Schools, Children and Myopia.

In the august 2023 issue of the AJO, a systematic review by Tang and colleagues 1 Tang J Liao Y Yan N et al. Efficacy of repeated low-level red-light therapy for slowing the progression of childhood myopia: a systematic review and meta-analysis. Am J Ophthalmol. 2023; 252: 153-163https://doi.org/10.1016/j.ajo.2023.03.036 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar focused on a recently available technology using twice-daily application of low-intensity red light for a total of 6 minutes per day. Initially designed to treat amblyopia, with results that were not encouraging, this intervention now appears to be effective in reducing myopia progression as measured by refractive power, axial length, and visual acuity. The wavelength of light emitted by this machine falls within the visible spectrum, and the source is categorized as class I, that is, safe for direct ocular exposure, according to a widely used standard. 2 International Electrotechnical Commission. Safety of laser products—part 1: equipment classification and requirements. IEC 60825-1. 2007. Google Scholar Expectations for safety in the treatment of a relatively benign condition such as myopia are appropriately high, and more data from larger and longer studies will be needed to exclude or to quantify the possibility of rare but serious side effects during home use. 3 Liu H Yang Y Guo J et al. Retinal damage after repeated low-level red-light laser exposure. JAMA Ophthalmol. 2023; 141: 693-695https://doi.org/10.1001/jamaophthalmol.2023.1548 Crossref PubMed Scopus (3) Google Scholar Nonetheless, it is biologically plausible that this treatment is safe. Given its simple design, it is reasonable to hope that costs may eventually be low. Additional research is needed to clarify the amplitude and clinical implications of “rebound” myopia progression after cessation of treatment, to compare efficacy and potential synergy with other treatments, and to better understand the mechanism of action, which may involve reduction of effective axial length through choroidal thickening. Efficacy of Repeated Low-Level Red-Light Therapy for Slowing the Progression of Childhood Myopia: A Systematic Review and Meta-analysisAmerican Journal of OphthalmologyVol. 252PreviewTo evaluate the long-term efficacy and safety of repeated low-intensity red light (RLRL) treatment for childhood myopia. Full-Text PDF