title: Associations of reading posture, gaze angle and reading distance with myopia and myopic progression.
abstract: OBJECTIVE
  To study the associations of habitual reading posture, gaze angle in reading and reading distance with myopia and changes in myopia among myopic children.
  
  
  METHODS
  A total of 240 myopic schoolchildren (mean age 10.9 years), with no previous spectacles, were recruited during 1983-1984 to a randomized 3-year clinical trial of bifocal treatment of myopia. Three annual examinations with subjective cycloplegic refraction were conducted for 237-238 subjects. A further examination was conducted at the mean age of 23.2 years for 178 subjects. Habitual reading posture was elicited by questionnaire at study outset. Reading distance was measured with a Clement Clark accommodometer and gaze angle with an angle scale at baseline and all three annual follow-ups. Height was measured by a school nurse. The connections between the variables were studied with the standard statistical methods.
  
  
  RESULTS
  Higher myopia was connected with shorter reading distance among girls at follow-ups 2 and 3, but not at the other examinations. The correlation of spherical equivalent with height was non-significant at each follow-up. Myopic progression across the whole follow-up was highest among those who read sitting down at baseline (-3.58 ± 1.75 D) and lowest among those who read face up lying down (-2.35 ± 1.53 D) (p = 0.021). Reading with eyes at a more downward angle was slightly connected with greater myopic progression (r = -0.166, p = 0.028).
  
  
  CONCLUSIONS
  Reading in a sitting posture at myopia onset predicted the greatest myopic progression to adulthood and reading face up on one's back the lowest. Reading with eyes on turned more downwards was slightly connected with greater myopic progression.
authors.affiliation: Department of Ophthalmology, Central Hospital of Central Finland, Jyväskylä, Finland.|Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Olavi
authors.initials: O
authors.lastname: Pärssinen
authors.affiliation: Department of Ophthalmology, Central Hospital of Central Finland, Jyväskylä, Finland.|Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Kauppinen
mesh_terms: D000065:Accommodation, Ocular; D000293:Adolescent; D000328:Adult; D002648:Child; D018450:Disease Progression; D004215:Distance Perception; D005139:Eyeglasses; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009216:Myopia / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D011187:Posture / Q000502:physiology*; D011932:Reading; D012029:Refraction, Ocular; D011795:Surveys and Questionnaires; D014796:Visual Perception / Q000502:physiology*; D055815:Young Adult
keywords: gaze direction; height; myopia; myopic progression; reading distance; reading posture