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Low-Level Red-Light Therapy: A Promising Frontier in Myopia Management

Vision Science Academy

Ishwarya A1, Bhargavy S2,

1M.Optom. Student, Dr. Agarwal’s Institute of Optometry, Chennai, India

2Assistant Professor Jr., Dr. Agarwal’s Institute of Optometry, Chennai, India

 

Myopia, or near-sightedness, has emerged as a pressing global public health issue. Epidemiological projections estimate that by 2050, nearly half of the world’s population may be affected. (1) Characterised by the eye’s inability to focus distant objects clearly due to excessive axial elongation, where the eyeball becomes too long, myopia causes light to focus in front of the retina instead of directly on it. Although traditionally managed with corrective lenses, high myopia significantly raises the risk of serious ocular complications such as retinal detachment, myopic maculopathy, and glaucoma. (1)

Current management strategies focus primarily on slowing myopia progression during childhood, a critical period of ocular development. Interventions include multifocal spectacles, orthokeratology (overnight corneal reshaping lenses), and pharmaceutical agents like low-dose atropine eye drops. While these methods show moderate effectiveness, none offer a definitive solution, especially for rapidly progressing cases. The continued rise in global myopia prevalence, particularly in children from urbanised environments, underscores the urgent need for novel and more effective treatments. (1)

An emerging and promising modality is low-level red light (LLRL) therapy, a non-invasive approach that delivers controlled exposure of red light, typically around 650 nanometres, to the eyes. Originally explored for neuroprotective and regenerative purposes in other medical disciplines, red light therapy has recently attracted interest in ophthalmology. In myopia research, LLRL is being studied for its potential to slow, or possibly reverse, axial elongation, a transformative shift in the approach to myopia control. (2,4)

While the exact biological mechanisms remain under investigation, several hypotheses have emerged. A leading theory suggests that LLRL enhances mitochondrial activity in retinal cells, boosting energy production and supporting healthier metabolism. Additionally, it may modulate neurotransmitter activity, especially increasing dopamine levels in the retina, which is known to inhibit axial elongation in animal models. (3) LLRL might also improve choroidal blood flow and promote tissue repair within the retina and sclera, helping maintain ocular structure. (2)

Clinical studies, particularly from East Asia where myopia prevalence is high, have shown encouraging outcomes. In one randomised controlled trial, children treated with LLRL therapy for three minutes twice daily over six months exhibited significantly less axial elongation and myopic progression compared to control groups. (2) The therapy was well tolerated, with no significant adverse effects reported, suggesting a favourable safety profile. (2,4)

Even more compelling are early reports suggesting LLRL may reverse some axial elongation. (5,6) If confirmed by larger trials, this could challenge the long-standing belief that myopia progression is irreversible, especially in children undergoing rapid changes. (6,7)

Despite these promising developments, barriers remain. Long-term safety data are still lacking, and optimal treatment protocols such as duration and frequency are not yet standardised. (4,7) Additionally, regulatory approval for LLRL devices is pending in many regions, and the rise of unregulated home-use products raises concerns over safety and effectiveness. (4)

In conclusion, LLRL therapy offers a groundbreaking opportunity in combating myopia. As research advances, it may become an essential addition to the myopia management toolkit, offering renewed hope for tackling this modern vision epidemic. (2,4,6)

 

References:

  1. Holden, B. A., et al. (2016). *Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050*. *Ophthalmology, 123*(5), 1036–1042. [https://doi.org/10.1016/j.ophtha.2016.01.006](https://doi.org/10.1016/j.ophtha.2016.01.006)
  2. Jiang, Y., et al. (2022). *Effect of Repeated Low-Level Red-Light Therapy for Myopia Control in Children: A Multicenter Randomized Controlled Trial*. *Ophthalmology, 129*(5), 509–519. [https://doi.org/10.1016/j.ophtha.2021.11.023](https://doi.org/10.1016/j.ophtha.2021.11.023)
  3. Feldkaemper, M., & Schaeffel, F. (2013). *An updated view on the role of dopamine in myopia*. *Experimental Eye Research, 114*, 106–119. [https://doi.org/10.1016/j.exer.2013.02.007](https://doi.org/10.1016/j.exer.2013.02.007)
  4. Wang, F., Peng, W., & Jiang, Z. (2023). *Repeated Low-Level Red Light Therapy for the Control of Myopia in Children: A Meta-Analysis of Randomized Controlled Trials*. *Eye & Contact Lens, 49*(10), 438–446. [https://doi.org/10.1097/ICL.0000000000001020](https://doi.org/10.1097/ICL.0000000000001020)
  5. Xiong, R., et al. (2022). *Sustained and rebound effect of repeated low-level red-light therapy on myopia control: A 2-year post-trial follow-up study*. *Clinical & Experimental Ophthalmology, 50*(9), 1013–1024. [https://doi.org/10.1111/ceo.14149](https://doi.org/10.1111/ceo.14149)
  6. Dong, J., Zhu, Z., Xu, H., & He, M. (2023). *Myopia Control Effect of Repeated Low-Level Red-Light Therapy in Chinese Children: A Randomized, Double-Blind, Controlled Clinical Trial*. *Ophthalmology, 130*(2), 198–204. [https://doi.org/10.1016/j.ophtha.2022.08.024](https://doi.org/10.1016/j.ophtha.2022.08.024)
  7. Xiong, R., et al. (2022). *Repeated low-level red light therapy in children with myopia: A randomized controlled trial*. *British Journal of Ophthalmology, 106*(4), 530–535. [https://doi.org/10.1136/bjophthalmol-2020-317458](https://doi.org/10.1136/bjophthalmol-2020-317458)
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