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How retinal photobiomodulation is helping practices move beyond passive AMD monitoring
By Walker Shaffer, OD
June 2, 2026
Low-level light therapy (LLLT), specifically photobiomodulation (PBM) of the retina, represents one of the most meaningful shifts I’ve seen in posterior segment care. For years, managing conditions like dry age-related macular degeneration (AMD) largely meant monitoring progression, recommending nutraceuticals and counseling patients on lifestyle. Today, PBM allows us to take a more proactive approach—supporting retinal function at a cellular level while creating new opportunities for practice growth and patient engagement.
UNDERSTANDING PBM AND ITS CLINICAL ROLE
At its core, PBM uses specific wavelengths of yellow, red and near-infrared light to stimulate mitochondrial activity in retinal cells. By improving efficiency within the electron transport chain, we can enhance cellular energy production while reducing oxidative stress—two key factors in retinal health.
As of today, PBM is FDA-approved for patients with AMD, making that the primary population I treat. However, emerging research and my own early observations suggest potential benefits in other conditions like glaucoma and diabetic retinopathy. As approvals expand, so will the scope of this technology.
IDENTIFYING THE RIGHT PATIENTS FOR PBM
At Eyecare of Lehi, patient selection starts with AMD. Any patient with early or intermediate AMD is a strong candidate, especially those beginning to notice subtle functional decline—changes in contrast sensitivity, visual clarity or color perception.
More broadly, I think in terms of what I call “retinal reserve,” or the retina’s remaining functional capacity to withstand metabolic stress. If we can identify patients before structural damage occurs, we have a window to intervene earlier and more effectively. That mindset is shaping how I approach PBM and preventive retinal care as a whole.
INTEGRATING PBM WITHOUT DISRUPTING WORKFLOW
One of the biggest misconceptions about adding a new technology is that it will slow your clinic down. That’s not the case with PBM, which can be seamlessly integrated with the right structure. We use the Optometric Aesthetics iLight LLLT Pro, a versatile device that allows us to customize parameters to deliver treatment for various ocular conditions.
In our office, treatments are fully delegated to trained technicians. Each session takes about 15 minutes, and patients are typically in and out of the office within 30 minutes. We’ve built dedicated technician schedules for PBM visits so the doctors can focus on interpretation, diagnosis and higher-level decision-making.
Because we were already using light-based devices for dry eye and aesthetics, implementation was straightforward. Training was minimal. Technicians mainly need to understand how to operate the device, ensure patient comfort and escalate clinical questions appropriately.
STRUCTURING TREATMENT PLANS AND FOLLOW-UP
Consistency is critical with PBM. My protocol is based on the LIGHTSITE III studies and includes three treatment cycles over the course of a year:
- Each cycle includes eight sessions (twice weekly for four weeks)
- Cycles are spaced approximately three months apart
- Patients return midway through each interval for monitoring
During follow-ups, I focus on three key metrics:
- Visual acuity
- Contrast sensitivity
- OCT findings, specifically the size and quantity of macular drusen and integrity of the ellipsoid zone
While studies suggest results may take 12 to 18 months to fully manifest, we are seeing measurable improvements as early as six to nine months.
PRICING, PACKAGING AND PATIENT VALUE
PBM sits at an interesting intersection of medical and elective care. CPT code 0936T allows for reimbursement in many Medicare patients who qualify for treatment. For those paying out of pocket, we’ve structured pricing around treatment cycles, offering each eight-session phase as a bundled package priced at $1,000.
We also provide a 20% discount for patients who choose to pay entirely upfront, which improves commitment to the full protocol.
Ultimately, pricing should reflect both the clinical value and the consistency of care being delivered. Patients aren’t just paying for individual sessions—they’re investing in a structured treatment plan tailored to preserve vision.
COMMUNICATING WITHOUT SELLING
One of the most important aspects of implementing PBM is how you present it to patients. I never approach it as a sales conversation. Instead, I lead with science and clinical judgment.
My responsibility is to recommend what I believe is the best course of action based on the data and the patient’s condition. From there, it’s up to the patient to decide whether it aligns with their personal and financial situation.
For most AMD patients, the motivation is already there. They understand the risks to their vision and are eager for options beyond passive monitoring. When you present PBM as a medically driven recommendation—supported by research and tailored to their needs—it resonates.
LONG-TERM IMPACT ON RETENTION AND GROWTH
The impact of PBM on the practice has been significant, both clinically and financially.
Patient retention is exceptionally high. These patients are engaged, returning regularly for treatments and follow-ups and developing a deeper level of trust in our care. We are also seeing new patients seek us out specifically for this service, as we are currently one of a few practices in Utah offering it.
From a business standpoint, the consistency of the treatment protocol creates a reliable revenue stream. With an average reimbursement of around $250 per session and a structured cadence of visits, we have seen nearly $350,000 in additional revenue since implementing PBM in January 2025—all while requiring minimal doctor chair time.
LOOKING AHEAD
The adoption of PBM is still in its early stages. As with many optometric innovations, there’s often a lag between approval and widespread implementation. Some clinicians are waiting for longer-term data or clearer protocols.
My advice is to start with the science. When you understand the mechanism and see the outcomes firsthand, confidence follows. From there, success comes down to building a repeatable protocol, training your team and committing to a proactive model of care.
For me, PBM has shifted the way I think about retinal disease—not just as something to monitor, but as something we can actively influence. That shift has been transformative for both my patients and the practice.
Read more on the medical model here.
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Walker Shaffer, OD, practices optometry in Utah with a clinical focus on proactive retinal care, early detection of retinal disease and integration of metabolic, functional and structural diagnostics. His work explores and implements strategies for identifying dysfunction earlier and preserving retinal health through lifestyle, nutritional and emerging metabolic therapies. |
