Photobiomodulation therapy for children's eye and vision conditions

Photobiomodulation (PBM) is a non-invasive, light-based technology that stimulates cellular mechanisms, with therapeutic effect on a variety of medical conditions. Wavelengths of light are absorbed by intracellular photoreceptors, resulting in the activation of signalling pathways that culminate in biological changes within the cell. PBM treatment has been reported for a range of eye/vision conditions, mostly in adults.

We carried out a scoping review of the published literature and collated reported uses of PBM for eye/vision/lid/orbital conditions in children and young people.

We developed a comprehensive Ovid Medline, Ovid Embase and Cochrane Library search strategy. We included primary research articles written in English reporting an age range from 0 to 18 years. Ocular, vision, lid, or orbital conditions treated with PBMT, low light therapy, or intense pulsed light therapy (400-1100 nm spectral range) were included. Case reports, meta-analyses, systematic reviews, and studies using photodynamic therapy, cross-linking, or optogenetics were excluded.

We used Covidence Systematic Review Software for de-duplication and screening of titles and abstracts, using a pre-specified screening tool.

We developed and used a data extraction tool in Covidence. Two reviewers (AF and CH) independently screened and extracted data, with disagreements resolved by discussion and senior-author adjudication where consensus could not be reached.

Of 5081 identified studies, 45 were included. The majority focused on myopia control, reporting reductions in axial elongation, some noted rebound effects upon cessation. Amblyopia, retinopathy of prematurity, meibomian gland dysfunction, chalazion, concussion, and visual fatigue were also investigated. Most studies were randomised controlled trials, with China as the predominant investigating region. PBMT demonstrated potential benefits across various conditions with a favourable safety profile.

PBMT may have a role in the management of childhood eye conditions, particularly myopia and blepharitis. It appears generally safe, with transient adverse effects such as mild photophobia and dry eye.

Further research is needed to optimise protocols and assess sustained efficacy and safety for widespread clinical adoption.