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    New study finds association between myopic progression and reading position


    The children were asked to select their habitual reading posture from sitting down, lying on their back, lying on their stomach and varying.

    About half of the respondents varied their reading posture, while about one-third of them preferred to sit to read.

    Twenty children reported lying on their back as their habitual reading posture at the initial visits, 11 of whom answered a follow-up questionnaire in 2015. The questionnaire asked ‘As far you remember, what was your preferred reading posture during childhood?’ and ‘What is your current preferred reading posture?’. Five respondents still preferred to read lying on their back, while the remainder reported a sitting or varied posture.

    Of course, reading for schoolwork and in a professional capacity is mainly performed in a sitting position; reading in other positions is generally possible only when at leisure. The answers to this new questionnaire support the view that many of those who read lying down as children continue to do so as they grow.

    Related: High myopia: Global pandemic with genetic and environmental causes

    Reading angle

    The researchers found a tendency towards more myopic progression with a steeper downward angle of gaze when reading.

    Although correlations between reading angle and myopic progression at the initial three yearly visits were mainly insignificant, the mean reading angle of the last two childhood follow-ups correlated with myopic progression in the subjects’ early 20s.

    Elongation of the eye has been suggested to result from the influence of the extraocular muscles.3 It is known that different gaze directions cause different tensions in the extraocular muscles, and also that eyelid pressure influences the shape of the cornea, depending on angle of gaze.

    Gaze direction was measured with an angle scale, starting at zero if the eyes were looking horizontally ahead. The posture of the head during reading was not recorded.

    Reading distance

    The correlation between spherical equivalent and reading distance was the only myopia parameter that showed significant differences between the sexes. Higher myopia was associated with a shorter reading distance in girls at the last two of the three yearly follow-ups, but not at other visits. However, it seems logical that myopes might hold their reading material close, especially when not using spectacles, so it is difficult to conclude whether the association is causal.

    In male subjects a correlation was observed at the fourth visit (early 20s) only, the direction of which opposed that seen in the younger girls: higher myopia was connected with a longer reading distance. It is possible that this was because they had been advised at the childhood visits to adopt a longer reading distance.

    “Larger follow-up studies including a wide distribution of refraction and controlling factors connected with reading, such as reading speed, intensity, pauses, etc, are warranted”, concluded Professor Pärssinen. “Based on our results, one can at least say that there is no need to prohibit children lying down to read.”


    1. O Pärssinen and M Kauppinen. Acta Ophthalmol 2016. doi: 10.1111/aos.13148.

    2. O Pärssinen, M Kauppinen and A Viljanen. Acta Ophthalmol 2014; 92: 730-739.

    3. A Ghosh, et al. Invest Ophthalmol Vis Sci 2012; 53: 6465-6471.

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