Repeated low-level red-light therapy for myopia control: An update on efficacy and safety

Repeated low-level red-light (RLRL) therapy has emerged as an effective intervention for myopia control, yet concerns regarding its safety remain. This review summarizes the current high-level evidence on the efficacy and safety of RLRL therapy. Randomized controlled trials consistently demonstrate that RLRL therapy significantly reduces axial elongation and slows myopic onset and progression in children, with network meta-analyses indicating superior efficacy compared with established interventions. The short-term safety profile appears favorable, and no irreversible damage has been reported. However, uncertainties persist regarding the clinical significance of observed structural changes, such as transient foveal hyperreflectivity and cystoid abnormality on optical coherence tomography, as well as functional changes on multifocal electroretinogram. Addressing critical knowledge gaps, including long-term monitoring, dose optimization, and device design refinement, will be essential for realizing the full potential of this therapy while ensuring its safety.