Red-light therapy pilot study for myopia control in Australia

Paper title: Efficacy of repeated red-light laser therapy for myopia control in Australian children: a pilot randomised controlled trial

Authors: Bulloch G (1), Qi Z (2), Aung YYM (3), Fakih Z (4), Rezazadeh D (4), Tran D (4), Zhu Z (3), Deen N (4)

1. Ophthalmology, Department of Surgery, University of Melbourne, Carlton, Victoria, Australia. 
2. Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 
3. Eyerising International, South Yarra, Victoria, Australia. 
4. National Vision Research Institute, Australian College of Optometry, Carlton, Victoria, Australia. 

Date: Published online April 8, 2026

Reference: Bulloch G, Qi Z, Aung YY, Fakih Z, Rezazadeh D, Tran D, Zhu Z, Deen N. Efficacy of repeated red-light laser therapy for myopia control in Australian children: a pilot randomised controlled trial. Clin Exp Optom. 2026 Apr 8:1-11.

[Link to open access paper]

Previous studies have shown repeated red-light therapy can slow myopia progression in Chinese children, but its efficacy and safety in other ethnic populations remained unclear. 

This pilot randomised controlled trial investigated whether the treatment could slow myopia progression in a multi-ethnic Australian paediatric population, addressing the lack of evidence for this treatment outside Chinese cohorts. Less than 10% of the cohort were of Chinese ethnicity. Thirty-four children aged 8–13 years with myopia were randomised to receive repeated red-light therapy with the Eyerising Myopia Management Device, alongside single-vision spectacles (SVS) or SVS alone over 12 months. Outcomes included changes in axial length and cycloplegic spherical equivalent refraction, while also monitoring treatment feasibility, compliance and ocular safety.

Key points were as follows.

• Children receiving repeated red-light (RLRL) therapy showed less axial elongation over 12 months than the single-vision spectacle group, with adjusted mean axial length changes of −0.03 mm (axial length stability) versus 0.12 mm growth in the SVS-only control group. 
• Myopia progression was also reduced, with adjusted spherical equivalent refraction changes of +0.08 D in the RLRL group (no refractive progression) and −0.20 D in the control group at 12 months. 
• Axial shortening and hyperopic shift were greatest at 3 months before trending back toward baseline over time. 
• No severe adverse events, retinal structural abnormalities or reductions in best-corrected visual acuity were detected during the study period. 
• Treatment compliance ranged from 60–80%, with two withdrawals due to poor compliance and one withdrawal related to headache. 

This study suggests RLRL therapy is an effective myopia control option for children in Australia and other ethnically diverse populations. Over 12 months, children receiving treatment showed 0.15mm less axial elongation and 0.29D less myopic progression than those wearing single-vision spectacles alone, despite treatment compliance ranging from 60–80%. The treatment group also demonstrated axial shortening and temporary hyperopic shift during short-term follow-up, consistent with findings from previous Chinese studies.

The study included children from diverse ethnic backgrounds, which improves confidence that repeated red-light therapy may have broader applicability beyond East Asian populations where most previous research has been conducted. No severe adverse events, retinal structural abnormalities or loss of best-corrected visual acuity were observed during the study period, adding confidence to the safety profile of RLRL. 

Careful patient selection, parental counselling and ongoing monitoring remain essential. Compliance also appears to be an important practical challenge, highlighting the need for clear education around treatment schedules and long-term myopia management goals when introducing this therapy into clinical practice.

Although repeated red-light therapy continues to show promising efficacy for myopia control, several important questions remain unanswered. Larger multi-centre studies in ethnically diverse populations are needed to confirm whether the treatment effect observed in this Australian cohort is consistent across different genetic and environmental backgrounds. Longer follow-up is also required to determine whether treatment effects are sustained over several years and whether rebound progression occurs after cessation.

The mechanism underlying axial shortening and temporary hyperopic shift also remains unclear. It is not yet known whether these changes represent true reversal of myopic eye growth or transient physiological responses involving the choroid, retina or sclera. Future studies incorporating detailed retinal and choroidal imaging, ocular blood flow measurements and biomarker analysis may help clarify these mechanisms.

Further work is also needed to better understand the long-term safety profile of repeated red-light therapy, particularly in light of some reports describing reversible retinal imaging changes and isolated retinal injury cases. Establishing optimal treatment duration, dosing schedules and compliance strategies will also be important for safe and effective clinical implementation.

Clinical relevance: Childhood myopia is increasingly prevalent in routine optometric practice and is associated with a lifetime risk of ocular complications. Clinically acceptable and evidence-based strategies to slow myopia progression are therefore important for long-term eye health management across diverse populations.

Background: To assess the efficacy, feasibility and safety of repeated red-light laser (RLRL) therapy among multi-ethnic school-aged children in Australia.

Methods: Randomised controlled trial. 34 multi-ethnic children aged 8-13 years with myopia were enrolled. Participants were randomly assigned to the RLRL therapy with single-vision spectacles (SVS) group or the SVS group. RLRL therapy was administered for 3 minutes, twice daily for 5 days per week, while SVS group continued routine activities. Assessments were scheduled at baseline and follow-up visits at 1, 3, 6 & 12 months, with compliance monitoring and safety assessments throughout. Axial length (AL), spherical equivalence refraction (SER) and Optical coherence tomography were conducted.

Results: A total of 34 children were randomised to 17 in the RLRL group and 17 in the SVS group. Three children in the RLRL group withdrew due to headache (n = 1) and poor compliance to treatment (n = 2). Adjusted mean changes of 12-month AL and SER were -0.03 (95% CI, -0.05 to -0.01) mm and 0.08 (95% CI, 0.04 to 0.13) D for RLRL group and 0.12 (95% CI, 0.10 to 0.14) mm and -0.20 (95% CI, -0.29 to -0.10) D for SVS group. No severe adverse events were observed during the study period.

Conclusion: This pilot study in a non-Chinese Australian population demonstrated that RLRL therapy may be a promising alternative treatment for myopia control in multi-ethnic school-aged children, with no documented functional and structural damages. Further research with a larger cohort is warranted to confirm results and explore the long-term efficacy and safety of RLRL therapy.

[Link to open access paper]