This article was originally published in a sponsored newsletter.

Myopia is understood as a progressive and irreversible condition.¹ Myopia management aims to slow axial elongation and reduce the risks of ocular issues associated with pathological myopia, such as retinal detachments, macular degeneration, and early cataracts. Red light therapy, also known as low-level light therapy (LLLT), is being studied as an alternative myopia management option, claiming to result in the shortening of axial length in patients, though this effect has not been observed by any other clinically accepted form of management.¹ A study conducted in China that assessed the efficacy and safety of repeated low-level red light therapy in myopia control in children, found a shortening of > 0.05mm in 39.8% of myopic participants in one month and that percentage increased to 21.6% at 12 months.¹

Although the investigators are still unsure of the exact mechanism of action, they theorize that the absorbance of long wavelength light in ocular tissues increases blood flow and stimulates metabolism within the posterior pole, causing scleral hypoxia and increasing scleral collagen levels.² With increased collagen levels, the eye is more malleable for changes in structure and scleral remodeling.¹ Choroidal thickening has also been noted as a mechanism of action in LLLT because the thickness of the choroid typically decreases as axial length increases.³ However, the therapy is still considered experimental at this time.³

There are some debates about the safety of low-level light exposure in the form of diffuse light versus laser light, with results indicating that low-level light with diffuse light exposure is safe.⁵ LLLT is also being studied to treat dry eyes, meibomian gland dysfunction, internal and external hordeola, chalazia, blepharitis, headaches, traumatic brain injuries, and concussion rehabilitation.^5-9 However, a recent study noted retinal damage with laser light exposure.⁴ Fundus photography noted a dark fovea with hypo-autofluorescent plaque buildup at the macula.⁴ There was also foveal ellipsoid zone destruction and interdigitation zone discontinuity upon optical coherence tomography imaging.⁴ Upon discontinuation of the laser light exposure, the bilateral outer retinal damage partially recovered after three months.⁴

Most red-light therapy studies are being done in China and have been approved by China’s National Medical Products Administration, but it has not yet been accepted as a therapy by the U.S. Food and Drug Administration. Long-term efficacy and safety rebound effects are still being studied, and it is currently being investigated as an effective, alternative, novel treatment for myopia management.

1. Jiang Y, Zhu Z, Tan X, et al. Effect of Repeated Low-Level Red-Light Therapy for Myopia Control in Children: A Multicenter Randomized Controlled Trial. Ophthalmology. 2022 May;129:509-519.

2. Wu H, Chen W, Zhao F, et al. Scleral hypoxia is a target for myopia control. Proc Natl Acad Sci. 2018 Jul 24;115:E7091-E7100.

3. Muhiddin HS, Mayasari AR, Umar BT, et al. Choroidal Thickness in Correlation with Axial Length and Myopia Degree. Vis Basel Switz. 2022 Mar 2;6:16.

4. Liu H, Yang Y, Guo J, Peng J, Zhao P. Retinal Damage After Repeated Low-level Red-Light Laser Exposure. JAMA Ophthalmol. 2023 May 25. [Online ahead of print]

5. Rojas JC, Gonzalez-Lima F. Low-level light therapy of the eye and brain. Eye Brain. 2011 Oct 14;3:49-67.

6. Park Y, Kim H, Kim S, Cho KJ. Effect of low-level light therapy in patients with dry eye: a prospective, randomized, observer-masked trial. Sci Rep. 2022 Mar 4;12:3575.

7. Marques JH, Marta A, Baptista PM, et al. Low-Level Light Therapy in Association with Intense Pulsed Light for Meibomian Gland Dysfunction. Clin Ophthalmol. 2022 Dec 6;16:4003-4010.

8. Figueiro Longo MG, Tan CO, Chan ST, et al. Effect of Transcranial Low-Level Light Therapy vs Sham Therapy Among Patients With Moderate Traumatic Brain Injury: A Randomized Clinical Trial. JAMA Netw Open. 2020 Sep 1;3:e2017337.

9. Stonecipher K, Potvin R. Low level light therapy for the treatment of recalcitrant chalazia: a sample case summary. Clin Ophthalmol. 2019 Sep 5;13:1727-1733.