IOP rises while reading, especially on screens
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Key takeaways:
- IOP rose from baseline among healthy volunteers and patients with controlled glaucoma at all reading intervals.
- IOP returned to baseline 20 minutes after reading.
Both healthy individuals and patients with medically controlled primary open-angle glaucoma experienced a rise in IOP while reading, especially when reading from a smartphone, according to a study published in the Journal of Glaucoma.
“Reading from digital screens is known to produce worse ocular asthenopic symptoms when compared with reading from printed text under similar viewing conditions,” Rajat Mohan Srivastava, MD, associate professor of ophthalmology at King George’s Medical University in India, and colleagues wrote. “It yet remains to be observed if reading from printed text and digital screens (smartphones) has varying effects on the IOP.”
In a 6-month study of 60 healthy volunteers (mean age, 31.2 years; 67% men) and 22 patients (mean age, 49.4 years; 55% men) with medically controlled primary open-angle glaucoma (POAG), researchers assessed changes in IOP after reading for 30 minutes on a smartphone compared with printed text.
Participants were offered printed literature in Hindi or English, and then read the same material in PDF format on a Vivo S1 Pro smartphone. Researchers assessed IOP in the right eye of healthy participants and the worse eye of POAG patients using a rebound tonometer, with measurements taken at baseline and 10, 20 and 30 minutes while reading and again 10 and 20 minutes after reading.
According to results, IOP rose from baseline in both groups at all reading intervals, with significantly higher IOP reported while reading with a smartphone compared with printed text. Healthy volunteers experienced a maximum rise in IOP at 20 minutes of reading, while patients with glaucoma experienced a rise in IOP with both reading modalities as early as 10 minutes.
In the healthy group, IOP returned to near baseline levels 20 minutes after reading, while it remained higher than baseline at this timepoint in the POAG group, although the difference was not significant.
“Reading using smartphones causes a greater rise in IOP,” Srivastava and colleagues wrote. “A larger study on older individuals and glaucoma patients would be useful in framing recommendations for prolonged reading.”
Perspective
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It has been thought that accommodation during reading enhances aqueous outflow and effectively lowers IOP, but the eye is a complex organ and intrinsically finds a way to contradict what we think we know. Recent literature has suggested an elevation in IOP with accommodation while reading on digital devices.
To further research this, Srivastava and colleagues compared IOPs in control and POAG groups while reading on paper vs. smartphones. They found IOP elevation in both groups while reading printed material and an even higher increase during smartphone use.
However, this study compared accommodative-related IOP changes among healthy volunteers in their early 30s with those of a POAG group, which had an average age of almost 50 years. Given what we know about age-related lenticular and accommodative changes, this may not be a fair comparison. Future studies should consider a control group closer in age and accommodative function to the POAG group.
Given the prevalence of digital media in our daily lives, it is hard to imagine that this slight elevation in IOP would be enough to convince any of our glaucoma patients to change their digital lifestyles, on either a personal or professional level.
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