The role of reading, writing, using a computer, or watching television in the development of myopia

Abstract

INTRODUCTION: The purpose of our investigation was to evaluate in a Polish population the role of reading, writing, using a computer, or watching television in the development of myopia. MATERIALS AND METHODS: In total 5601 students (2688 boys and 2913 girls, 6–18 years of age, mean 11.9 + 3.2 years) were examined. The children examined were Polish students of elementary and secondary schools. In every student cycloplegia after 1% tropicamide was performed. Non-parametric tests were used due to the SE distribution being significantly different from normal distribution in Kolmogorow-Smirnov test. Spearman rank correlation coefficient (Rs) was used to evaluate the strength of correlation between these variables. General linear model was used for multivariate analysis. A P-value less than 0.05 was considered significant. RESULTS: It has been established that with the increase in time spent on reading and writing, the spherical equivalent (SE) of the examined students decreases (Rs = –0.16, p < 0.000001). It was observed that an increase in the time spent working on a computer correlates with the decrease of the SE (Rs = –0.11, p < 0.000001). No relationship between watching television and the spherical equivalent of the examined schoolchildren was found (Rs = +0.01, p = 0.31). CONCLUSIONS: Reading, writing, or using a computer may lead to the development of myopia. Watching television has no influence on the incidence of myopia.

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53
Copyright © 2016 Via Medica, ISSN 2450–7873
ORIGINAL PAPER
DOI: 10.5603/OJ.2016.0009
CORRESPONDING AUTHOR:
Maciej Czepita M.D., Ph.D., Department of Pathology, Pomeranian Medical University, al. Powstancow Wlkp. 72, 70–111, Szczecin, Poland,
e-mail: maciej@czepita.pl
The role of reading, writing, using a computer,
or watching television in the development
of myopia
Maciej Czepita1, Leszek Kuprjanowicz2, Krzysztof Safranow3, Artur Mojsa2, Ewa Majdanik2,
Maria Ustianowska2, Damian Czepita2
1Department of Pathology, Pomeranian Medical University, Szczecin, Poland
2Department of Ophthalmology, Pomeranian Medical University, Szczecin, Poland
3Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
ABSTRACT
INTRODUCTION. e purpose of our investigation was to evaluate in a Polish population the role of reading, writing,
using a computer, or watching television in the development of myopia.
MATERIALS AND METHODS. In total 5601 students (2688 boys and 2913 girls, 6–18 years of age, mean 11.9 +
3.2 years) were examined. e children examined were Polish students of elementary and secondary schools. In every
student cycloplegia after 1% tropicamide was performed. Non-parametric tests were used due to the SE distribution
being signicantly dierent from normal distribution in Kolmogorow-Smirnov test. Spearman rank correlation
coecient (Rs) was used to evaluate the strength of correlation between these variables. General linear model was
used for multivariate analysis. A P-value less than 0.05 was considered signicant.
RESULTS. It has been established that with the increase in time spent on reading and writing, the spherical equivalent
(SE) of the examined students decreases (Rs = –0.16, p < 0.000001). It was observed that an increase in the time
spent working on a computer correlates with the decrease of the SE (Rs = –0.11, p < 0.000001). No relationship
between watching television and the spherical equivalent of the examined schoolchildren was found (Rs = +0.01,
p = 0.31).
CONCLUSIONS. Reading, writing, or using a computer may lead to the development of myopia. Watching television
has no inuence on the incidence of myopia.
KEY WORDS: myopia, refractive errors, prevalence
Ophthalmol J 2016; Vol. 1, No. 2, 53–57
INTRODUCTION
Myopia is a serious unsolved health problem
in the contemporary world. It is believed that over
22% of the current world population has myopia.
is translates to 1.5 billion people. In many East
Asian countries the prevalence of myopia is rising
sharply and has already reached 70–80% of the
population. In Western countries 25–40% of peo-
ple have myopia. In the United States the number
of myopes has doubled in the past 30 years [1–3].
e incidence of myopia depends on genetic and
environmental factors. An important environmen-
tal factor that inuences the development of myo-
pia is visual near work [4]. Many authors believe
that reading, writing, and using a computer lead
to a higher prevalence of myopia [5–16]. However,

OPHTHALMOLOGY JOURNAL 2016, Vol. 1, No. 2
54 www.journals.viamedica.pl/ophthalmology_journal
there have also been some publications that have
not found such an association [17–23].
To the best of our knowledge only a few articles
have been published so far that have studied the
relationship between watching television and the
development of myopia [6–10, 12, 13, 16, 17].
In the majority of these studies no dependency
between watching television and myopia has been
described [6, 7, 9, 17].
Because of the dierences in the obtained data
we decided to evaluate, in a Polish population, the
role of reading, writing, using a computer, or watch-
ing television in the development of myopia.
MATERIALS AND METHODS
A total of 5601 students (2688 boys and
2913 girls, 6–18 years of age, mean 11.9 + 3.2 years)
were examined. e children examined (students of
elementary and secondary schools) were Polish. In
every student cycloplegia after 1% tropicamide was
performed. e mean SE was calculated after exam-
ination of both eyes. e methods are described in
detail in previous papers [6, 24].
e obtained results were entered into an EXCEL
spreadsheet and analysed statistically using Statis-
tica 10 software. Non-parametric tests were used
due to the SE distribution being signicantly
dierent from normal distribution in Kolmogo-
row-Smirnov test. Spearman rank correlation co-
ecient (Rs) was used to evaluate the strength of
correlation between these variables. A general linear
model was used for multivariate analysis. A P-value
less than 0.05 was considered signicant.
RESULTS
It was established that with increase in the time
spent reading and writing, the spherical equivalent
of the examined students decreases (Rs = –0.16,
p < 0.000001) (Fig. 1).
It was observed that the increase in time spent
using a computer correlates with the decrease of SE
(Rs = –0.11, p < 0.000001) (Fig. 2).
No relationship between watching television and
the spherical equivalent of the examined schoolchil-
dren was found (Rs = +0.01, p = 0.31) (Fig. 3).
Multivariate analysis has shown that independ-
ent factors associated with lower SE values are: old-
er age (b = –0.26, p < 0.000001), parents with
myopia (b = –0.15, p < 0.000001), being female
(b = –0.036, p = 0.006), longer time spent reading
FIGURE 1. Mean spherical equivalent in relation to reading and writing

Maciej Czepita et al., The role of reading, writing, using a computer, or watching television in the development of myopia
55
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FIGURE 2. Mean spherical equivalent in relation to using a computer
FIGURE 3. Mean spherical equivalent in relation to watching television

OPHTHALMOLOGY JOURNAL 2016, Vol. 1, No. 2
56 www.journals.viamedica.pl/ophthalmology_journal
and writing (b = –0.044, p = 0.002), and less time
watching television (b = 0.043, p = 0.0008).
DISCUSSION
In numerous papers a relationship has been de-
scribed between reading, writing, or using a comput-
er and the possibility of increased incidence of my-
opia (Tab. 1) [5–16]. However, as yet a mechanism
for myopia development has not been found. It is
assumed that the cues for the development of myo-
pia are, among others, natural lag of accommodation
and the associated retinal blur during near work [4].
In 2005 Buehren et al. [25] demonstrated that
that the compression of the cornea by the eyelids
during reading may be the cause of myopia. ey
explained this as the eyelids causing lower and high-
er order aberrations of the eye. ese changes were
observed to occur much more often in people with
myopia than in emmetropia.
A year later Collins et al. [26] conducted similar
research in which they demonstrated that reading, ob-
serving through a microscope, and working on a com-
puter have dierent eects on corneal aberrations. e
authors concluded that lid-induced corneal aberra-
tions may lead to more frequent incidence of myopia.
Currently, most authors believe that watching
television does not inuence the prevalence of my-
opia (Tab. 1). [6, 7, 9, 17]. is is probably caused
by the fact that when watching television our eyes
do not accommodate and are aligned in the centre
of the palpebral ssure.
Similar to the results of other researchers, we
have concluded that reading, writing, or using
a computer may lead to an increase in the develop-
ment of myopia. We did not observe a dependen-
cy between watching television and the incidence
of myopia.
e results obtained by us are credible because
the examinations have been conducted under cy-
cloplegia on a large population. Besides, the study
was conducted on a racially homogenous group
living in the same climatic conditions. is enables
a precise evaluation of the role of reading, writing,
using a computer, or watching television in the de-
velopment of myopia.
CONCLUSIONS
Reading, writing or using a computer may lead
to the development of myopia. Watching television
has no inuence on the incidence of myopia.
Table 1. Dependency between reading, writing, using a computer, watching television, and myopia
First author,
year of publication
Country Dependency between
reading, writing, and
myopia
Dependency between
using a computer and
myopia
Dependency between
watching television and
myopia
Nyman, 1988 Sweden –
Wong, 1993 Hong Kong +
Toppel, 1994 Germany –
Cole, 1996 Australia +
Mutti, 1996 USA –
Rechichi, 1996 Italy –
Kinge, 2000 Norway +
Saw, 2001 China +
Loman, 2002 USA –
Mutti, 2002 USA +
Khader, 2006 Jordan + + –
Saw, 2006 Singapore –
Jones, 2007 USA – –
Konstantopoulos, 2008 Greece + + –
Czepita, 2010 Poland + + –
You, 2012 China + + +
Pärssinen, 2014 Finland + +
Li, 2015 China + + +
Saxena, 2015 India + + +

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