Introduction To investigate the effects of different reading postures on intraocular pressure (IOP) and near-work-induced transient myopia (NITM) in children with myopia. Methods Sixty myopic children were instructed to read a book text placed at 33 cm for 30 min with two different reading postures: head bowed and head upright postures. The participants' IOP and NITM were assessed using a rebound tonometer and an open-field autorefractor. The measurement of IOP was conducted prior to reading, during reading sessions (at 5, 10, 20, and 30-min intervals), and after a 5-min recovery period. Results For the head bowed posture, the mean baseline IOP was 16.13 +/- 2.47 mmHg. A significant rise in IOP was observed after 5 min of reading (17.17 +/- 2.97 mmHg; +1.03 +/- 2.29 mmHg; p = 0.014). Subsequent measurements revealed a further increase after 20 min (17.87 +/- 2.90 mmHg; +1.73 +/- 2.58 mmHg; p < 0.001), which continued to persist even after 30 min of reading (17.57 +/- 3.46 mmHg; +1.43 +/- 2.66 mmHg; p = 0.002). The IOP at different time points measured in the head upright posture did not show any significant difference in comparison to the baseline measurement (all p = 1.000). Compared to reading with the head upright, reading with the head bowed resulted in a greater increase in IOP at each time point (p < 0.05). Furthermore, the NITM was higher for reading with the head bowed than for reading with head upright at 30 min (-0.24 +/- 0.53 D vs. -0.12 +/- 0.47 D, p = 0.038). Conclusion Reading in a head bowed position resulted in greater increases in IOP and NITM compared to reading in a head upright posture.