Eye Pressure / Glaucoma

[GearMonkey]

Thread Revival!

I had my FC1A supplemental yesterday, It was just all eye tests. I had gone through this already for my comissioning physical but i crept up again. In the puff machine, my pressures were 23 and 24, but i went to a eye doc back home at my own expense and he found my corneas were thicker than normal and my eye pressures were 18 and 19. I have already given them a letter from the doc ststing i am not a candidate for glacoma. What alse should i give them for my waiver? I have to go back next tuesday for a field of vision test as well.

From my experience the AF doesn't buy the thick corneas explanation. The best thing you can do for yourself is get a bunch more test values that are within standards. Also, get contact measurements which are more accurate than the "puff" test. To help yourself out make sure that you are sitting up perfectly straight (this can be tough for tall folks) when the doc pokes you in the eye [fighter queers insert "sts" here]. You can also toke up on vitamin C beforehand to help produce lower readings.

The reg requires two high readings recorded by contact tonometry to give you the OHT (ocular hypertension) scarlet letter. Technically this isn't waiverable for non-aviators but stranger things have happened.

Depending on your situation a waiver could be easy, difficult, or impossible. If you get them some good pressures, show through all the other tests that glaucoma isn't an issue, and overwhelm them with your persistence you'll probably be in business.

[Guest MizzNav]

From my experience the AF doesn't buy the thick corneas explanation. The best thing you can do for yourself is get a bunch more test values that are within standards. Also, get contact measurements which are more accurate than the "puff" test. To help yourself out make sure that you are sitting up perfectly straight (this can be tough for tall folks) when the doc pokes you in the eye [fighter queers insert "sts" here]. You can also toke up on vitamin C beforehand to help produce lower readings.

The reg requires two high readings recorded by contact tonometry to give you the OHT (ocular hypertension) scarlet letter. Technically this isn't waiverable for non-aviators but stranger things have happened.

Depending on your situation a waiver could be easy, difficult, or impossible. If you get them some good pressures, show through all the other tests that glaucoma isn't an issue, and overwhelm them with your persistence you'll probably be in business.

I have values well within regs from the poke test from an optometrist as well as a letter describing how my eyes are fine, i guess i will make them do manother poke test just to be safe. God damn it i hate those numbing drops!

[Guest MizzNav]

They did another test, my eyes are t 22, which i think is the highest possible you can have and get it waivered. I did my field of vision and passed just fine s well. The eye doc said i shouldn't have a problem getting this waived, since there is nothing worng with my eyes and the pressufre is articfically high due to the cornea thing, which he wrote on his notes so that they support the other eye doc's findings. So i guess we'll see in a couple of weeks!

[Guest MizzouNav]

So i got a call from my CC today. My waiver for Glaucoma was approved, but they denied me based on hypertension of the eye. I have Measurements taken in my town saying my eyes are fine, and some measurements from whiteman AFB saying they are high. The AFB ones were taken in the morning, the locals in the afternoon, which i know can cause the difference.

So am I sunk, or can I do something? My CC said he would call the Surgeon General's office and ask for a clarifycation, but i want to know what i can do from here since the waiver was denied.

[Guest P27:17]

So i got a call from my CC today. My waiver for Glaucoma was approved, but they denied me based on hypertension of the eye. I have Measurements taken in my town saying my eyes are fine, and some measurements from whiteman AFB saying they are high. The AFB ones were taken in the morning, the locals in the afternoon, which i know can cause the difference.

So am I sunk, or can I do something? My CC said he would call the Surgeon General's office and ask for a clarifycation, but i want to know what i can do from here since the waiver was denied.

He what my doc has to say...

I'm not sure why they would waive glaucoma, and then DQ based on ocular hypertension. Maybe they decided that the diagnosis of glaucoma was not valid? But why waive if that's the case.

Not sure what clarification we can offer. If IOPs are 22 or above using contact tonometry (confirmed on multiple tests) then he is DQ per policy. Yes, time of day may impact IOP which is why we perform diurnal pressures on borderline cases. Low IOPs in the afternoon do not "over-ride" normal IOPs in the morning.

[Guest MizzouNav]

I just feel they should have asked for more testing. My pressures at the local doc using applanation were 16 and 17, the ones at Whiteman were like 24 and 26, a huge difference. I just think someone's data is wrong, and would like a chance to figure it out. Hpefully i will have some info Friday or Monday. My Col is going up to bat for me, so hopefully it will help.

[GearMonkey]

Sorry to hear your latest news MissouNav. I agree that USAF takes a very short-sighted view in cases like these. They are spoiled with a such an enormous number of applicants that they choose to ignore anything slightly out of the norm. It doesn't help that the links between high eye pressure and glaucoma are still not totally understood (i.e. people with high pressure never getting glaucoma and people with normal pressure getting it). Like the old 20/20 eyesight requirement this is simply a tool for narrowing the field.

I went back and read your previous posts and am a bit confused as to when you got the 24/26 pressures you mentioned and if they were puff or contact measurements. If they were contact measurements you've got an uphill battle ahead of you. If they were puff and were not verified with contact then you've got a pretty good argument for an ETP.

If I were you I'd get as many contact pressure checks as possible in the next few weeks/months. If you are close to Whiteman I'd drop in occasionally and sweet talk the opthalmology techs into checking your pressures. It is pretty quick and if they are between appointments you can probably talk them into it. It doesn't cost them anything and if you are nice about it they shouldn't have any problem helping you out. I did this in Atlanta at a nearby Army base and it worked great. This is a good way to go about getting data because nothing goes into the computer or your medical record unless you want it to. As I mentioned before you should sit up completely straight (I was 2 mmHg higher when slouching forward and down to put my chin on the test machine instead of having them set it to fit my natural sitting height) when doing the test. Also, take vitamin C. It is probably a plecebo but supposedly it helps lower your eye pressures. I'm no doctor but I think that being nervous about getting disqualified accounts for a lot of the high pressure cases they find.

It is great that your CC is going to bat for you but I doubt he'll be able to do much. My O-6 tried to help me out but didn't get very far. He was a dumbass but even if he wasn't I think the system is stacked against the "lowly" ROTC Colonel. Hope for the best but start planning for the worst. If things work out great, if not I can help you with the ETP process. I did several years as an engineer while I massaged the system. Eventually I got an ETP from the Vice CSAF and the rest is history. Set yourself up with a good interim assignment and hopefully you'll be at UPT some day soon.

In the end just remember that the Air Force isn't only about the flying. Most folks from this site will disagree with that statement and any time you tell anyone you're in the Air Force they'll ask what you fly but the majority of folks out there aren't in the cockpit. There are as almost as many MG officers in the Air Force as their are pilots. Be positive and do your best wherever you end up and you'll be taken care of. It sounds like bullshit (and I thought it was) but it really is true. I didn't want to be an engineer but I enjoyed every moment of it. I worked with great folks and it was a constant challenge. I even miss that life sometimes when I'm out on the road and don't know where I'll be next or when I'll be sent there. Everything has its ups and downs. You may not believe me but I've had plenty of days where I was so fed up with the bullshit I deal with as a pilot I wish I was back at my 9-5, every other Friday off, AFMC job.

Finally, baseops.net is a great resource. I wish I'd have known about it when I was fighting the system trying to get into UPT. There is a ton of info here to help you and those in similiar situations.

Good luck.

Edited August 8, 2012 by GearMonkey

[Guest MizzouNav]

Thanks, I found out i am just awaiting reclassification now, so the nav stuff is gone. I am hoping to get my CE slot back and apply for the active duty Nav boards when I get some higher ups on my side. I am still excited about CE as i did 5 years of school for it and i have a buddy who seems to be enjoying it. I might even just stay in that field if i enjoy it enough.

I will just take what i have learned this time and use it to my advantage next time. But i am not going to get bitter and mad about it because that will do nothing but give me a bad attitude that will hurt my preformance and in turn my chances for a rated job later. Plus i don't want to be one of those shoes everyone goes on about, rather be a help and held in a higher regard than looked down on.

Building stuff and playing army every once in a while beats the hell out of a total desk job. Plus if i get any of my bases the worst place i will be is las vegas.

[GearMonkey]

Great attitude dude! Let me know if/when you want to pursue an ETP. I've got mine and the one I modeled it after (both were accepted) for you to use as reference.

CEs do some cool shit. I've known a bunch and they all enjoy it. There are downs but tons of ups! You'll actually get to put all that ROTC leadership shit into practice in the CE world. Plus, it beats a real job. . .

Don't get too excited about the location until it is official. I got a place that wasn't even on the list of six available locations. It was freaking sweet but it wasn't on the list.

GM.

Edited April 24, 2008 by GearMonkey

[FalconXtreme]

revival!

so ive takin my fc1 and i have high pressure per the ovt. after reading this thread and talking to my mom who just told me that my grandma just got glaucoma. im worried i might have it also. so since im ready for the worse. my important question is, is glaucoma gonna dq me from commissioning completely??

[GearMonkey]

so ive takin my fc1 and i have high pressure per the ovt. after reading this thread and talking to my mom who just told me that my grandma just got glaucoma. im worried i might have it also. so since im ready for the worse. my important question is, is glaucoma gonna dq me from commissioning completely??

I seem to have a sixth sense about when to check this thread. . .

1. I can't remember what the OTV is. Get contact measurements to verify the pressure levels if all you got was the puff test.

2. High pressure without optic nerve damage is called OHT (ocular hypertension). This is just one of many risk factors for glaucoma. A small percentage (10%ish) of people with OHT eventually develop glaucoma but a small percentage of people with normal pressure do as well. There are a number of additional tests (visual field, contrast sensitivity, laser scans, etc.) that the doc can give you to check for optic nerve damage.

3. OHT will not DQ you from commissioning. Glaucoma may.

4. Capital letters and punctuation are awesome, you should try them sometime (Sorry, it has been a long day and this is a pet peeve of mine).

Cheers.

GM.

[Guest goducks]

revival!

so ive takin my fc1 and i have high pressure per the ovt. after reading this thread and talking to my mom who just told me that my grandma just got glaucoma. im worried i might have it also. so since im ready for the worse. my important question is, is glaucoma gonna dq me from commissioning completely??

GearMonkey covered a good bit of this already, but to rehash.

The OVT does not measure pressure, so something doesn't jive. If your pressure was measured using the air puff, then don't sweat until you get the applanation (Goldmann) test.

Glaucoma is rare among 20-30 year olds. Not impossible, but it's more of an older person's condition. You may have risk factors for glaucoma (i.e. elevated eye pressure, genetics, abnormal looking optic nerve), but that doesn't necessarily mean you have glaucoma.

I can't speak on the question of commissioning as I don't know how these issues are handled, but I think you may be jumping the gun to worry about having glaucoma at this time.

GD

[FalconXtreme]

1. GM ur a life saver

2. what are the stipulations if someone does actually have glaucoma? how much glaucoma is to much glaucoma sts?

3. You are right Capital letters and punctuation are awesome. but my 1337 1nt3rw3b 5k1llz will never allow me to use them. sucks bout the long day atleast its friday!

[GearMonkey]

1. GM ur a life saver

2. what are the stipulations if someone does actually have glaucoma? how much glaucoma is to much glaucoma sts?

3. You are right Capital letters and punctuation are awesome. but my 1337 1nt3rw3b 5k1llz will never allow me to use them. sucks bout the long day atleast its friday!

You're right about the beer. . . especially if it is a #9 at Manas!

My expertise in the OHT/Glaucoma arena is mostly confined to flight physical & flying waiver requirements. Because of this I'm not 100% sure of the limits on the commissioning physical. I would imagine that if your pressures are stabilized below 30 mmHG, with or without eye drops, you should be on the right track. The flying world has a limit that is something like "no visual field defects within 30 degrees of center". If that is good enough for aviators it is almost certainly good enough for the rest of the Air Force. I'm sure there are regs out there which spell out the limits but I'm not sure which ones to look for.

You can check AFI48-123 for flying standards and the USAF Waiver Guide for comparison purposes. In general the commissioning limits will be equal to or looser than the limits spelled out in either of those references. Ask your cadre and/or flight doc for commissioning physical specifics. They should be able to point you in the right direction. There has to be an AFI or AFROTCI out there with details.

Your situation hits close to home. Good luck.

GM.

[Guest Otto]

Hello all. I have a question for the flight docs concerning narrow angle glaucoma. Lets say there was a 34 year old ANG C-130 pilot with ten years flying experience who got a call from his or her mother one day telling them they need to see an opthamologist for an eye examination. The mother found out she had narrow angles in her eyes, predisposing her to narrow angle glaucoma. To be on the safe side, the pilot visited an opthamologist and found out that indeed, they had inherited the same narrow angles, supposedly giving them a higher risk for glaucoma.

This pilot had never had any symptoms of eye problems whatsoever and the narrow angles had never been discovered in spite of numerous Air Force and civilian eye exams, all reading normal pressures. In fact, if the pilot had not informed the eye doctor to look for the specific condition, the problem would never have been discovered. The pilot had no family history of glaucoma or sudden blindness.

Questions: 1) Would this pilot be required to disclose this condition? 2) Would it be grounding immediately? 3) If it were grounding, would it be waiverable if corrective surgery were performed? How long is the evaluation period after the surgery?

Thanks!

[Guest goducks]

Hello all. I have a question for the flight docs concerning narrow angle glaucoma. Lets say there was a 34 year old ANG C-130 pilot with ten years flying experience who got a call from his or her mother one day telling them they need to see an opthamologist for an eye examination. The mother found out she had narrow angles in her eyes, predisposing her to narrow angle glaucoma. To be on the safe side, the pilot visited an opthamologist and found out that indeed, they had inherited the same narrow angles, supposedly giving them a higher risk for glaucoma.

This pilot had never had any symptoms of eye problems whatsoever and the narrow angles had never been discovered in spite of numerous Air Force and civilian eye exams, all reading normal pressures. In fact, if the pilot had not informed the eye doctor to look for the specific condition, the problem would never have been discovered. The pilot had no family history of glaucoma or sudden blindness.

Questions: 1) Would this pilot be required to disclose this condition? 2) Would it be grounding immediately? 3) If it were grounding, would it be waiverable if corrective surgery were performed? How long is the evaluation period after the surgery?

Thanks!

Otto,

1) Having narrow angles is not disqualifying (as best I know) so you really have nothing to disclose. As you seem to understand, narrow angles make you potentially more susceptible to an angle closure condition that is caused when the drain system of the eye is blocked by the iris, causing the eye pressure to quickly elevate. This most often happens at night/ early morning when your pupils are naturally dilated and can result in symptoms ranging from no symptoms to a thrombing, light sensitive eye. Depending on the specifics of the case, treatment may or may not be indicated. The standard treatment is to use a laser to make a small hole in the iris to allow fluid to flow through the tissue and eliminate the possibility of pressure building up. Having narrow angles is quite common, whereas developing an angle closure conditions is fairly rare. But, it's easily preventable if the doc feels it's warranted. Also, as we get older, our angles will sometimes get smaller (due to the lens inside the eye getting thicker), which may increase the potential for angle closer.

2) You would not be grounded due to simply having narrow angles.

3) I don't have any personal experience on the grounding period if you were to have treatment, but I'd be very surprised if it were for more than a couple of days (if that).

Bottom line is that it's good to be aware of the potential symptoms that accompany an angle closure event. I've personally only seen one or two patients that were treated prophylactically due to narrow angles and I've only seen a handful of cases that developed a true angle closure event.

The fact that you've had numerous eye exams without the condition being detected attests to the fact that eye practioners don't really get too worried about narrow angles as a major source of ocular pathology. If you've had your eyes dilated and didn't develop a very sore eye the following day, then I would consider the risk of spontaneous angle closure to be fairly low since the drops would have precipatated angle closure if you were that prone to developing it. But, I'm not saying that any doc would be wrong if they suggested to go ahead and treat it rather than worry about what could happen if left untreated.

GD

[FalconXtreme]

well in an update to my situation:

yesterday i went to the required eye docs and i legitimately have OHT. so thats gonna DQ me from my nav slot but i'm just glad i can still be in the air force after the glaucoma scare. now its time for me to get reclassified and hope for the best.

[Guest Otto]

Otto,

1) Having narrow angles is not disqualifying (as best I know) so you really have nothing to disclose. As you seem to understand, narrow angles make you potentially more susceptible to an angle closure condition that is caused when the drain system of the eye is blocked by the iris, causing the eye pressure to quickly elevate. This most often happens at night/ early morning when your pupils are naturally dilated and can result in symptoms ranging from no symptoms to a thrombing, light sensitive eye. Depending on the specifics of the case, treatment may or may not be indicated. The standard treatment is to use a laser to make a small hole in the iris to allow fluid to flow through the tissue and eliminate the possibility of pressure building up. Having narrow angles is quite common, whereas developing an angle closure conditions is fairly rare. But, it's easily preventable if the doc feels it's warranted. Also, as we get older, our angles will sometimes get smaller (due to the lens inside the eye getting thicker), which may increase the potential for angle closer.

2) You would not be grounded due to simply having narrow angles.

3) I don't have any personal experience on the grounding period if you were to have treatment, but I'd be very surprised if it were for more than a couple of days (if that).

Bottom line is that it's good to be aware of the potential symptoms that accompany an angle closure event. I've personally only seen one or two patients that were treated prophylactically due to narrow angles and I've only seen a handful of cases that developed a true angle closure event.

The fact that you've had numerous eye exams without the condition being detected attests to the fact that eye practioners don't really get too worried about narrow angles as a major source of ocular pathology. If you've had your eyes dilated and didn't develop a very sore eye the following day, then I would consider the risk of spontaneous angle closure to be fairly low since the drops would have precipatated angle closure if you were that prone to developing it. But, I'm not saying that any doc would be wrong if they suggested to go ahead and treat it rather than worry about what could happen if left untreated.

GD

GD,

Thanks for the great response! That was very informative.

[FalconXtreme]

ok i have a question. after going to maxwell for my fc1 i got flagged for glaucoma due to IOPs. i took a visual field test by a civ doc to rule out glaucoma but now the optometry folks at maxwell wont take it bc they said i needed to have it done by a military doc. when they first said i needed to be tested to rule out glaucoma they didnt say it needed to be done by a mil doctor. is there a reg that says this? i really dont feel like waiting weeks for the next available appointment, i've been fighting with this process for 2 long.

[Guest goducks]

ok i have a question. after going to maxwell for my fc1 i got flagged for glaucoma due to IOPs. i took a visual field test by a civ doc to rule out glaucoma but now the optometry folks at maxwell wont take it bc they said i needed to have it done by a military doc. when they first said i needed to be tested to rule out glaucoma they didnt say it needed to be done by a mil doctor. is there a reg that says this? i really dont feel like waiting weeks for the next available appointment, i've been fighting with this process for 2 long.

I'd be surprised if it's in the regs (I've never run across it), but when it comes to FCI physicals, the USAF puts a lot more faith into findings from military docs than civilian docs. It's probably your best bet to make the appointment and repeat the visual field.

[Guest Fuse]

I'd be surprised if it's in the regs (I've never run across it), but when it comes to FCI physicals, the USAF puts a lot more faith into findings from military docs than civilian docs. It's probably your best bet to make the appointment and repeat the visual field.

I had to redo a vision test and was initially told by the person taking care of my whole medical package that I could goto a civ doc. I did that and when I came back to talk with the mil flight surgeon he said it wasn't valid and I had to redo it there. Luckily I was already on base, so I took care of it AGAIN.

You'll get conflicting info about it, but the safest bet is to just have the base do it.

[FalconXtreme]

does anyone know of an AFI that list what would make you ineligible for deployment to a conflict zone? i'm trying to see if i get diagnosed with glaucoma or OHT if that will make me non deploy-able.

[Guest goducks]

does anyone know of an AFI that list what would make you ineligible for deployment to a conflict zone? i'm trying to see if i get diagnosed with glaucoma or OHT if that will make me non deploy-able.

Falcon,

I'm not a flight surgeon, but since you're not getting any other responses I'll take a stab at this...

I'm not aware of any AFI that describes all conditions that result in non-deployment, which as you probably know is coded as a 4T profile. Generally, this profile is reserved for conditions that are temporary, but are expected to go away soon. Examples would be pregnancy, or taking certain medications short term. If you were first diagnosed with OHT you might?? be put into such a profile until an appropriate treatment was established, however, generally speaking it's my feeling that if you are waivered to continue on flying status for either OHT or glaucoma, you will be fully deployable.

Just my interpretation.

GD

[FalconXtreme]

thanks ducks. i got diagnosed for having OHT. no waiver allowed so i got reclassed' into a combat comm assign. i'm going to get prescription eye drops to lower my eye pressure and was wondering if that would disqualify me from deploying with my combat comms unit in the future.

also a second question, would it be easier for me to get a FC1 waiver if i apply for a guard/reserve slot later in my non-rated AF career?

third question is would it be easier for me to get a FC1 waiver if I try to get a pilot slot in the army or navy/marines?

[Guest goducks]

thanks ducks. i got diagnosed for having OHT. no waiver allowed so i got reclassed' into a combat comm assign. i'm going to get prescription eye drops to lower my eye pressure and was wondering if that would disqualify me from deploying with my combat comms unit in the future.

also a second question, would it be easier for me to get a FC1 waiver if i apply for a guard/reserve slot later in my non-rated AF career?

third question is would it be easier for me to get a FC1 waiver if I try to get a pilot slot in the army or navy/marines?

#1. I would think that once the IOP is normal and there are no other factors (visual field defects, etc) that you would be deployable (that's my guess anyhow). People deploy using blood pressure, cholesterol, etc medication. I don't see why this would be any different.

#2. FCI waivers are all handled by the same people (AETC, AFMS, AFMOA) whether you are guard/reserve or applying from OTC/ROTC. One factor in your favor by going Guard/Reserve is that you may have a unit commander willing to go to bat for you. Otherwise, it's all the same.

#3. I don't have any personal experience with Navy or Marine waiver policies. Sorry.

GD