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Thirty-five-year trend in the prevalence of refractive error in Austrian conscripts based on 1.5 million participants
  1. Lin Yang1,2,3,
  2. Clemens Vass4,
  3. Lee Smith5,
  4. Alfred Juan6,
  5. Thomas Waldhör1
  1. 1Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
  2. 2Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada
  3. 3Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
  4. 4Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
  5. 5Department of Life Sciences, Anglia Ruskin University – Cambridge Campus, Cambridge, UK
  6. 6Personnel Marketing Division, Ministry of Defence, Vienna, Austria
  1. Correspondence to Professor Thomas Waldhör, Medical University of Vienna Center for Public Health, Wien 15, Austria; thomas.waldhoer{at}


Background To quantify the current burden of myopia and hyperopia in Austrian young men and the time trend of myopia in the past 35 years by individual and social correlates.

Method We included data on all Austrian military conscripts from 1983 to 2017 (n=1 507 063) from six medical investigation stations. Young men provided data on education, weight and height for calculating body mass index, blood pressure and resting heart rate. Non-cycloplegic refractions were measured by an autorefractometer. Spherical equivalent was calculated by standard formula (sphere+cylinder/2, unit dioptres (D)). Myopic refractive error was defined as <−0.5 D). Hyperopic refractive error was defined as >0.5 D.

Results The largest burden of refractive error in Austria is myopia, which rose from 13.8% to 24.4% over 35 years, with less than 5% hyperopic population. Over time, the prevalence of myopia was constantly lower yet increased more rapidly among those with low education levels (11.4%–21.7%) compared with those with higher education (24.5%–29.6%) in all medical investigation stations. We found consistent associations of some unfavourable health indicators (underweight: ORs 1.1–1.4, higher resting heart rate: all p trend <0.001) with higher myopia prevalence, which point towards lifestyle factors playing an important role in the development of myopia.

Conclusion Primary preventive measures are needed to curb the observed trend in myopia among Austrian young men. Future research should investigate the impact of modifiable factors on myopia development and progression, particularly lifestyle factors that are dramatically shifting.

  • epidemiology
  • public health

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  • Contributors LS, CV and AJ reviewed the manuscript. LY analysed the data and drafted and revised the manuscript for important intellectual content. TW designed the study, acquired and analysed the data, drafted the initial manuscript and reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. All data relevant to the study are included in the article or uploaded as supplementary information.

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