Red Light Therapy for Myopia: Emerging Risks and Safety Concerns

As red-light laser therapy gains traction as a potential treatment for slowing myopia (nearsightedness) in children, emerging reports of vision damage are prompting researchers to call for more thorough safety evaluations before widespread adoption. Although initial studies suggested promise in slowing myopia progression, recent investigations raise concerns about potential retinal risks.

The Rise of Red Light Therapy for Myopia

Low-level red light (LLRL) therapy has gained popularity, particularly in Asia, as a non-invasive method to control myopia. Clinical trials have indicated that repeated exposure to low-level red light can slow the progression of myopia and axial elongation – the lengthening of the eye that contributes to worsening nearsightedness. This is often accompanied by choroidal thickening, which helps stabilize eye growth. The Eyerising International device, one device used in these therapies, has been used in over 100,000 children in China and in more than 250,000 sessions globally.

Safety Concerns Emerge

Despite the promising results, researchers at the University of Houston are warning about potential safety issues. Lisa Ostrin, a professor of optometry at UH, and her team have found that some red-light therapy devices may exceed national safety standards for laser classifications. Their quality improvement study, published in JAMA Ophthalmology, evaluated the Sky-n1201, Future Vision, EyeRising, and AirDoc instruments.

“Although red laser therapy is a potential intervention for myopia, its rapid clinical adoption has outpaced thorough safety validation,” reports Ostrin. She emphasizes the need for rigorous, independent safety validation before widespread use in children.

Findings from the University of Houston Study

The study revealed that the Sky-n1201 and EyeRising devices reached ANSI Group 1 safety limits within exposure times of 2.8 and 1.4 seconds, respectively, for a 7-mm pupil. The Future Vision device reached limits under extended exposure times (over 253 seconds), while the AirDoc, a light-emitting diode-based device, had a much longer time to reach the limit (22,761 seconds). These findings suggest that some devices may deliver irradiance levels that exceed safety recommendations within the typical treatment timeframe.

Reports of actual vision damage have also surfaced. One case involved a 12-year-old patient who experienced structural retinal damage following repeated red laser therapy, with only partial visual recovery after treatment cessation. Another report documented a reduction in cone cells – crucial for sharp, detailed, and color vision – in a patient’s retina.

Recommendations and Future Research

Ostrin and her colleagues urge eye care professionals, researchers, and regulatory agencies to prioritize comprehensive safety assessments of these devices. They recommend utilizing advanced imaging techniques like adaptive optics retinal imaging and multifocal electroretinography, along with long-term cohort monitoring, to fully understand the potential risks.

“Establishing a balance between therapeutic efficacy and ocular safety remains essential to ensure that this intervention intended to preserve lifelong vision does not itself pose avoidable risks that outweigh benefits,” Ostrin stated.

Key Takeaways

• Red light therapy shows promise in slowing myopia progression, but safety concerns are emerging.
• Some commercially available devices may exceed established safety limits.
• Retinal damage has been reported in patients undergoing red light therapy.
• Further research and rigorous safety evaluations are crucial before widespread pediatric use.

Source: University of Houston, JAMA Ophthalmology