During 2001-2018, there were approximately 1.38 million incident diagnoses of myopia, 1.21 million incident diagnoses of astigmatism, and 492,000 incident diagnoses of hyperopia among active component service members (crude overall incidence rates of 7.8, 6.6, and 2.2 diagnoses per 100 personyears, respectively). Incidence rates of all 3 conditions were higher among women compared to men. Service members in the Marine Corps, enlisted personnel, and those working in other/unknown military occupations had higher overall rates of incident myopia diagnoses compared to their respective counterparts. Incidence rates of astigmatism diagnoses were similar across all services and among both enlisted personnel and officers. Overall rates of hyperopia diagnoses were similar across all race/ethnicity groups and service branches and among both enlisted personnel and officers. However, across occupational groups, overall rates of hyperopia and astigmatism diagnoses were highest among service members working in healthcare occupations. Future analyses should focus on the specific effects of military refractive surgery programs on the readiness of service members.