Trends in visual impairment among Austrian conscripts (1965-2003) after screening introduction : A retrospective, descriptive study.

Abstract

Purpose: This retrospective descriptive study assesses the impact of Austria's pregnancy passport (Mutter-Kind-Pass, MKP) program, which was implemented in 1974, on best-corrected visual acuity (BCVA), with a particular focus on its potential role in reducing the prevalence of unilateral or bilateral visual impairment (UoBVI).

Methods: As part of mandatory military service, Austrian males aged 17-19 years undergo standardized medical examinations, including BCVA assessment for amblyopia detection and service eligibility. This study analyzed BCVA data from 1,694,681 conscripts born between 1965 and 2003 using data from the Austrian military conscription database. The UoBVI was classified according to defined BCVA thresholds (in Snellen decimal).

Results: Among the total cohort, 1,561,292 conscripts (98.0%) demonstrated a BCVA of ≥ 0.8 in both eyes. The overall prevalence of amblyopia decreased from an initial 4% to 1.5% in the period between 1965 and 2003. When comparing individuals born between 1965-1967 and 2001-2003, those achieving BCVA ≥ 0.8 in both eyes increased from 147,002 (96.6%) to 80,419 (98.4%). Those with BCVA < 0.8 in both eyes decreased from 1511 (1.0%) to 383 (0.5%); individuals with BCVA between 0.4-0.7 in 1 eye remained relatively stable at 1432 (0.9%) vs. 719 (0.9%); while those with BCVA ≤ 0.3 in 1 eye decreased markedly from 2459 (1.6%) to 237 (0.3%).

Conclusion: The MKP program, through structured ocular screening during key periods of visual development, appears to significantly contribute to the reduction in UoBVI prevalence in Austria, most likely due to early detection and treatment of amblyopia. These findings underscore the value of early vision screening as a component of public health strategy.