress—from imperial workshops standardizing lens production to grassroots artisans making vision aids affordable. As modern students face similar academic pressures to their Ming Dynasty counterparts, the historical struggle against myopia offers both cautionary tales and admiration for human ingenuity in overcoming physical limitations. The next time you adjust your prescription glasses, remember the nearsighted scholar who mistook fertilizer for seafood—and be grateful for modern optometrists.