Ophthalmoscopic : What to Expect at the Flight Physical

The FAA recommends that AMEs establish a routine for ophthalmoscopic examinations to aid in the conduct of a comprehensive eye assessment. Routine use mydriatics (dilating eye drops) are not recommended, but in rare circumstances the AME may need to dilate the pilot's pupils to better visualize internal structures. The doctor will check for the following:

• a. Cornea — observed for abrasions, calcium deposits, contact lenses, dystrophy, keratoconus, pterygium, scars, or ulceration. Contact lenses should be removed several hours before examination of the eye. (See 50. Distant Vision)
• b. Pupils and Iris — checked for the presence of synechiae and uveitis. Size, shape, and reaction to light will be evaluated during the ophthalmoscopic examination. The AME will check for coloboma, reaction to light, and any disparity in size.
• c. Aqueous — hyphema or iridocyclitis (blood or inflammation around iris).
• d. Lens — observed for aphakia, discoloration, dislocation, cataract, or an implanted lens.
• e. Vitreous — AME will note any discoloration, hyaloid artery, floaters, or strands.
• f. Optic nerve — observed for atrophy, hemorrhage, cupping, or papilledema.
• g. Retina and choroid — examined for evidence of coloboma, choroiditis, detachment of the retina, diabetic retinopathy, retinitis, retinitis pigmentosa, retinal tumor, macular or other degeneration, toxoplasmosis or other identifiable signs of ocular or systemic disease.