Eye Pressure / Glaucoma

[SurelySerious]

Male Astronauts Return With Eye Problems

In the past few years, about half of the astronauts aboard the international space station have developed an increasing pressure inside their heads, an intracranial pressure that reshapes their optic nerve, causing a significant shift in the eyesight of male astronauts. Doctors call it papilledema.

Female space travelers have not been affected.

Barratt is one of 10 male astronauts, all older than 45, who have not recovered. Barratt returned from a six-month stint aboard the station in October 2009 and has experienced a profound change in his sight.

He used to be nearsighted. But now, the space veteran says he’s eagle-eyed at long distance but needs glasses for reading. There is no treatment and no answers as to why female space flyers are not affected.

Not really Glaucoma related, but an interesting issue.

[matmacwc]

An epidemic of masturbation on the space station is my theory, the ladies, well, not so much. BQZips mom an sell them some stuff to help this, but keep that on the DL.

[nonflyboy]

Thread revival...

I believe i have done my due diligence on researching my options.

For background, I went to WPAFB to certify my local IFC1 by completing the MFS only portion (one day).  The WPAFB docs caught a >21mm Hg pressure, believe it was a 24 or 25 mm Hg (apparently my local doc didn't put on their that I had corneal thickness >540um, which is considered meets standards).  

Since the local doc didn't justify my >21mm with my corneal thickness >540um, i had to stick around for more testing.  I ended up doing the puff test and applanation tonometry (eye poke?) around four times each spanning from that early morning to the next morning for one more each again.

Ultimately, i had two measurements coming back at 27 and 28 mm Hg that were both from the initial morning tests and the next day morning tests - which hits the "two or more applanation tonometry" for >26 and corneal thickness >540um.

To add to the mess, the eye docs told me that IOP will always measure higher in the morning vs the afternoon. Which if I only did afternoon measures, i would be considered meet standards.  Further, I was told my corneal thickness is around 620um, which is quite high.  The eye doc even said that studies show that IOP will increase with corneal thickness, and even though mine being ~15% thicker than the current "median" of 540 they use, there is no elevated allowance of IOP.  

Only good news i have is that the eye docs stated everything else about my eye was within standards (no nerve damage, etc). Also, I did not leave WPAFB with a stamped DQ, but they would be holding all my paperwork.

I was told they're going to hold it for a med board, but understanding that I am considered initial aircrew, so per the reg this is considered non waiverable. If all goes bad (or according to reg), i assume my only other option would be ETP. 

Has anyone else been down this avenue and can shed light on how it went? I hate that i have learned so much about my particular eyeballs...

I've seen @stuckindayton answer a few threads in here, you still active?

Thanks everyone.

Edited November 25 by nonflyboy
Spelling

[jonlbs]

5 hours ago, nonflyboy said:

Thread revival...

I believe i have done my due diligence on researching my options.

For background, I went to WPAFB to certify my local IFC1 by completing the MFS only portion (one day).  The WPAFB docs caught a >21mm Hg pressure, believe it was a 24 or 25 mm Hg (apparently my local doc didn't put on their that I had corneal thickness >540um, which is considered meets standards).  

Since the local doc didn't justify my >21mm with my corneal thickness >540um, i had to stick around for more testing.  I ended up doing the puff test and applanation tonometry (eye poke?) around four times each spanning from that early morning to the next morning for one more each again.

Ultimately, i had two measurements coming back at 27 and 28 mm Hg that were both from the initial morning tests and the next day morning tests - which hits the "two or more applanation tonometry" for >26 and corneal thickness >540um.

To add to the mess, the eye docs told me that IOP will always measure higher in the morning vs the afternoon. Which if I only did afternoon measures, i would be considered meet standards.  Further, I was told my corneal thickness is around 620um, which is quite high.  The eye doc even said that studies show that IOP will increase with corneal thickness, and even though mine being ~15% thicker than the current "median" of 540 they use, there is no elevated allowance of IOP.  

Only good news i have is that the eye docs stated everything else about my eye was within standards (no nerve damage, etc). Also, I did not leave WPAFB with a stamped DQ, but they would be holding all my paperwork.

I was told they're going to hold it for a med board, but understanding that I am considered initial aircrew, so per the reg this is considered non waiverable. If all goes bad (or according to reg), i assume my only other option would be ETP. 

Has anyone else been down this avenue and can shed light on how it went? I hate that i have learned so much about my particular eyeballs...

I've seen @stuckindayton answer a few threads in here, you still active?

Thanks everyone.

Been down the ETP road. Went well till it didn’t go well, had lots of weight backing it up too and went all the way to the top.

Good luck, best advice would be don’t let your life stop while you wait for the Air Force to do the right thing. That’s how I ended up with better seniority than most dudes I generate sorties for. Odds aren’t in your favor, but don’t let it stop you from trying still, it’s possible.

pm me and I’m happy to share what I got but the AF has probably developed a new form and process for it all by now. All streamlined and efficient I’m sure… /s

 

 

 

[stuckindayton]

On 11/25/2024 at 9:29 AM, nonflyboy said:

 

I've seen @stuckindayton answer a few threads in here, you still active?

 

Yea, I'm still lurking around.

Eye pressure has been an item that the Air Force has been very wary of historically.  A few years ago, the policy was an IOP of 22 or higher was DQing with no waiver.  That was plain old stupid because (as you now know), IOP alone really doesn't mean that much unless it is crazy high, ie. >30.  Also, IOP is influenced by corneal thickness because the applanation tonometer is simply measuring resistance over an area to determine pressure.  Corneal thickness is part of this equation.  Thus, thicker corneas tend to read higher and vice versa for thin corneas.

Average corneal thickness is around 540 microns.  So, the Air Force was willing to give some wiggle room if the corneal was thicker than average and now allows an IOP up to 26 if the corneal is above 540 microns.

Personally, I don't like the policy and most of the eye docs at WP don't either.  But, the AF doesn't like big changes to policy and getting the corneal thickness measurement in the equation and going up to 26 was a big change and a step in the right direction even if it is not ideal.

It sounds like you DO NOT have glaucoma.  One of the tests they do called an OCT can demonstrate this.  You have ocular hypertension that may lead to glaucoma someday, but that's it.  Glaucoma is generally an old person disease.  The likelihood of this ever impacting a flying career is exceedingly low.

It's a tough one because the AF hears elevated IOP and immediately thinks glaucoma....blindness.  The problem is that when you measure something you get a number and when you get a number you need a limit.  The docs would prefer the policy just say glaucoma is DQing.  That leaves too much room for interpretation and standards don't like that.

Best of luck,

Steve

 

 

[nonflyboy]

On 11/26/2024 at 11:39 AM, stuckindayton said:

Yea, I'm still lurking around.

Eye pressure has been an item that the Air Force has been very wary of historically.  A few years ago, the policy was an IOP of 22 or higher was DQing with no waiver.  That was plain old stupid because (as you now know), IOP alone really doesn't mean that much unless it is crazy high, ie. >30.  Also, IOP is influenced by corneal thickness because the applanation tonometer is simply measuring resistance over an area to determine pressure.  Corneal thickness is part of this equation.  Thus, thicker corneas tend to read higher and vice versa for thin corneas.

Average corneal thickness is around 540 microns.  So, the Air Force was willing to give some wiggle room if the corneal was thicker than average and now allows an IOP up to 26 if the corneal is above 540 microns.

Personally, I don't like the policy and most of the eye docs at WP don't either.  But, the AF doesn't like big changes to policy and getting the corneal thickness measurement in the equation and going up to 26 was a big change and a step in the right direction even if it is not ideal.

It sounds like you DO NOT have glaucoma.  One of the tests they do called an OCT can demonstrate this.  You have ocular hypertension that may lead to glaucoma someday, but that's it.  Glaucoma is generally an old person disease.  The likelihood of this ever impacting a flying career is exceedingly low.

It's a tough one because the AF hears elevated IOP and immediately thinks glaucoma....blindness.  The problem is that when you measure something you get a number and when you get a number you need a limit.  The docs would prefer the policy just say glaucoma is DQing.  That leaves too much room for interpretation and standards don't like that.

Best of luck,

Steve

 

 

Good day,

So i've been told by WP docs that they're pushing me for a waiver at the next board, since this past one was cancelled due to the holidays.  I read the waiver guide and since I am initial aircrew it states "non-waiverable".  Does the board have the ability to waive it even though the reg states it can not be? To me I am just expecting a DQ, which is a world of suck.

I also went and saw the eye doc locally on base this week and they conducted the same two test. 3x measurements for air puff and then the applanation tonometry test two times (3x measurements ea). They all came back as <24mm Hg for all with the average amongst each set of measurements to be 22 and 23.

I've asked WP if i can send these data points as more weight for my waiver (waiting for an answer), but do you think it would even be considered?

Thanks,

Toni

[pbar]

I would always get false positives on the yearly puff test and then I would have to do the Goldman test.  Turns out I had abnormally thick corneas and so the Air Force made me do PRK surgery (or I would have been grounded according to my flight surgeon at the time).  The PRK surgery fixed the issue. 

[stuckindayton]

Anything can be waived if the waiver authority chooses to do so.  I'm surprised the WP docs said they'd recommend a waiver since their recommendations are supposed to follow the waiver guide.  Things might work differently now.

It can't hurt to include IOPs from a civilian doc, but generally the AF doesn't pay much attention to civilian exams for various reasons.

I wasn't going to mention what Pbar did, but he is correct.  PRK will bring your IOP down.  So will eye drops and certain plants that people smoke.  I'll just leave it at that.

I wish you the best and I'm sorry to not have better feedback.

Steve

[nonflyboy]

@stuckindayton that was my impression as well on the waiver aspect.  And as for the additional exam I had done, it was done on base so I suppose that counts as the whole "military doc" thing?

I appreciate your responses in here.

I feel like I have done as much as I can while I await their decision....now time to wait. 

Edited December 5 by nonflyboy
clarity