Lasik/PRK and the airlines
 

I currently fly for the Air Force and am seriously considering doing the Lasik/PRK they offer. Before I take the leap of faith I want to make sure I'm not closing doors on myself.

Though I don't know of anyone who has had issues cotinuing their Air Force flying career post-surgery, does corrective eye surgery preclude you from flying for the airlines, especially as a new hire? Specifically, are there regulations that create medical hassles (waivers or required additional testing)? Would any airline care (or even ask) if you've had corrective eye surgery?

In other words, am I screwing myself if I choose to ditch the glasses that are doing a mighty fine job of correcting my vision to 20/10 but are a pain in my a$$?

I had it done, and it's never come up in an interview. Best thing I have ever done. They could care less as long as you have a first class medical.

I've know a few who had it done and a couple of years later required glasses again to correct their near-sightedness.

In other instances they can't always achieve 20/20 or better. Some folks end up with vision slightly worse than 20/20.

By the way, not sure if others know this but here's what 20/20 indicates.

Let's say your vision is 20/300.

What a person with normal eye sight (20/20) sees clearly at 300 feet, you see clearly at 20 feet. In other words, the clarity you have at 20 feet will be the same clarity a person with 20/20 vision has at 300 feet.

If you are a professional pilot and can pass an FAA first class medical, you should think carefully before getting vision surgery.

Do they offer LASIK or PRK? LASIK is better in many ways, but the military has historically prefered PRK since it doesn't penetrate the structure of the cornea.

There is always a smal risk of complications.

Another concern is your Best Corrected Visual Acuity (BCVA). I'm about 20/100 without glasses, but I correct to 20/15 with glasses. Laser surgery can improve your uncorrected acuity by reshaping the cornea while at the same time damaging the cornea and reducing your BCVA. Someone like me might go from:

20/100 (uncorrected) and 20/15 (corrected) to
20/25 uncorrected and 20/20 corrected.

So I end up with MUCH better vision without glasses, but even with glasses I can only see 20/20, so I've lost 5 points on the eye chart. This is actually pretty common, and is not likely to ever be correctable. It is also possible to lose enough BCVA to end up worse than 20/20, like say 20/25. This would make you ineligible for an FAA first class medical without a waiver.

Anyone who knows anything about laser eye surgery will STRONGLY recomend a VERY experienced surgeon...the military doc is likely to be somewhat junior, and it's military medicine. I've found they are very good at some things (like orthopedic surgery) but not so great at other things.

There is also a new procedure, a version of LASIK, which instead of just carving your cornea into a perfect geometric shape uses a laser to measure the optical imperfections INSIDE your eyeball. Then it cuts your cornea to the right general shape AND adds intentional deviations to the cornea to cancel out the inner-eye imperfections. This procedure can actually give you a serious INCREASE in BCVA by correcting those inner-eyeball errors which were previously not correctable. 20/10 uncorrected would not be uncommon. This is the procedure that I would be looking into for myself...hopefully the military has the new equipment.

I had PRK done about 2 years ago. My vision was 20/250 and is now 20/20. The reason I chose PRK was b/c I didn't want to exclude military as a possible career path. It was the best $3k I've spent.

Rick makes a lot of good points. As a matter of fact, it sounds a lot like the brief the eye sugeon will give you if you choose to enter the program. I had mine done in San Diego by a Navy CAPT who is one of the most experienced around. Do your homework, they will give you a ton of info while you are going through the screening process and you have ample oppertunity to bail out if you change your mind. I went from 20/400 to 20/16 with no complications so it was nothing less than a life changing event for me, but since you are already flying now, YMMV.

Excellent advise by rickair as usual. Another point to consider is that in some countries eye surgery is an automatic disqualification. For example, if you wanted to do contract work for any of the Japanese carriers - which can pay very well - any eye surgery is an automatic disqualification.

I've had friends who opted for LASIK obtain vastly different results. Some are very satisfied but one can no longer hold a 1st class due to night vision problems that he developed post surgery. If you're a military pilot your uncorrected vision can't be that bad to start with right? If you have good vision with glasses, I wouldn't take the risk associated with surgery no matter how small. It's kind of like playing russian roulette with your career in my book...

To answer your question, and not give you the cautionary side, I had Lasik a while back. Have interviewed at a number of airlines, and offered a job at all. It was never an issue, they could care less. They only care if you can pass a first class medical.

Not true. That may be the case with many US airlines but there are certainly some foreign airlines / aviation authorities that will unfortunately not consider you if you have had LASIK, PRK, etc.

I agree that no US airlines would be likely to have an issue with it.

The problem is the risk of LONG TERM complications...if your vision degrades over time you might need further surgery, or might not be able to pass an FAA medical (without a waiver).

I know plenty of folks who have had good luck with the surgery, but I don't know anyone who has gone 30 years post-surgery without complications...and neither does anyone else! There's no long term history on the new stuff, you're the guinea pig!

As a professional pilot (and military guy) I won't do it (maybe when I retire?). If I was employed in a regular job, I probably would.

If you NEED the surgery to qualify for military flying, that is your ultimate dream, and you are otherwise competetive... then consider it. I probably would have back in the day, in those circumstances.

If you're a civilian and can pass the medical now, think twice before slicing up your eyes.

I had PRK a year and half done into my second tour flying Hornets for the Navy. I wouldn't trade it for the world. PRK has many more benefits, mostly in terms of long term side effects, over it's LASIK counterpart, especially with night acuity issues. The Navy currently is conducting several studies with LASIK for aviators, but to date it is NOT approved for Naval Aviation(USMC/USCG as well). One thing you must consider for military aviation before getting PRK is that your initial refractive error will determine if you are eligible for a waiver regardless of your PRK outcome(read: If you're correction is large, and diopters are big numbers, you may be disqualified from flying).

As for your FAA exam you're fine as long as you can pass the test. I had no issues. I'm 20/15 in both eyes now nearly a year and a half after the procedure. I was 20/40 and 20/50, but was 20/100 in both eyes when they were dilated. My eye muscles were compensating alot. Now, life is good, and NO night issues. The week worth of pain and 90 days of not flying was well worth the reward.

Several years ago an ANG unit was considering me for a flying position, but my eyesight didn't meet their requirements. They had me consult with their eye doctor, and he gave me the following advice:

If I had a non-flying career and was interested in flying solely for the military, take the chance with the PRK surgery. If I ended up only being able to see 20/25, or had trouble with night vision - as a regular non-flying person, I wouldn't be very affected by it in day-to-day life. Therefore, it would be worth the risk.

However, if I also wanted a flying career as a civilian (which was the case), he advised me not to jeopardize my chances of being able to pass a 1st Class Medical, in the event that the surgery didn't turn out perfectly. He said the chances were good that everything would turn out great, but why take the risk, when I'm able to pass a 1st Class Medical now. He also mentioned that if the military accepted LASIK, he would be less inclined to dissuade me, because he believed PRK surgery was too crude of a method in correcting eyesight.

Reluctantly, I had to agree with his judgement, and I passed up the opportunity to fly for the military. Glasses and contact lenses are a pain, but at least I still get to fly airplanes. I know of pilots who have had LASIK and swear by the results - I'm just not willing to take the chance in risking my whole career over an unnecessary procedure. If you decide to go for it - good luck!!!! :)

I know plenty of folks who have had good luck with the surgery, but I don't know anyone who has gone 30 years post-surgery without complications

Have the procedures been around for that long? I thought they were fairly recent developments in medicine.

A pretty common misconception wrt PRK/LASIK is that you will not need glasses. NOT TRUE. As you age(i.e. get close the the 40ish region) your ability to read close up still goes by the wayside, hence the need for bifocals. That requirement doesn't change with the surgery. I had PRK done at 31, so the 9 years of not wearing glasses/contacts was well worth the risk, not to mention I see a heckuva lot better.

As for the post debating risk vs reward and PRK with the military career vs civilian, your assumptions are a bit off. Even if the procedure for PRK was only to allow you 20/25, you'd most likely still be able to get a class I with glasses correcting you to 20/20. Its definitely a personal decision, most noteably influenced by the fear of someone scraping or cutting your eye with either a blade or a laser. Could the computer screw up and zap your eyes the wrong way....sure, is it likely.....no, is there risk, yes, is there risk each time you fly.......most definitely. If you look at statistics for these procedures.....you're in good shape. Just my .02.

how does the PRK and/or lasik effect those with astigmatism?
are there any benefits? or is astigmatism uncorrectable?

I had PRK done with the aforementioned condition. I am now seeing 20/15 in both eyes. It really depends on the amount of correction they need to make and how 'off shape' your eyes are. It can be done, certainly an exam with a LASIK/PRK specialist(get a consult from your flight doc if you're military first) will be able to answer the questions you have.