Refractive Procedures: Pilot Eye Problems
Ophthalmologic Issues Addressed by FAA
Excerpts from Guide for Aviation Medical Examiners
Application Process for Medical Certification
Exam Techniques and Criteria for Qualification
Items 31-34. Eye - Refractive Procedures
The FAA accepts the following Food and Drug Administration approved refractive procedures for visual acuity correction:
- Radial Keratotomy (RK)
- Epikeratophakia
- Laser-Assisted In Situ Keratomileusis (LASIK)
- Photorefractive Keratectomy (PRK)
- Conductive Keratoplasty (CK)
Please be advised that these procedures have potential adverse effects that could be incompatible with flying duties, including: corneal scarring or opacities; worsening or variability of vision; and night-glare.
Pilots must not resume airman duties until their treating health care professional determines that their post-operative vision has stabilized, there are no significant adverse effects or complications (such as halos, rings, haze, imparied night vision and glare), the appropriate vision standards are met, and reviewed by an AME or AMCD. When this determination is made, the airman should have the treating health care professional document this in the health care record, a copy of which should be forwarded to the AMCD before resumption of airman duties. If the health care professional's determination is favorable, the applicant may resume airman duties, after consultation and review by an Examiner, unless informed otherwise by the FAA.
An applicant treated with a refractive procedure may be issued a medical certificate by the Examiner if the applicant meets the visual acuity standards and the Report of Eye Evaluation (FAA
Form 8700-7) indicates that healing is complete; visual acuity remains stable; and the applicant does not suffer sequela such as; glare intolerance, halos, rings, impaired night vision, or any other complications. There should be no other pathology of the affected eye(s).
If the procedure was done 2 years ago or longer, the FAA may accept the Examiner's eye evaluation and an airman statement regarding the absence of adverse sequela.
If the procedure was performed within the last 2 years, the airman must provide a report to the AMCD from the treating health care professional to document the date of procedure, any adverse effects or complications, and when the airman returned to flying duties. If the report is favorable and the airman meets the appropriate vision standards, the applicant may resume airman duties, unless informed otherwise by the FAA.
- Conductive Keratoplasty (CK): CK is used for correction of farsightedness. As this procedure is not considered permanent and there is expected regression of visual acuity in time, the FAA may grant an Authorization for special issuance of a medical certificate under 14 CFR 67.401 to an applicant who has had CK.
The FAA evaluates CK procedures on an individual basis following a waiting period of 6 months. The waiting period is required to permit adequate adjustment period for fluctuating visual acuity. The Examiner can facilitate FAA review by obtaining all pre- and post-operative medical records, a Report of Eye Evaluation (FAA Form 8700-7) from a treating or evaluating eye specialist with comment regarding any adverse effects or complications related to the procedure.
See
Conductive Kerotoplasty Disease Protocol.
For guidance regarding the conduction of visual acuity, field of vision, heterophoria, and color vision tests, please refer to Items 50-54.
The FAA specifices that the examination of the eyes be directed toward the discovery of diseases or defects that may cause a failure in visual function while flying or discomfort sufficient to interfere with safely performing airman duties.
The Examiner should personally explore the applicant's history by asking questions concerning any changes in vision, unusual visual experiences (halos, scintillations, etc.), sensitivity to light, injuries, surgery, or current use of medication. Does the applicant report inordinate difficulties with eye fatigue or strain? Is there a history of serious eye disease such as glaucoma or other disease commonly associated with secondary eye changes, such as diabetes? (Also see Item 53 and Item 54).
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