Repeated Low-Level Red-Light for Myopia Control

Review of Myopia Management: The Latest in Red Light Therapy

https://reviewofmm.com/the-latest-in-red-light-therapy/

Key Concepts: RLRL for Myopia Control

1. What is Repeated Low-Level Red-Light (RLRL) Therapy?
   A treatment involving brief daily exposure (typically a few minutes, twice daily) to red light (~650 nm) ➝ aims to mimic the benefits of outdoor bright light exposure by stimulating retinal pathways that slow down myopia progression. en.wikipedia.org+10reviewofmm.com+10visionmonday.com+10
   
   

2. Mechanism of Action
   RLRL is a form of photobiomodulation, believed to enhance choroidal blood flow and mitochondrial energy production, promoting increased dopamine release in the retina—which signals the eye to reduce axial elongation (lengthening). reviewofoptometry.com+5scholars.duke.edu+5journals.lww.com+5journals.lww.com
   
   

3. Clinical Evidence (Key Trials & Reviews):
   
   

   • Standalone RLRL: Meta-analysis of ~1,700 participants shows significant reduction in axial length (AL) and refractive error (SER) compared to standard single-vision spectacles over long-term (up to 2 years) scholars.duke.edu+9pubmed.ncbi.nlm.nih.gov+9ajo.com+9.
     
     

   • RLRL vs Ortho-K Lenses: A 138-child, 2-year study showed AL growth around 0.17 mm (RLRL) vs 0.50 mm (Ortho-K). Early regression of AL observed in 55% of RLRL users after 1 month; 42% sustained that improvement at 1 year journals.lww.com+1reviewofoptometry.com+1.
     
     

   • RLRL + Orthokeratology: Combined therapy produced average AL change of –0.02 mm vs +0.27 mm in Ortho-K alone after 12 months, suggesting additive benefits en.wikipedia.org+7reviewofmm.com+7journals.lww.com+7.
     
     

4. Efficacy Highlights:
   
   

   • Short-term: 55% of children showed AL shortening after one month; sustained in 42% at 12 months journals.lww.com+1reviewofoptometry.com+1.
     
     

   • Year 1: AL growth ~0.03 mm with RLRL vs ~0.28 mm with Ortho-K;
     
     

   • Year 2: RLRL users averaged 0.14 mm growth, still less than Ortho-K's 0.21 mm .
     
     

5. Safety & Side Effects
   
   

   • RLRL is generally well tolerated in children—no serious retinal damage reported in 2-year studies.
     
     

   • Some caution over potential retinal exposure parameters; standards and protocols continue to evolve journals.lww.com.
     
     

   • “Rebound” effect possible when stopping treatment, requiring more long-term follow-up .
     
     

6. Unanswered Questions & Research Needs
   
   

   • Optimal treatment duration, wavelength, and device standardization need refinement.
     
     

   • Long-term effects, rebound after cessation, use in early/pre-myopia children—all require more investigation reviewofmm.comen.wikipedia.org+10scholars.duke.edu+10journals.lww.com+10.
     
     

 Bottom Line

• RLRL therapy is an emerging, promising technique to slow or even reverse myopia progression in children, with efficacy sometimes surpassing orthokeratology lenses.
  
  

• It is convenient, non-invasive, and shows sustained benefits in early use.
  
  

• Further high-quality research is needed to finalize treatment guidelines, safety protocols, and its long-term role, including potential synergy with optical therapies like Ortho-K.