Visual Acuity in Late Adolescence and Future Psychosis Risk in a Cohort of 1 Million Men

Abstract Background We aimed to determine whether late adolescent visual impairment is associated with later psychosis. Methods We conducted a longitudinal cohort study of Swedish male military conscripts aged 18 or 19 years from January 1, 1974, through December 31, 1997 (N = 1140710). At conscription, uncorrected and optometry-lens-corrected distance visual acuity was measured. Participants were then followed up to see if they received an inpatient diagnosis of non-affective psychotic disorder, including schizophrenia (N = 10769). Multivariable Cox modeling was used to estimate differences between groups. Results After adjustment for confounders, those with severe impairment before optical correction in their best eye (decimal fraction 0.5 compared to those with no between eye acuity difference). Individuals with impaired vision that could not be corrected to normal with lenses had highest rates of psychosis (best eye adjusted HR 1.56; 95% CI 1.33–1.82), those with imperfect, but correctable vision also had elevated rates (best eye adjusted HR 1.21; 95% CI 1.15–1.28). Individuals with visual impairment had higher rates of psychosis than their full siblings with normal vision (adjusted HR 1.20, 95% CI 1.07–1.35). Conclusions Impaired visual acuity is associated with non-affective psychosis. Visual impairment as a phenotype in psychosis requires further consideration.