For those who may not know, 40 percent of the U.S. population has myopia, also known as nearsightedness. Most people with myopia use corrective lenses, either eyeglasses or contact lenses to achieve near 20/20 vision. For some, turning to surgical procedures, such as LASIK or having intraocular lenses implanted, is an option. Although myopia is often treated with corrective lenses, ongoing research aims to develop further treatments, particularly for children.
One possible treatment for myopia involves low-level red light (LLRL) therapy. This therapy exposes the retina of a child to a red-light laser that has a wavelength of 650 nanometers, plus or minus 10 nanometers, twice daily for three minutes each time. The treatment is separated by least four hours in between and it is given five to seven days a week. This treatment is available in several countries but has not been approved by the Food and Drug Administration (FDA) for use in the United States.
Several randomized controlled trials have been published on the use of LLRL therapy on children of Chinese descent and one meta-analysis concluded that it may be effective in slowing the progression of myopia. However, rebound effects were seen in two of the studies. Also, there are safety concerns regarding this therapy, since can put the retina at risk of photochemical and thermal damage.
That’s why Lisa Ostrin, an associate professor of optometry at the University of Houston College of Optometry, warns against the use of LLRL therapy. Her research has shown that for red light machines currently in use for myopia, the three minutes of continuous viewing either came close or exceeded the maximum permissible exposure level and this puts the retina at risk for damage.
What other treatments are available for myopia? Atropine drops have shown promise in slowing the progression of myopia in children. The Childhood Atropine for Myopia Progression (CHAMP) trial, a three-year study on the use of atropine drops in children ages 6 to 10 with myopia, demonstrated that using these drops limited eyeglass prescription changes and inhibited the elongation of the eye.
However, it is important that the dose is at a certain level. Another study on the use of atropine, showed that the use of low-dose, 0.01 percent concentration, drops are no better than a placebo at slowing the progression of myopia and the elongation of the eye. This study, done by the Pediatric Eye Disease Investigator Group (PEDIG) and funded by the National Eye Institute (NEI) contradicted results from earlier studies that showed the effectiveness of the 0.01 percent concentration.
Does that mean that atropine is not effective? No. What these results demonstrate is the need for more research on atropine to see if a different dose, combining atropine with other strategies or developing other approaches to the treatment of myopia, would yield a better outcome. In fact, current studies have shown that the stronger concentrations of the drops at the 0.5 to 1.0 percent concentration are effective in slowing myopic progression. The problem is that these doses cause light sensitivity and blurry near vision. So, the search is on for the right therapy for myopia.
While myopia might not seem significant compared to other vision conditions, it is associated with retinal detachment, myopic maculopathy and glaucoma. This demonstrates the importance of research in developing treatments that slow myopic progression.
Sources:
https://reviewofmm.com/repeated-low-level-red-light-therapy-critical-questions-remain/
https://uh.edu/news-events/stories/2024/january/01292024-ostrin-red-light-therapy-danger-eyes.php
https://optometry.osu.edu/news/eye-drops-slow-nearsightedness-progression-kids-study-finds
https://www.aao.org/eyenet/article/myopia-research-from-margins-to-mainstream