BACKGROUND: The optimal myopia control measures for children with intermittent exotropia (IXT) have yet to be determined. This study evaluates the impact of Repeated low-level red-light therapy (RLRL) on myopia control in this population. METHODS: This retrospective study included 94 participants divided into three groups: Myopic children without strabismus receiving RLRL treatment (RLRL Group).Children with IXT and myopia undergoing RLRL treatment (IXT with RLRL Group).Children with IXT and myopia not receiving any myopia control interventions(Control Group).Axial length (AL) and spherical equivalent refraction (SER) were measured before and after the intervention. For patients with IXT, distance and near exodeviation angles and near stereopsis were also assessed. RESULTS: Post-RLRL treatment, the IXT with RLRL Group exhibited significantly less AL elongation compared to the Control Group at various time points (P<
0.001). After 6 months, the mean AL increase in the dominant eye was 0.005±0.130 mm for the IXT with RLRL Group, compared to 0.164±0.090 mm in the Control Group (difference = -0.159 mm
95% CI, -0.226 to -0.093 mm
P <
0.001). No significant differences were found between the two groups in changes in exodeviation angles and near stereopsis (P>
0.05). Additionally, no significant differences in AL and SER control were observed between the IXT with RLRL Group and the RLRL Group (P>
0.05), and treatment efficacy was similar between the two eyes. CONCLUSIONS: RLRL is effective in controlling myopia progression in children with IXT without adversely affecting strabismus parameters. Its efficacy is comparable to that observed in children without strabismus, suggesting RLRL as a viable option for myopia management in this population.