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Non-Pharmacological and Non-Optical Interventions for Myopia Prevention and Control in Children: A Systematic Review and Meta-Analysis

Domínguez-Morras C, Paniagua García M, Castro Garrido I, Moreno-Montañés J, Fernandez-Montero A, Moreno-Galarraga L

Children (Basel, Switzerland), 2026

2,438 participants

Abstract

Background: Myopia is projected to affect 50% of the global population by 2050. Its progression increases the risk of severe ocular pathologies, making it imperative to validate safe and effective non-pharmacological prevention interventions.

Aim: To evaluate the clinical efficacy of low-level red-light therapy (RLRL) and nutritional supplementation in preventing and controlling myopia progression in children and adolescents.

Methods: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420261301596). Randomized clinical trials in pediatric populations (aged 0-18 years) were included. The primary quantitative outcome measures for myopia were axial length (AL) and spherical equivalent (SE). Risk of bias (RoB 2) and heterogeneity (I2) were assessed.

Results: 18 articles were included (n = 2438). RLRL demonstrated a significant reduction in axial elongation (mean difference (MD): -0.26 mm; 95% CI: -0.34 to -0.18) and a protective effect on refractive progression (MD: +0.60 D; 95% CI: 0.42 to 0.78), although with high heterogeneity (I2 > 97%). Nutritional supplementation exhibited a modest, non-significant effect on axial length (-0.22 mm; 95% CI: -0.44 to 0.00), acting primarily as functional support.

Conclusions: RLRL slows ocular elongation and myopia progression. Recent studies provide reassuring evidence regarding its long-term safety when recommended treatment protocols are followed. However, the high heterogeneity among…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,438 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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