Nose portion of FAA Eye Exam for Pilots Seeking Medical Certification
Item 26: Nose
Apr 2014
Abbreviated Briefing:
Examiner should primarly focus on:
- Evidence of Allergic Rhinitis (Hay Fever)
- Obstructions of sinus openings
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Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide pages 46-50, FAA and FDA web data (www.FAA.gov & www.FDA.gov), instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).
The nose should be examined for the presence of polyps, blood, or signs of infection, allergy, or substance abuse. The Examiner should determine if there is a history of epistaxis (nose bleeding) with exposure to high altitudes and if there is any indication of loss of sense of smell (anosmia). Polyps may cause airway obstruction or sinus blockage. Infection or allergy may be cause for obtaining additional history. Anosmia is at least noteworthy in that the airman should be made fully aware of the significance of the handicap in flying (inability to receive early warning of gas spills, oil leaks, or smoke). Further evaluation may be warranted.
Commentary:
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This is a hotly debated topic likely to change. From footnote #1 on page 49 (2014 AME Guide): Hay fever controlled solely by desensitization without requiring antihistamines or other medications is not disqualifying. Applicants with seasonal allergies requiring antihistamines may be certified by the Examiner with the stipulation that they not exercise privileges of airman certification within 24 hours of experiencing symptoms requiring treatment or within 24 hours after taking an antihistamine. The Examiner should document this in Item 60: AME Comments on History and Findings. However, non-sedating antihistamines loratadine or fexofenadine may be used while flying, after adequate individual experience has determined that the medication is well tolerated without significant side effects.
|
DISEASE/CONDITION |
CLASS |
EVALUATION DATA |
DISPOSITION |
|---|---|---|---|
|
Obstruction of sinus ostia, including polyps, that would be likely to result in complete obstruction |
All |
Submit all pertinent medical information and current status report |
Requires FAA Decision |
|
Evidence of severe allergic rhinitis1
|
All |
Submit all pertinent medical information and current status report |
Requires FAA Decision |
|
1Hay fever controlled solely by desensitization without requiring antihistamines or other medications is not disqualifying. Applicants with seasonal allergies requiring antihistamines may be certified by the Examiner with the stipulation that they not exercise privileges of airman certification within 24 hours of experiencing symptoms requiring treatment or within 24 hours after taking an antihistamine. The Examiner should document this in Item 60: AME Comments on History and Findings. However, non-sedating antihistamines loratadine or fexofenadine may be used while flying, after adequate individual experience has determined that the medication is well tolerated without significant side effects. | |||
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This page discussed the Nose portion of the ENT section of the Fight Physical Examination required of pilots.
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