Objectives As the evidence on the possible association between lifting and retinal detachment (RD) is limited and controversial, we analysed a large population-based cohort to investigate the risk of RD arising from occupational lifting.

Methods We assessed the incidence of surgically treated RD occurring between 1991 and 2009 in a national cohort of 49,321 Swedish men conscripted for military service in 1969–1970. We applied a job exposure matrix to occupational data from the 1990 census to estimate the frequency of heavy lifting (>20–25 kg) at the workplace. We fitted Poisson regression models including lifting, myopia, income, and education level to estimate incidence rate ratios (IRR) and 95% confidence intervals of RRD.

Results We analysed 217 RD cases that occurred in 7 80 166 person-years. Estimates adjusted by myopia and socioeconomic factors support the hypothesis that the risk of RD increases among subjects lifting heavy weights at least twice per week, compared to workers not performing lifting (IRR 2.38, 95% CI 1.15–4.93, p for trend across lifting categories 0.014). Myopia was a strong negative confounder of the lifting - RD association. While RD was rare in the entire cohort (0.28 cases per 1000 person-years), the rate peaked at 7.9 per 1000 person-years among workers frequently lifting heavy loads, aged between 50 and 59 years, and affected by severe myopia.

Conclusions Our study provides evidence that performing heavy occupational lifting increases the risk of RD, while myopia and socioeconomic factors may be important negative confounders of this association.