Post LASIK Medical Requirements

[KyleKJ90]

On Thursday I'll be undergoing LASIK eye surgery. After talking with the staff at the clinic, it sounds like I should be seeing clearly within a day or so of my surgery. I have a visit with my optometrist the following day so I can be legal to drive again. My question/concern comes with my pilot medical certificate when it comes to filling out the FAA form 8500-7 Report of Eye Evaluation. Just wondering if anyone could help shed some light on this topic and perhaps help guide me through it. Does this get done by my regular optometrist or do I need to visit my AME and have him evaluate me and fill out the form?

[Deb]

From the Guide for Aviation Medical Examiners pg 58 (found here: http://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/guide.pdf)

"The FAA expects that airmen will 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, impaired night vision and glare), the appropriate vision standards are met, and they have been reviewed by an Examiner 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 and after consultation and review by an Examiner, the applicant may resume airman duties, unless informed otherwise by the FAA."

[1964-M20E]

I have thought about having the surgery but that is it no further action not even talking with my eye doctor.  I do not want to venture into the FAA medical rabbit hole on this one.

However, this is JMHO if I did get the surgery it would be not long after my FAA physical.  I would get my clearance from my eye doctor to resume normal activities, keep the paper work to file with my next FAA physical and go flying.

The link above is to 400 pages of bureaucratic doublespeak and is why we are where we are today.  Hopefully the 3rd class reform will pass and this will become a non issue.

Edited March 2, 2016 by 1964-M20E

[Piloto]

I got cataract surgery on both eyes. And was night driving the day after. When I went to my AME for my due medical I had 2020 on both eyes. He issued the certificate with no additional paper work required. If you can drive at night you definitely can fly a plane safely.

José

[CaptainAB]

I had Lasik done about 10 years ago. Its starting to degrade. I was told recently by an eye doctor that the new proceed is some sort of a disc implant that is better and it corrects both near and far. The reason I mention it, is I was told you are less likely to be a candidate after you have had Lasik.

 

 

[flyboy0681]

11 minutes ago, CaptainAB said:

I had Lasik done about 10 years ago. Its starting to degrade. 

Same here. After 15 years mine are starting to degrade. I'm perfectly fine during the day but got a pair of glasses for driving at night, although the prescription is fairly weak. I guess nothing is forever.

[Oscar Avalle]

Yes, daytime it is great but at night, it starts being a problem, but I was told that that would happen. Like reading glasses

Sent from my iPhone using Tapatalk

[ALP]

I am not familiar with LASIK, however I just recently had cataract surgery done. My eye doctor is also a pilot, and told me of the different lenses availabile. Not all of the lenses are acceptable to the FAA. The lense that was approved would still require reading glasses. I verified with my AME that if I had approved lenses and could meet the vision requirements there would be no problem. I now have 20/20 in both eyes and use mild reading glasses. 2 week heal time. I think the lense that corrected near and far was not approved due to halos, but do your own homework.

[Piloto]

Sounds like you guys are getting the beginnings of cataracts. I had the same symptoms and opted for full lens replacement. With the new embeded lenses I can easily read the street signs at night and the craters of the Moon with no glasses. Near vision takes about six months to settle down. After it settle I can easily read the small characters on the cell phone and the TAS scale on the airspeed indicator without glasses. Because of the increased light sensitivity and contrast I need to use transition glasses for outdoors.

José

[Hank]

I made the lens implants for nine years. There are many styles and options, various optic choicest d kens materials. Not sure which models are FAA approved. The multifocal lenses are wonderful thingss, we used to get Thank You letters from patients (amazing, considering we made over 6 million lenses each year!).

BUT . . . most eye doctors do not recommend multifocal lenses to two population groups:  pilots and engineers. I'm both . . . Our MF lenses had up to 12 different focal rings, and most people are spectacle free after surgery. There are models that correct for astigmatism, too. Talk to your eye doctor, and bounce it off your AME before doing anything.

LASIK, like RK before it, makes cuts on your cornea, the front of the eye, to compensate for poor focus. Cataracts form in your lens, in the middle of the eye, and in cataract surgery your natural lens is removed and an artificial lens is put in it's place. Takes a few days for everything to settle into permanent place. No stitches, though. It's an amazing process, we all had to watch an actual surgery video (taken through the surgeon's microscope) our first day in the job.

Good luck with whatever you decide to do. If your have any undesired optical effects afterwards, do your best to ignore them. Paying attention and getting aggravated will make them permanent. If you ignore them, your brain will compensate and they will "disappear" from your vision. As remarkable as the technology is, the adaptability of the human brain is even more amazing.

Edited March 3, 2016 by Hank
Stupid mistake, caught below

[flyboy0681]

Interesting comments about cataract lens replacements. My wife had both eyes done in 2015 and is marveled by the results.

Not getting on my soapbox here, but it's amazing that millions of people go completely blind around the world each year because they either can't afford or have access to the 15 minute procedure.

[mooniac15u]

2 hours ago, Hank said:

LASIK, like RK before it, makes cuts on your retina, the back of the eye, to compensate for poor focus. 

Both LASIK and RK reshape the cornea at the front of the eye. 

[Hank]

30 minutes ago, mooniac15u said:

Both LASIK and RK reshape the cornea at the front of the eye. 

Oopsie! Rods and cones are at the back, don't want to start slicing them up. Guess I better fix the long post above.

Not sure how the doctors measure for an IOL with pre-existing LASIK/RK.

Edited March 3, 2016 by Hank
Spell changer

[carusoam]

Siri respelled your cones, Hank.

Best regards,

-a-

[Hank]

9 minutes ago, carusoam said:

Siri respelled your cones, Hank.

Best regards,

-a-

Thanks, Anthony!  

Gotta love automation that changes what you type without asking . . . My iThingy here "suggests" about one word every 3 or 4 sentences, and changes one word per sentence without asking. My Galaxy S6 makes multiple suggestions for every single word that I type, and allows me to choose any or none of them. But Peter will be along soon to tell me how superior the Apple system is.    Because, well, you know, it's Apple.

[MyNameIsNobody]

Ten plus years post LASIK.  All good...Except reading vision...Not so much.

[KyleKJ90]

Sorry for the delay. It wasn't until today that I was finally able to focus my eyes on the computer screen to type up a response. I had a last minute change by the surgeon to go with PRK instead of LASIK. Turns out my corneas were a little thin and I have a slight astigmatism which can cause complications and he assured me that PRK was the better option of the two in my case. I'll spare you the boredom of explaining the difference and instead direct you to the YouTube link below. I found it to be spot on with my surgeon's explanation. There isn't really too much difference other than the method they use to get the outer layer of your eyeball out of the way so the laser can do it's job. On top of that the other difference is the extended amount of pain and healing time. As disappointed as I was about the added recovery time and pain, I was rather comforted to know that PRK was more commonly accepted by our branches of the military when it comes to applicant pilots. So far everything is going pretty good and I'm almost seeing 20/20 but only when I squint. Turns out this is normal and my vision will only get better as the days go by. The laser eye center was spot on when they said days two and three after the surgery would be the worst when it comes to pain. I fought like hell to sit through my IA renewal seminar and even had to have the girlfriend drive me there and back. When it comes to my medical certificate, I called my AME and his office assistant said to have FAA form 8500-7 filled out by my regular eye doctor and sent down to the FAA office in Oklahoma City when my vision is back to 20/20. Obviously I won't be doing any flying until then but I'm hoping to make a quick recovery. I can keep you all posted on my recovery and thanks again for all your help and suggestions!

https://www.youtube.com/watch?v=dKANhIU7Sxk

[carusoam]

Great report Kyle!

Good luck with the recovery.

Best regards,

-a-

[KyleKJ90]

Friday March 11th was my third post surgery visit to my regular eye doctor. During the visit he confirmed I was back to 20/20 vision and said I could fly again. My vision cleared up dramatically just a few days prior to that and I feel as though I'm seeing just as clear as I did with glasses/contacts. I haven't filled out the FAA form 8500-7 yet but I was cleared to drive and fly so I made a XC trip to KSTL following my appointment with the eye doc. For those of you who are considering LASIK or PRK, my advice is to go see if you're a candidate. My only wish is that I did this sooner. Don't be like me and let the fear of losing your medical hold you back from such a wonderful innovation such as LASIK or PRK. Thanks for the advice and safe flying to all!

Kyle

 

[kortopates]

I believe the only difference between the PRK and LASIK is that with the latter, a flap is cut on the surface and peeled back. Then the laser resurfaces the cornea below the flap. A custom ablation can be done to correct for astigmatism. To cut the flap, they need a minimum thickness in the cornea. But it gets thinner as we age to the point that they can only do the PRK. The PRK does the same surface treatment but without the flap. The flap is nice because it heals almost instantly as the flap is laid back down and is painless. Not so with the PRK it takes time and some scarring occurs which makes it a bit less accurate. Some people can have an adverse reaction to the process which results in significant scarring but I understand it's very rare with some eye drops they prescribe to avoid this. Still a scary thought because subsequent treatments generally result in greater reactions and they say the drug to prevent it becomes less effective with multiple treatments making PRK more limited for touchups. LASIKs though can be touched up in minutes by just lifting the flap back up.

I am not a doctor, just have had experience with both. Talk to your doctor. But I also highly recommend it. I got my LASIK when they first became approved. At that time ATL Pilots were lining up to get them done and did not need to take any more than a few days - to a week off. The FAA though wants you to stay grounded till your doc has verified your vision has stabilized without any bad side effects that are more pronounced at night. (E.g. Stars etc)

Sent from my iPhone using Tapatalk

[ZuluZulu]

Sorry to resurrect an old thread but I just had a LASIK consultation this morning. He recommended LASIK over PRK and has had many military and commercial pilots. Have any of you LASIK patients had issues that would lead you to recommend PRK (or sticking with contacts) instead? 

[0TreeLemur]

Hi @ZuluZulu I had LASIK for on my 40th birthday in 2004, for my 40th birthday present, and haven't looked back.  Of course when I turned fifty-ish I had to get reading glasses.  Nothing related to distance vision improvement is going to change that.   Go for it.  My distance vision is still 20/15 and 20/25.

In the past I've done a lot of field work in tropical settings.  That is why I really wanted to get rid of glasses- they always fog up in the jungle.   My eye dr. just told me "Don't get stuck in the eye by a stick", which I successfully avoided- not for the lack of trying...  The eye flap from LASIK can be lifted/torn by sharp impact to the eye of the kind that would probably not do a normal eye any good.

Good luck.

[gsxrpilot]

LASIK in 2001... still 20/20. Only wish I'd done it sooner.

[M016576]

On 3/3/2016 at 8:33 AM, MyNameIsNobody said:

Ten plus years post LASIK.  All good...Except reading vision...Not so much.

Old person problem.  That’s part of the fine print prior to undergoing lasik, prk, etc.... you’ll be “good” for a decade... but eventually, you’ll need reading glasses.  

Ask me how I know...I’m just getting to that point now...

[M016576]

9 hours ago, Fred_2O said:

Hi @ZuluZulu I had LASIK for on my 40th birthday in 2004, for my 40th birthday present, and haven't looked back.  Of course when I turned fifty-ish I had to get reading glasses.  Nothing related to distance vision improvement is going to change that.   Go for it.  My distance vision is still 20/15 and 20/25.

In the past I've done a lot of field work in tropical settings.  That is why I really wanted to get rid of glasses- they always fog up in the jungle.   My eye dr. just told me "Don't get stuck in the eye by a stick", which I successfully avoided- not for the lack of trying...  The eye flap from LASIK can be lifted/torn by sharp impact to the eye of the kind that would probably not do a normal eye any good.

Good luck.

The new LASIK technology (post 2008-ish), uses a technique that now effectively “dove-tails” the flap back into the eye.  This method was tested with direct physical impacts and on pig eyes into a 600 knot wind blast.  The flaps remained in place- without any sort of degradation.  

Once this method was standardized for lasik, they started allowing military fast jet pilots to get LASIK.  PRK had been an option previously (starting around 2000)... but lasik is far less painful... and arguably more effective.  

Source of information: I was in the trial program for LASIK for naval aviators in 2009.

oh.... I went from 20/50 to 20/12... and was back flying within 6 weeks.  My vision was back to “functional” within hours.. and after one day, was stable enough for me to do just about anything. No real pain to speak of either.  I highly recommend it.

Edited January 20, 2019 by M016576