PRK and LASIK Information

[Guest Vipernum]

Im new here so please forgive me if this question has already been answered. I looked at the previous posts and didnt see any info.

Im an ROTC student and have just been approved to get PRK by HQ. Unfortunately they said that even if I did get PRK I would not qualify for ANY flying position. Here is my info:

OD: .75x.25x117

OS: 1.5x.75x044

By my understanding I am over on both eyes in the SPH section (first set of numbers) by .25 and 1.0 respectively.

I have two questions:

1) Did I understand that information correctly?

2) If in fact I am over, is there a waiver that I can get?

Please let me know any information as soon as possible. I am scheduled for the PRK 7 May 2009 but if I can't get a waiver then I wont get PRK since my vision is fine otherwise.

Thanks for all your help!

Vipernum

[StoleIt]

I forget what OS and OD mean, but If your eye pressure (I think?) is outside of regs BEFORE PRK even it falls inside after PRK you will still be DQed.

This happened to a buddy of mine, he was going ENJJPT, and nobody told him until about 3 months before graduation. Big FUBAR situation and he got Space & Missiles.

When I get back from ASBC I will look at my PRK paperwork and compare what numbers I had. So expect a follow up post Sat or so.

[Guest Vipernum]

I forget what OS and OD mean, but If your eye pressure (I think?) is outside of regs BEFORE PRK even it falls inside after PRK you will still be DQed.

This happened to a buddy of mine, he was going ENJJPT, and nobody told him until about 3 months before graduation. Big FUBAR situation and he got Space & Missiles.

When I get back from ASBC I will look at my PRK paperwork and compare what numbers I had. So expect a follow up post Sat or so.

Thanks alot! Im not sure if SPH refers to my eye pressure or not. I dont know how to read the form really... I just know those numbers were given for my CREF testing. Additionally, OD is just a term referring to my right eye and OS is my left eye.

Additional comment from multiple users would be appreciated! I'd really like a waiver haha.

Thanks everyone

[Guest goducks]

Im new here so please forgive me if this question has already been answered. I looked at the previous posts and didnt see any info.

Im an ROTC student and have just been approved to get PRK by HQ. Unfortunately they said that even if I did get PRK I would not qualify for ANY flying position. Here is my info:

OD: .75x.25x117

OS: 1.5x.75x044

By my understanding I am over on both eyes in the SPH section (first set of numbers) by .25 and 1.0 respectively.

I have two questions:

1) Did I understand that information correctly?

2) If in fact I am over, is there a waiver that I can get?

Please let me know any information as soon as possible. I am scheduled for the PRK 7 May 2009 but if I can't get a waiver then I wont get PRK since my vision is fine otherwise.

Thanks for all your help!

Vipernum

Viper,

I have moved your question into the thread related to PRK and LASIK information. This topic has been discussed at length in the past and I believe your specific questions have been addressed, however your Rx was written improperly and I cannot explicitly answer your question without the correct Rx.

An Rx is written in the following format

Sph Cyl Axis

There may be a plus or minus in front of the sphere component. Generally if nothing is designated, it is considered to be positive. There will always be either a plus or minus in front of the cylinder component (never an x). There will always be an "x" in front of the axis.

Please check your Rx (specifically the sign in front of the cylinder value) and repost. I can then give you a specific answer.

I'm inclined to think that you do not need PRK and will be fine as is, but I need the correct numbers to confirm.

GD

[Guest Vipernum]

Viper,

I have moved your question into the thread related to PRK and LASIK information. This topic has been discussed at length in the past and I believe your specific questions have been addressed, however your Rx was written improperly and I cannot explicitly answer your question without the correct Rx.

An Rx is written in the following format

Sph Cyl Axis

There may be a plus or minus in front of the sphere component. Generally if nothing is designated, it is considered to be positive. There will always be either a plus or minus in front of the cylinder component (never an x). There will always be an "x" in front of the axis.

Please check your Rx (specifically the sign in front of the cylinder value) and repost. I can then give you a specific answer.

I'm inclined to think that you do not need PRK and will be fine as is, but I need the correct numbers to confirm.

GD

Thanks for moving me GD! My apologies on writing the Rx incorrectly. I have a copy of my eye exam but it is difficult for me to understand. (you know doctors' handwriting haha)

My info on the exam is as follows. There are 2 references but I believe its the CRef that is the main concern:

MRef

OD: +.50+.25x124

OS: +.75+.50x053

CRef

OD: +.75+.50x117

OS: +1.50+.75x044

Ok so here's the deal as far as I'm informed. I had the ophthalmologist fill out a "PRK ACCESSION WAIVER CRITERIA CHECKLIST". The section she filled out reads exactly as below:

OD: By: +.75 Sph: +.50 CX: 117

OS: By: +1.50 Sph: +.75 CX: 044

Those numbers are based off my CRef which I believe is pertinent because they dilated my eyes for these tests. The SSgt's at my detachment plugged me into a "WINGS" program which I guess tells me if I'm qualified for pilot. They told me this; according to the "CORNEAL REFRACTIVE SURGERY WAIVER CHECKLIST" for flying duties my eyes must meet the following criteria:

"No cycloplegic cannot be >-8.00/+.50, have an astigmatism >+3.0 either eye in any meridian or Anisometropia >2.5 to be acceptable (no exceptions)"

Just to clarify the numbers filled out on my sheet read " By, Sph, and CX". I do not know if that is the same as "SPH, CYL, and AXIS".

Thanks for the help.

[Guest goducks]

Thanks for moving me GD! My apologies on writing the Rx incorrectly. I have a copy of my eye exam but it is difficult for me to understand. (you know doctors' handwriting haha)

My info on the exam is as follows. There are 2 references but I believe its the CRef that is the main concern:

MRef

OD: +.50+.25x124

OS: +.75+.50x053

CRef

OD: +.75+.50x117

OS: +1.50+.75x044

Ok so here's the deal as far as I'm informed. I had the ophthalmologist fill out a "PRK ACCESSION WAIVER CRITERIA CHECKLIST". The section she filled out reads exactly as below:

OD: By: +.75 Sph: +.50 CX: 117

OS: By: +1.50 Sph: +.75 CX: 044

Those numbers are based off my CRef which I believe is pertinent because they dilated my eyes for these tests. The SSgt's at my detachment plugged me into a "WINGS" program which I guess tells me if I'm qualified for pilot. They told me this; according to the "CORNEAL REFRACTIVE SURGERY WAIVER CHECKLIST" for flying duties my eyes must meet the following criteria:

"No cycloplegic cannot be >-8.00/+.50, have an astigmatism >+3.0 either eye in any meridian or Anisometropia >2.5 to be acceptable (no exceptions)"

Just to clarify the numbers filled out on my sheet read " By, Sph, and CX". I do not know if that is the same as "SPH, CYL, and AXIS".

Thanks for the help.

Based on the Cyclo Rx you report, DO NOT have refractive surgery. You exceed the +0.50 D limit. Your refractive error in the most hyperopic meridian is +1.25 OD (+0.75+0.50) and +2.25 OS (+1.50+0.75). If you have any refractive surgery you will be permanently DQ and, almost certainly, will not get a waiver.

Again, based on the Rx you've written, you might need a waiver for excessive hyperopia, however this will only be determined once you have your FCI/MFS at Brooks. This is a fairly routine waiver that only requires you to have normal depth perception (or more accurately normal stereopsis). Bottom line is that if you have PRK/LASIK, you will not be waived. If you don't you may or may not even need a waiver.

GD

[Guest Vipernum]

Based on the Cyclo Rx you report, DO NOT have refractive surgery. You exceed the +0.50 D limit. Your refractive error in the most hyperopic meridian is +1.25 OD (+0.75+0.50) and +2.25 OS (+1.50+0.75). If you have any refractive surgery you will be permanently DQ and, almost certainly, will not get a waiver.

Again, based on the Rx you've written, you might need a waiver for excessive hyperopia, however this will only be determined once you have your FCI/MFS at Brooks. This is a fairly routine waiver that only requires you to have normal depth perception (or more accurately normal stereopsis). Bottom line is that if you have PRK/LASIK, you will not be waived. If you don't you may or may not even need a waiver.

GD

Thank you very much for the advice. A few more questions and I promise I'll leave you alone haha. Ok, I understand not getting PRK. Here's what I'm not clear about. The SSgt's at my detachment entered my eye information in a program, "WINGS" I think, and they said based on my current informationI do not qualify for pilot.

So here are my questions:

1) Even though I dont qualify as of now, can I still apply for pilot and determine if I can get a waiver from Brooks?

2) Should I get another DoDMERB done (my last one was in 2005) so that I can update my eye info and see if I qualify?

3) Can I get a waiver right now and if so how do I go about finding information about it?

I just really want to have the chance at pilot, nav, or ABM. If I can be selected and make it to Brooks I would be pumped!

Thanks

[Guest goducks]

Thank you very much for the advice. A few more questions and I promise I'll leave you alone haha. Ok, I understand not getting PRK. Here's what I'm not clear about. The SSgt's at my detachment entered my eye information in a program, "WINGS" I think, and they said based on my current informationI do not qualify for pilot.

So here are my questions:

1) Even though I dont qualify as of now, can I still apply for pilot and determine if I can get a waiver from Brooks?

2) Should I get another DoDMERB done (my last one was in 2005) so that I can update my eye info and see if I qualify?

3) Can I get a waiver right now and if so how do I go about finding information about it?

I just really want to have the chance at pilot, nav, or ABM. If I can be selected and make it to Brooks I would be pumped!

Thanks

1. You should still be able to apply for a pilot slot and be potentially eligible for a waiver pending your FCI/MFS at Brooks.

2. I don't see where another DODMERB would make a difference, however, it is important to note that all qualifying numbers related to refractive error (your Rx) are based on using two drops of Cyclopentolate and waiting one hour to make the measurements. If they used a weaker dilating drop at your DODMERB then the degree of hyperopia that is measured would be less than what Brooks would measure, which could affect your waiverability. So, if you want to know ahead of time whether any surprises will come up at the FCI, you could have them repeat the cyclo refraction using Cyclopentolate, but it's not necessary, per se.

3. I don't think you can apply for a waiver ahead of time. There is a small group of people who have their FCI done ahead of time (not at Brooks) and they are stamped with a waiver pending successful outcome of the MFS at Brooks. However, if you're having a combined FCI/MFS at Brooks, I don't believe you can apply for a waiver ahead of time based on your DODMERB findings.

GD

[Guest Vipernum]

1. You should still be able to apply for a pilot slot and be potentially eligible for a waiver pending your FCI/MFS at Brooks.

2. I don't see where another DODMERB would make a difference, however, it is important to note that all qualifying numbers related to refractive error (your Rx) are based on using two drops of Cyclopentolate and waiting one hour to make the measurements. If they used a weaker dilating drop at your DODMERB then the degree of hyperopia that is measured would be less than what Brooks would measure, which could affect your waiverability. So, if you want to know ahead of time whether any surprises will come up at the FCI, you could have them repeat the cyclo refraction using Cyclopentolate, but it's not necessary, per se.

3. I don't think you can apply for a waiver ahead of time. There is a small group of people who have their FCI done ahead of time (not at Brooks) and they are stamped with a waiver pending successful outcome of the MFS at Brooks. However, if you're having a combined FCI/MFS at Brooks, I don't believe you can apply for a waiver ahead of time based on your DODMERB findings.

GD

All right I think I understand what youre saying.. so then based on our conversation you recommend not getting the PRK and still applying for pilot then hopefully getting a waiver at brooks?

[Guest goducks]

All right I think I understand what youre saying.. so then based on our conversation you recommend not getting the PRK and still applying for pilot then hopefully getting a waiver at brooks?

That's correct.

[Bishop]

I had the ophthalmologist fill out a "PRK ACCESSION WAIVER CRITERIA CHECKLIST". The section she filled out reads exactly as below:

OD: By: +.75 Sph: +.50 CX: 117

OS: By: +1.50 Sph: +.75 CX: 044

https://www.specialtactics.com/pjcctprk.pdf

Is this the checklist your tailing about how does one acquire this checklist,

another question that has me confused all to heck. My optometrist wanted to put me in glasses that would go to 20/10, I said no, and asked for an even weaker prescription so my glasses take me to 20/40 ( I have read that the stronger your prescription the worse your eyes get)

so is it your prescription to get you to the cutoff (20/70) or to 20/20, im confused, and im sure this information is in here somewhere, but i don't see it (then again i'm not wearing my glasses :).

[Guest goducks]

https://www.specialtactics.com/pjcctprk.pdf

Is this the checklist your tailing about how does one acquire this checklist,

another question that has me confused all to heck. My optometrist wanted to put me in glasses that would go to 20/10, I said no, and asked for an even weaker prescription so my glasses take me to 20/40 ( I have read that the stronger your prescription the worse your eyes get)

so is it your prescription to get you to the cutoff (20/70) or to 20/20, im confused, and im sure this information is in here somewhere, but i don't see it (then again i'm not wearing my glasses :).

Bishop,

I'm not sure I understand your question. Are you asking about how the maximum pre-PRK (or LASIK) refractive error is determined? If so, the answer is that it is the Rx your doctor measures after your eyes have been dilated and is based on the lens that gives the best visual acuity possible. This is different than the way that refractive errors are determined as part of the FCI/MFS. Those are also done under dilated conditions, but it is the minimum amount of lens power needed to give 20/20 vision.

Let me know if I've misunderstood your question.

GD

[Guest NavHopeful]

I'm active duty and just had PRK this month. Here are my questions for the flight docs:

1) How soon will I be able to take a flight physical, and get a vision waiver for PRK?

2) Will I be able to apply for the Jan 2010 UFT board? (applications due Nov 09)

Thanks.

[Bishop]

Bishop,

I'm not sure I understand your question. Are you asking about how the maximum pre-PRK (or LASIK) refractive error is determined? If so, the answer is that it is the Rx your doctor measures after your eyes have been dilated and is based on the lens that gives the best visual acuity possible. This is different than the way that refractive errors are determined as part of the FCI/MFS. Those are also done under dilated conditions, but it is the minimum amount of lens power needed to give 20/20 vision.

Let me know if I've misunderstood your question.

GD

I was asking where to find the ""PRK ACCESSION WAIVER CRITERIA CHECKLIST"" and I did some goggling and was wondering if I had found it.

[Chip]

I'm active duty and just had PRK this month. Here are my questions for the flight docs:

1) How soon will I be able to take a flight physical, and get a vision waiver for PRK?

2) Will I be able to apply for the Jan 2010 UFT board? (applications due Nov 09)

Thanks.

Well I'm no flight doc, but I just went through this process and should be getting my waiver within the week.

1) How soon will I be able to take a flight physical, and get a vision waiver for PRK?

This question depends on how well your eyes heal. For UPT applicants, you can get a physical and start applying for a waiver as early as 6 months after surgery. Assuming you've had no problems and your eyes have stabilized at the 3month post surgery time frame, you take your first cycloplegic exam (where they dilate your eyes). 3 Months later you take another one. If you're eyes have remained stable, you've got the green light to get a physical and apply for a waiver. Even if you succeed, it doesn't mean your legal to fly. Your waiver/physical isn't valid for flying purposes until your 1 year post op date. This caveat just lets you get your waiver accomplished for the purposes of meeting the board. If selected, your class date would not be before your 1 year post op date.

Check out the link below for more reading. The specific attachment I'm talking about is "USAF Aviation and Special Duty PRK Waiver Program attachment 1-applicants" dated 1/29/2007

https://kx.afms.mil/kxweb/dotmil/kjDocs.do?...nalArea=RS_USAF

2) Will I be able to apply for the Jan 2010 UFT board? (applications due Nov 09)

Looking at timelines, you're going to be cutting it pretty close. You're in the same boat I was in for last years board. If everything goes perfectly, you'll have the waiver by late Oct/early Nov. I had surgery on Apr 23 08, but there were a couple minor setbacks and I wasn't able to make the deadline.

BL: There's a chance you'll be able to apply for the 2010 board, but you're timeline to make it happen is very tight. Even if you did make it and got selected, officially, your class date couldn't be before your 1 year post-op date.

Good Luck!

[Guest NavHopeful]

Thanks for the info.

Is it possible to get started on the class 1a physical prior to my 6 month point? If I have to wait until late Oct to apply for the waiver and take the physical, then I'll be cutting it too close. I will only have 3-4 weeks between being 6 months post op and the application deadline, but this is my last chance since I'll turn 30 at the end of next year.

[Chip]

Nav

You'd need to talk with the flight docs/public health at your base. Maybe they can get you the hookup. Mine told me I couldn't do the physical until I was ready to accomplish the waiver since they both go up to HQ at the same time. You should still be able to get all the prepwork out of the way - labs, dental, xray, etc. - but, I don't know if there's much more you could do.

Edit: On a side note, while it took my flight doc 3 months or so to submit all the info for my waiver and physical in the system (he was new), it went up to headquarters and the waiver authority and was approved/returned within 4 weeks. I had the Public Health folks calling on my behalf daily, which really helped push it through quick.

Edited May 1, 2009 by Chip

[Guest willbee7]

Hey all..quick question. I also am active duty AF who had PRK done in December 08. Ive heard from some...that I can get the ball rolling with my flight physical at the 6 month point...but after reading the AFI's...it looks like you cannot even get the waiver process started for eyesight until the 12 month point unless you're applying for JSUPT? Can someone PLEEEEEEEEEEEEEEEEEEEASE shed some light on this? I want to apply for this year's board...thanks a bunch

-Will

[Bishop]

https://www.specialtactics.com/pjcctprk.pdf

Is this the checklist your tailing about how does one acquire this checklist,

Still wondering if this is the form that people are mentioning here

And taken from the page.

"Any cycloplegic cannot be > - 5.50 for FC1 or > -8.00 (no hyperopia allowed) for FC1A/II/III duties in any meridian to be acceptable. (No

exceptions)"

It doesn't talk about astigmatism in there I thought PRK and Lasik correct astigmatism to a degree

Also whats the difference between Lasik and Epi-Lasik looking at some plans they talk about Conventional lasik, Custom Lasik, and Blade less Lasik (something about computer guided) are all forms of Lasik acceptable.

And there seems ot be an ongoing discussion which is better PRK vs Lasik, I have heard that with PRK since the part of the eye is removed it grows back stronger rather then the "flap" associated with Lasik, Id have to look into it more because I have no idea myself which is better. Heck I dont even know if Id qualify for either one!

Edited May 12, 2009 by Bishop

[Guest goducks]

Still wondering if this is the form that people are mentioning here

And taken from the page.

"Any cycloplegic cannot be > - 5.50 for FC1 or > -8.00 (no hyperopia allowed) for FC1A/II/III duties in any meridian to be acceptable. (No

exceptions)"

It doesn't talk about astigmatism in there I thought PRK and Lasik correct astigmatism to a degree

Also whats the difference between Lasik and Epi-Lasik looking at some plans they talk about Conventional lasik, Custom Lasik, and Blade less Lasik (something about computer guided) are all forms of Lasik acceptable.

And there seems ot be an ongoing discussion which is better PRK vs Lasik, I have heard that with PRK since the part of the eye is removed it grows back stronger rather then the "flap" associated with Lasik, Id have to look into it more because I have no idea myself which is better. Heck I dont even know if Id qualify for either one!

Bishop,

I don't know where the checklist is, but you can call the folks at Brooks if you need it:

https://afspp.afms.mil/idc/groups/public/do...b_071755~20.pdf

All of the information you need is in the current waiver guide:

https://airforcemedicine.afms.mil/idc/group...name=CTB_070655

For FCI, refractive surgery is allowed for up to -8.00 D of myopia and 3.00 D os astigmatism (Sec 4.1 of the waiver guide). The -5.50 D for FCI is from the old policy.

There are a bunch of different laser surgies available...too many for me to easily explain in a short summary. In general however, most people consider surface procedures (PRK, Epi-LASIK, LASEK) to be a little safer and preferred for refractive errors up to about 4.00 D of myopia. Stromal procedures (LASIK, including bladeless LASIK- otherwise known as femptosecond LASIK) are preferred in higher amounts of myopia, but there are some aeromedical concerns about the flap. Any procedure can be done as a conventional treatment versus a custom or wavefront-guided treatment. Custom or wavefront-guided means that the optics of the eye are measured to a greater degree of accuracy and is expected to result in a better visual outcome. However, differences in outcomes between conventional and custom are not night and day. Conventional can still give you very good outcomes, just maybe not quite as good as custom.

All current laser procedures can correct myopia and astigmatism. They can also correct hyperopia, however, this has not been approved by the USAF for a litany of reasons that are all very valid IMHO.

It would be impossible to tell you which procedures are best for you. The physical characteristics of your eyes (corneal thickness, corneal curvature, corneal topography, and refractive error) will play a big role in making the decision. You'll have to consult a good refractive surgeon for an accurate answer.

GD

[tlr9489]

Sorry if this has been addressed already- I had searched recently.

I am a non-prior hoping to enlist and pursue a pilot slot in the Guard this Fall. I had PRK in November 2008, and I am coming up on my 6-month post-op appointment. I passed my FAA Class I 2 months ago with 20/20 uncorrected vision, and no limitations, however I noticed I struggled a bit with my right eye on the chart. I have been recorded as 20/20 or better for both eyes at each of my follow-ups with my PRK doc. I have periodically checked my vision by reading things at a distance (left eye, then right), and there is no question my right eye is noticeably worse. Before the procedure, they were the same. I also think I am experiencing some starbursts at night when I'm driving, but this may be normal. I am worried that my vision in my right eye seems to be getting worse, after what had been a quick recovery.

Is there anything I can do to possibly fix this? I am using more eye drops now (I have very dry eyes), any other suggestions? Less computer? Is it worth it to have a follow up procedure? I'm probably 20/20 left, 20/40 right. What is required post op correction after 12 months for PRK (pilot)?- I had thought it was 20/20, but I have heard 20/50 as well (correctable to 20/20).

I realize MEPS/EMFS will look over the docs notes, which to this point are perfect. Is it worth it to mention some concerns to the doc?- basically if I say at my 6-mo follow up that I am starting to experience blurring, or vision isn't stabilized, will that put me in a bad spot come MEPS/EMFS and it's on my notes? As opposed to keeping my mouth shut letting the numbers speak for themselves and hopefully by the Fall everything is healed up just right.

Please advise on an appropriate course, or tell me to get a life and quit being paranoid. Thanks much.

[Guest goducks]

Sorry if this has been addressed already- I had searched recently.

I am a non-prior hoping to enlist and pursue a pilot slot in the Guard this Fall. I had PRK in November 2008, and I am coming up on my 6-month post-op appointment. I passed my FAA Class I 2 months ago with 20/20 uncorrected vision, and no limitations, however I noticed I struggled a bit with my right eye on the chart. I have been recorded as 20/20 or better for both eyes at each of my follow-ups with my PRK doc. I have periodically checked my vision by reading things at a distance (left eye, then right), and there is no question my right eye is noticeably worse. Before the procedure, they were the same. I also think I am experiencing some starbursts at night when I'm driving, but this may be normal. I am worried that my vision in my right eye seems to be getting worse, after what had been a quick recovery.

Is there anything I can do to possibly fix this? I am using more eye drops now (I have very dry eyes), any other suggestions? Less computer? Is it worth it to have a follow up procedure? I'm probably 20/20 left, 20/40 right. What is required post op correction after 12 months for PRK (pilot)?- I had thought it was 20/20, but I have heard 20/50 as well (correctable to 20/20).

I realize MEPS/EMFS will look over the docs notes, which to this point are perfect. Is it worth it to mention some concerns to the doc?- basically if I say at my 6-mo follow up that I am starting to experience blurring, or vision isn't stabilized, will that put me in a bad spot come MEPS/EMFS and it's on my notes? As opposed to keeping my mouth shut letting the numbers speak for themselves and hopefully by the Fall everything is healed up just right.

Please advise on an appropriate course, or tell me to get a life and quit being paranoid. Thanks much.

The important question with the right eye is whether the blurred vision is a result of residual refractive correction (i.e. can be corrected with glasses) or some other factor such as corneal scar tissue or abnormal healing. Ask the doc which it is at your next visit. Needing a little lens correction is no big deal. If there is some scarring, then it's more serious and potentially problematic for waiverability.

USAF vision and refractive standards for post-PRK are generally no different than if you never had surgery. You can be up to 20/70 (or -1.50 D nearsighted) and be within standards as long as it's correctable to 20/20.

Keep in mind that there is a mandatory 1 year wait period after surgery before you can complete your MFS evaluation. If you elected to have the right eye retreated to tweak the Rx, the clock would be reset. If you have some scar tissue that requires the epithelium to be scraped off, I BELIEVE the clock would be reset as well, although I'm not 100% sure about that.

I would advise you to discuss your concerns with the doc. If there is an issue that goes beyond needing some lens correction, it will be identified at the MFS eval and may potentially jeopardize your waiverability. If something needs to be addressed, now is the time to get it done.

GD

[Number 2]

The important question with the right eye is whether the blurred vision is a result of residual refractive correction (i.e. can be corrected with glasses) or some other factor such as corneal scar tissue or abnormal healing. Ask the doc which it is at your next visit. Needing a little lens correction is no big deal. If there is some scarring, then it's more serious and potentially problematic for waiverability.

USAF vision and refractive standards for post-PRK are generally no different than if you never had surgery. You can be up to 20/70 (or -1.50 D nearsighted) and be within standards as long as it's correctable to 20/20.

Keep in mind that there is a mandatory 1 year wait period after surgery before you can complete your MFS evaluation. If you elected to have the right eye retreated to tweak the Rx, the clock would be reset. If you have some scar tissue that requires the epithelium to be scraped off, I BELIEVE the clock would be reset as well, although I'm not 100% sure about that.

I would advise you to discuss your concerns with the doc. If there is an issue that goes beyond needing some lens correction, it will be identified at the MFS eval and may potentially jeopardize your waiverability. If something needs to be addressed, now is the time to get it done.

GD

GD,

Have you had any experience in dealing with slight GASH (glare, starbursts, halos) night vision symptoms in post-operative flight crew/studs? I'm wondering if those who pass through the Brooks post-surgery evaluation successfully but have some minor symptoms are able to improve the quality of their experience with a small amount of over-minusing, miosis-inducing eyedrops, or other flight-doc approved techniques.

Thanks for your time.

[Guest goducks]

GD,

Have you had any experience in dealing with slight GASH (glare, starbursts, halos) night vision symptoms in post-operative flight crew/studs? I'm wondering if those who pass through the Brooks post-surgery evaluation successfully but have some minor symptoms are able to improve the quality of their experience with a small amount of over-minusing, miosis-inducing eyedrops, or other flight-doc approved techniques.

Thanks for your time.

I've run into a few that have had such complaints and it's been hit or miss on trying to "correct" it. Sometimes, there's a small amount of residual refractive error that may be minimal enough that during the day (when the pupil is small) it's no problem, but at night becomes symptomatic. A pair of specs (with a good anti-reflective coating) can help. I've seen that once or twice.

Another potential cause of night complaints after refractive surgery is induced spherical aberration. This creates a scenario where the central optics may be on plane (ie. emmetropic), but the peripheral optics are focused in front of the retina (i.e. myopic). Again, no problem during the day, but symptomatic at night. This is difficult to correct with lenses as you essentially need multiple powers built into the lens. There are aspheric glasses and contact lenses that minimize spherical aberration, however, these are designed to minimize the aberrations associated with fabrication of the lens versus correcting aberrations in the eye. As you alluded to, you could try a little extra minus to "split the difference" between the central and peripheral optics. You could also try an apheric contact lens- the Frequency 55 Aspheric is approved for USAF aviation use. But, it would just be a bit of trial and error. I've seen cases where rigid gas permeable contact lenses make a dramatic improvement on post-operative night vision, but these are not approved for flying in the USAF.

Miosis inducing eyedrops would be problematic for a couple of reasons. The most commonly used miotic is Pilocarpine and two common side effects are headaches and accommodation spasms (which would result in blurred vision). Plus, Pilocarpine would fix your pupil at about 2 mm and not nearly enough light would come through to make it possible to function well in dim conditions.

For a long time, we were hearing that wavefront guided treatments would be a cure for these types of problems; both in terms of not creating the problem in the first place, or fixing the problem via retreatment. I've not seen this to hold true to any large degree. However, I'm also not exposed to the worst case scenarios where WFG might be of some help.

So basically the answer is, yes, I've run into it a few times. But, I'm not aware of any particularly effective treatments.

GD

[Bayou_Eagle_Driver]

Once again GD - your insights and information are great! I check this forum often for any questions you answer.

RE: The above topic (Night vision), do you think a SLIGHT SLIGHT ghosting at night following WFG LASIK (if i squint it goes away, and it's not present under certain lighting conditions....mostly when there's a SINGLE illuminated point in a dark area.) would be of any concern for someone going through brooks?

I function fine at night, and fly regularly at night.

Thanks

`LS