Red Light Therapy for Children with Myopia

Chinese researchers have demonstrated that repeated low-level red light (RLRL) therapy can effectively control the progression of myopia in children.

Red Light Therapy for Children with Myopia

 

Author: Linda Charters

Key Points

(Myopia, or nearsightedness, is one of the most common refractive errors in children. In this condition, distant objects appear blurry, while near objects are seen clearly.)

  • Repeated Low-Level Red Light (RLRL) therapy may help control myopia progression in children, but there are concerns about potential retinal damage, reduced cone density, and the development of abnormal retinal lesions.

  • Imaging with Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) showed significant differences in cone cell density between RLRL users and controls, especially 0.5 mm from the foveal center.

News Summary

Chinese researchers have demonstrated that repeated low-level red light (RLRL) therapy can effectively control the progression of myopia in children. However, the therapy was associated with a decrease in cone cell density, particularly 0.5 mm from the center of the fovea, and in some cases, drusen-like lesions were observed. This was reported by Dr. Xinyi Liao from the Department of Ophthalmology and Key Laboratory for Eye Disease at Peking University.

Liao and colleagues explain that RLRL is being evaluated as a potential method to slow myopia progression in children and adolescents. The system uses red light at a wavelength of 650 ± 10 nm, with a minimum radiant power of 0.29 mW entering a 4-mm pupil, in accordance with international laser safety standards. Nevertheless, there are reports that continuous irradiation—even when adhering to safety standards—can cause photothermal effects and subsequent retinal damage.

In this study, researchers used AOSLO high-resolution imaging to assess live changes in cone photoreceptor cells. They compared cone cell changes in myopic children aged 5–14 years who underwent RLRL therapy with those in a control group. Cone density was analyzed at various retinal locations (superior, inferior, nasal, temporal) from the center of the fovea to approximately 4 degrees eccentricity.

 

AOSLO Findings

  • A total of 99 myopic children were enrolled. The RLRL group consisted of 52 children (97 eyes, mean age 10.3 years), while the control group included 47 children (74 eyes, mean age 9.8 years).

  • Cone Density: RLRL users showed a significant reduction in cone density 0.5 mm from the fovea, especially in the temporal area. At 0.3 mm temporal to the fovea, the mean difference in cone density between the RLRL and control groups was –2,100 cells/mm² (95% CI: –3,680 to –590; P=0.003).

  • Abnormal lesions were observed in 11 eyes (with low-frequency signals and high brightness near the fovea). The odds ratio for such lesions in the RLRL group was 7.23 times higher than in controls (P=0.02).

  • In one child, small cystoid lesions were seen in the retinal ganglion cell layer on OCT, which resolved 3 months after discontinuation of RLRL treatment.

 

Conclusion

Liao and colleagues concluded:

“Treatment with RLRL for at least one year was associated with decreased cone density around the fovea and some subtle retinal changes. While this therapy may help control myopia progression, more research is needed to confirm its long-term efficacy and safety. These findings highlight the importance of further evaluating the risk–benefit balance of RLRL therapy in children with myopia, with a focus on AOSLO retinal imaging outcomes.”

 

References:

  1. Liao X, Yu J, Fan Y, et al. Cone density changes after repeated low-level red light treatment in children with myopia. JAMA Ophthalmol. 2025

  2. Wang W, Jiang Y, Zhu Z, et al. Ophthalmol Ther. 2023

  3. He X, Wang J, Zhu Z, et al. JAMA Netw Open. 2023

  4. Jiang Y, Zhu Z, Tan X, et al. Ophthalmology. 2022

  5. Chen Y, Xiong R, Chen X, et al. Transl Vis Sci Technol. 2022

  6. Youssef MA, Shehata AR, Adly AM, et al. BMC Ophthalmol. 2024

  7. Zhou L, Tong L, Li Y, Williams BT, Qiu K. Sci Rep. 2023

  8. Xiong R, Zhu Z, Jiang Y, et al. Clin Exp Ophthalmol. 2022

  9. LIA. American National Standard for Safe Use of Lasers

  10. Ostrin LA, Schill AW. Ophthalmic Physiol Opt. 2024

  11. Liu H, Yang Y, Guo J, Peng J, Zhao P. JAMA Ophthalmol. 2023

  12. Merino D, Loza-Alvarez P. Clin Ophthalmol. 2016

  13. Wynne N, Carroll J, Duncan JL. Prog Retin Eye Res. 2021