The blue light paradox in myopia: Conflicting evidence from experimental and clinical studies

Myopia is the most prevalent refractive disorder worldwide. Projections show it will affect nearly half of the global population by 2050, posing significant public health concerns due to its association with sight-threatening complications. Among various environmental and behavioral interventions, increased exposure to natural light-particularly sunlight-has emerged as a promising strategy to mitigate the progression of myopia. However, the precise mechanisms underlying this protective effect are still not completely understood. Within the solar spectrum, blue light has garnered particular interest for its influence on retinal physiology and the regulation of ocular growth. This review integrates findings from basic research and clinical investigations to elucidate the modulatory role of blue light in the development and progression of myopia. A literature search for this narrative review was conducted via MEDLINE (PubMed), up to March 2025, using keywords including "myopi∗", "eye growth", "refracti∗", "blue light", "short wavelength", "monochrome∗", "wavelength", and "colored light". Thirty-one in vivo studies and five clinical investigations met the inclusion criteria. Findings were categorized into three outcome groups: 21 studies reported that exposure to blue light was more effective than white light in attenuating myopia progression; 10 studies found no significant difference; and 5 studies favored white light. Despite a growing body of evidence supporting the anti-myopiagenic potential of blue light, consensus remains elusive. Variability in outcomes may be attributed to interspecies differences, photoreceptor distribution, and experimental parameters, such as the onset, duration, and intensity of light exposure. In addition, despite the inclusion of clinical studies, the evidence base is constrained by short-term designs and small sample sizes; consequently, translation into practice should be approached with caution. This review highlights the need for standardized methodologies and translational frameworks to elucidate the biological pathways involved, and to inform future clinical applications.