RLRL - Repeated Red Light Therapy.

A growing body of research. Parameters still matter.

Editors #PunktZwrotny2050 Sources checked: 09.09.2026 How to read this data

What is this method?

RLRL is a controlled, repeated exposure to red light with parameters specified in the protocol and device documentation. It is not the name of every red lamp. The database includes RCTs, real-world observations, retinal imaging and safety signals.

Mechanism and idea

Hypotheses investigated include photobiomodulation, choroidal response, and pathways regulating eye growth. Changes in choroidal thickness or short-term axis shortening alone do not explain lasting benefit or safety.

How has the evidence developed?

The pivotal multicenter RCT of Jiang et al. appeared in the 2022 volume. Subsequently, comparative studies, post-treatment follow-up, a safety review, and studies from outside China were published. In 2026, a record of multi-center real-world work for up to five years is also available.

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Key randomized trials

2022RCTChina

Effect of Repeated Low-Level Red-Light Therapy for Myopia Control in Children: A Multicenter Randomized Controlled Trial

In the multicenter RCT RLRL, the mean adjusted axis gain at 1 year was 0,13 mm versus 0,38 mm in the control group.

No sham; annual observation, Chinese population. We do not transfer the result to any red light lamps.

Publication, Authors and Restrictions
2025RCT crossoverChina

Effect of Repeated Low-Level Red Light Versus 0.01% Topical Atropine on Myopia Progression: A Randomized Crossover-Controlled Trial

The study compares RLRL with atropine 0,01% in a crossover design.

It does not examine the simultaneous use of both methods. The choroidal parameters publication from DOI 10.1007 /s40123- 025-01169-0 describes the initial phase of the same study; We don't double the attempt.

Publication, Authors and Restrictions
2026 Pilot RCT Australia

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

The Australian pilot RCT showed less axis gain in the RLRL group; extends data beyond Chinese populations.

34 children, three withdrawals in the RLRL group, including one due to headache. It does not confirm equal effectiveness in all populations.

Publication, Authors and Restrictions
2026RCTSpain

Repeated low-level red-light therapy combined with orthokeratology for myopia control in Spain: a randomized controlled study

A Spanish RCT showed greater axis control when RLRL was added to orthokeratology than with orthokeratology alone.

Small, single-center and unblinded trial. This is a combination treatment study, not a European monotherapy RCT RLRL .

Publication, Authors and Restrictions

Evidence reviews and syntheses

The review is not a substitute for checking a specific intervention. The publication date and query end date may vary.

2024 Systematic review Global

Safety of repeated low-level red-light therapy for myopia: A systematic review

The RLRL safety review included 20 research; 1436 participants received therapy. No permanent vision loss was reported in the analyzed corpus.

Median follow-up 9 months, maximum 24. Two descriptions referred to the same patient. The absence of an observed event does not prove zero risk.

Publication, Authors and Restrictions
2025 Systematic review Global

Interventions for myopia control in children: a living systematic review and network meta-analysis

Cochrane 2025 indicates that pharmacological and optical interventions may reduce progression, but the certainty of results and long-term data are mixed.

Last query 19.02.2024 . Does not include all tests with 2025–2026 ; poorly connected networks do not justify simple product ranking.

Publication, Authors and Restrictions
2025 Review/Consensus Global

IMI-Interventions for Controlling Myopia Onset and Progression 2025

IMI 2025 organizes optical, pharmacological, environmental and lighting strategies and the state of research on their effects.

Mature technologies and emerging methods have a different evidence base. The inspection is not an individual clinical eligibility assessment of the child.

Publication, Authors and Restrictions

What do longer observations tell us?

The three-year real-world study groups by length of treatment, with a median 3,65 year in the longest group. The five-year publication has confirmed metadata; We do not publish its detailed effect estimate without a full assessment of the text. Follow-up after RCT indicates rebound after interruption; does not establish a validated tapering regimen.

Safety

OCT, ERG and AOSLO imaging expands knowledge but does not exclude rare events. The corpus remains a description of visual impairment and changes in the outer layers of the retina after Eyerising, with improvement after discontinuation. We separate this signal from the number and duration of follow-up in studies without severe events.

Device, parameters, contraindications

The key RCT of Jiang et al. concerns the Eyerising device and a specific protocol. The AOSLO study describes the laser parameters, but without checking the full-text model we do not assign it to the Eyerising product.

Documentation of contraindications, including concomitant use of atropine, should be checked in the current device manual. The comparison of RLRL versus atropine is not a study of this combination.

Documentation in the related project

Limitations and open questions

Most of the research comes from Asia. The Australian RCT includes 34 children; Spanish 26 and concerns the addition of RLRL for orthokeratology. Safety depends on device, power, optics, exposure and clinical eligibility assessment criteria. The RLRL versus atropine study does not investigate concomitant use.

  • What is the risk of rare events in long-term exposure?
  • Which results are replicated in large European trials?
  • How to stop therapy with the least rebound?
  • Which imaging changes are transient and which are clinically significant?

When is it considered?

It can only be considered within the framework of clinical eligibility assessment according to the local availability and documentation of the specific device. Test results are not a substitute for IFU or eye evaluation; they are not instructions for self-exposure to light.

What should be monitored?

  • Axis length, refraction and best corrected acuity
  • Post-exposure symptoms and retinal condition according to protocol
  • The device, its parameters, contraindications and actual exposure
  • Assessment after changing or discontinuing treatment

This is a framework for a conversation with a specialist, not an individual treatment plan.

References for this chapter

2022Follow-up after RCTChina

Sustained and rebound effect of repeated low-level red-light therapy on myopia control: A 2-year post-trial follow-up study

Follow-up of RLRL showed maintenance of the effect in those continuing and rebound in some people after discontinuation.

Second year without re-randomization; only 11 children continued RLRL, 114 with 199 eligible were analyzed. It does not establish verified tapering.

Publication, Authors and Restrictions
2023Case descriptionChina

Retinal Damage After Repeated Low-level Red-Light Laser Exposure

Bilateral visual impairment and retinal changes have been reported following the use of RLRL; improvement was observed after exposure was discontinued.

The case report is a safety signal, not an indicator of incidence or evidence that all devices have the same risk profile.

Publication, Authors and Restrictions
2026Observational studyChina

Three-year efficacy and safety of repeated low-level red-light therapy for myopia control: a multicenter real-world study

The real-world study includes groups with varying durations of RLRL use, including 91 participants treated with 3 for at least one year.

These are groups by length of treatment, not a three-year RCT. Possible selection of continuators. Median in the longest group 3,65 of the year.

Publication, Authors and Restrictions
2026Observational studyChina

Five-year efficacy and safety of repeated low-level red light therapy for myopia control in children: a multicenter, real-world study

The 2026 publication by Zhang et al. describes multicenter real-world data with follow-up dating back to 5 years.

DOI, authors and publication type were verified. Follow-up for 5 years does not mean that each participant was followed for 5 years; this is not a five-year RCT.

Publication, Authors and Restrictions
2026Cross-sectional studyChina

Safety analysis of repeated low-level red light therapy on cone mosaic and microvasculature by adaptive optics scanning laser ophthalmoscopy

The AOSLO study showed no significant loss of cone density or differences in microcirculatory parameters tested after at least 8 months of RLRL.

66 eyes, of which 20 in the RLRL group; the unit is the eye, not the number of patients. Cross-sectional examination does not exclude rare or distant lesions.

Publication, Authors and Restrictions
2021Guidelines/consensusEurope

Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute

ESO and IMI present a framework for the selection of management, prevention and monitoring of myopia progression.

The guidelines require reference to current knowledge, local availability and the specific patient.

Publication, Authors and Restrictions

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