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    New study finds association between myopic progression and reading position

    It is not better to sit up straight to read, a long-term study has concluded. Finnish researchers Olavi Pärssinen and Markku Kauppinen published their results in Acta Ophthalmologica this month.1

    Who, as a child, was not issued with an ominous warning that reading in an awkward position, under the bedclothes or lolling about on the floor, would "ruin your eyes"? It has long been a popular belief that myopia can be caused by an improper reading posture, by reading too close or by reading in dim light, perhaps with a torch in bed. As long ago as 1864, it was suggested that myopia could be caused by a stooped reading position and use of a horizontal, rather than sloped, writing surface.

    “There is substantial epidemiological evidence of a connection between myopia and reading, without accepted proof of the mechanisms behind this connection”, Professor Pärssinen explained. “Reading is a complex neurophysiological process involving not only accommodation and convergence but also keeping the fixation and regulating saccadic eye movements by varying the tension of six extraocular muscles. The pressure between lids and eye may also vary in reading, not only because of anatomical differences but also with differences in posture and the alignment of the eyes. All of these factors may gradually have an influence on scleral stretching, which is the anatomical change behind myopic progression.”

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    This long-term study, analysing the connections between myopia and posture, distance and gaze angle when reading, is part of a trial that began in the early 1980s by recruiting 240 schoolchildren (119 boys and 121 girls; mean age 10.9 years) with previously untreated myopia to a randomised clinical trial of three treatments – continuous use, distance use only or bifocals. No previous studies have compared reading posture at the onset and during the progression of myopia.

    Annual examinations were conducted for three successive years, after which time ordinary fully corrected spectacles were prescribed and continuous use recommended. The next clinical follow-up, in which nearly three-quarters of patients participated, came after a further 10 years when they were in their early 20s. Examinations at all visits included biomicroscopy, ophthalmoscopy and biometric measurements, and measurement of intraocular pressure. Habitual reading distance and gaze direction were also measured.

    A structured questionnaire was used to record average daily time spent reading and performing other types of close work outside school; time spent watching television, playing sports and on outdoor activities; and data on parents’ myopia.2

    Reading posture

    Mean spherical equivalent at baseline was highest in those who sat to read, as was myopic progression across all follow-up visits. Myopic progression from baseline to their early 20s was lowest for those who reported reading lying on their backs, by a difference of 0.96 D and 1.38 D for men and women, respectively, compared with progression in those who read in a seated position. Overall, there was about one-third less myopic progression in those reading on their backs compared with those whose reading posture was sitting.

    Reading angle and distance

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