USAF / USA / USN / USMC Vision

[dsharpless]

On 4/3/2017 at 7:20 PM, stuckindayton said:

I believe most physicals take around 6 weeks to process.  Requiring waivers does not change this.  If someone is on a short timeline, their physical will get expedited.  BTW- there is no longer a visual acuity standard.  You simply have to meet the refractive error requirements (-3.00 for myopia, -1.50 for astigmatism and +2.00 for hyperopia).

Can you provide a reference for this info? I'm not doubting you, but I've been searching for a little while now for some concrete info like this (up to date vision requirements for USAF pilots), and I've yet to find it in anything official, other than your statement. I'd really like to know where to look for stuff like this.

Additionally, can anyone do either of the following:

1) Comment on how to go about getting one's refractive errors. Are these measurements equivalent to the measurements given in one's spectacle prescription? My prescription gives spherical (myopia) and cylindrical (astigmatism) diopter powers, and I'm sure it would give other measurements as required if I needed any other corrections (i.e. for hyperopia). So are these the numbers I need to refer to to determine my own eligibility for pilot duties?

2) Comment on the waivability (is that the right word?) of these requirements. Are these the absolute or waiverable limits, or are there higher limits requiring waivers?

Thanks in advance.

[BEEPBEEPIMINAJEEP]

Air Force Waiver Guide 2017

https://www.wpafb.af.mil/Portals/60/documents/711/usafsam/USAFSAM-Wavier-Guide-170601.pdf 

 

[dsharpless]

2 hours ago, BEEPBEEPIMINAJEEP said:

Air Force Waiver Guide 2017

https://www.wpafb.af.mil/Portals/60/documents/711/usafsam/USAFSAM-Wavier-Guide-170601.pdf 

 

Finally! Thank you!

This is the most valuable resource I've seen on this subject. For those who were searching as I was for this info, from the above link it's clear what the refractive error limits are for each type of common eye ailment, and whether these limits are waiverable.

I know this is stated earlier in this thread, BUT, for those who are only looking at the end of this thread or are still seeking clarification, from the above link it's clear that a cycloplegic refraction, performed by an optometrist or ophthalmologist, is the only way to determine one's refractive error for the purposes of determining compliance or noncompliance with the USAF eye standards. A manifest refraction ("Better 1 or better 2?" exam) is, or can be, subject to patient bias. According to other sources I've since read, this bias (called accommodation) can make a person seem more myopic or hyperopic than they actually are, whereas, in a cycloplegic refraction, the doctor actually measures refractive error directly from your eyes. This is done by temporarily inhibiting the eye's ability to focus and then measuring the amount of manual correction required to achieve 20/20 acuity. Anyone, please feel free to correct or clarify if I have misrepresented anything here.

For reference, see pg. 782 and following in the above link.

For anyone else, a follow-up question: I'm a civilian looking into the possibility of laser corrective surgery prior to applying to ANG/AF Reserve units for a UPT slot. Are there any requirements I need to be aware of--choice of doctor, choice of procedure, wait time between surgery and application package submission, or otherwise? The only ones I seem to be aware of are that PRK is preferred, that there is a minimum 12 months wait time before UPT may be commenced following a laser corrective surgery, and that there is a minimum 3 months wait time before surgery waivers may be applied for. Is this all still correct? Please, any information would be hugely helpful. I know much of this has been hashed out before, but figuring out what's current and what's not is proving to be the biggest challenge.

Edited July 31, 2017 by dsharpless

[Stoker]

1 hour ago, dsharpless said:

For anyone else, a follow-up question: I'm a civilian looking into the possibility of laser corrective surgery prior to applying to ANG/AF Reserve units for a UPT slot. Are there any requirements I need to be aware of--choice of doctor, choice of procedure, wait time between surgery and application package submission, or otherwise? The only ones I seem to be aware of are that PRK is preferred, that there is a minimum 12 months wait time before UPT may be commenced following a laser corrective surgery, and that there is a minimum 3 months wait time before surgery waivers may be applied for. Is this all still correct? Please, any information would be hugely helpful. I know much of this has been hashed out before, but figuring out what's current and what's not is proving to be the biggest challenge.

No one expressed a preference for PRK when I was at Wright-Pat a few weeks ago. I had LASIK and there was practically no concern. My guess is that while PRK might be somewhat less prone to complications, all things being equal, I bet the average doc does 100 times more LASIK surgeries than PRK (because of the drastically shorter recovery time) and that volume and experience makes LASIK the safer option. I considered getting PRK when I had my surgery done because I had heard it was less prone to trauma-related post-surgery complications, but where I was imagining getting hit in the head with a soccer ball and losing my vision, the doc said it'd pretty much take a stick in the eye to dislodge the flap created by LASIK.

And I don't have the regs, but I could have sworn I read that the minimum wait before UPT was down to six months. Don't quote me on that, though.

[stuckindayton]

7 hours ago, sforron said:

No one expressed a preference for PRK when I was at Wright-Pat a few weeks ago. I had LASIK and there was practically no concern. My guess is that while PRK might be somewhat less prone to complications, all things being equal, I bet the average doc does 100 times more LASIK surgeries than PRK (because of the drastically shorter recovery time) and that volume and experience makes LASIK the safer option. I considered getting PRK when I had my surgery done because I had heard it was less prone to trauma-related post-surgery complications, but where I was imagining getting hit in the head with a soccer ball and losing my vision, the doc said it'd pretty much take a stick in the eye to dislodge the flap created by LASIK.

And I don't have the regs, but I could have sworn I read that the minimum wait before UPT was down to six months. Don't quote me on that, though.

I'll quote you on the six month wait between PRK/LASIK and your IFC I exam.  You are correct.

[dsharpless]

5 hours ago, stuckindayton said:

I'll quote you on the six month wait between PRK/LASIK and your IFC I exam.  You are correct.

Can you comment further on the timeline from surgery to medical exam? Specifically, for applying to ANG/Reserve units, is the IFC I exam conducted before or after submitting an application/interviewing with a board? In other words, if I need and elect to have laser corrective surgery, do I need to wait six months to apply to units, or should the timeline from zero to starting all training (going from civilian to Guardsman/Reservist, so starting with AMS) function more or less as normal, save for getting necessary waivers for surgery? 

Thanks again, by the way, to all who have contributed. Best help I've been given in this subject thus far. I've scheduled a cycloplegic refraction for tomorrow afternoon with my optometrist, gonna see whether I'm compliant or will need surgery. From my glasses prescription it could go either way. 

Edited July 31, 2017 by dsharpless

[stuckindayton]

There is no policy on when you have surgery and when you can talk with ANG/AFRC units.  The policy is only in regards to the IFC I eye exam.  Most guys I see for IFC I exams already have offers from a unit and I'm really not sure if you can practically get an IFC I exam without a unit "sponsoring" you.  I could see that they might be reluctant to hire you knowing that you have a disqualifying condition, however, refractive surgery is so routine these day and very few people are disqualified anymore that I don't think it should be much of an issue at all.

[dsharpless]

That makes sense. Just curious, is there a fairly standard wait time between receiving an offer from an ANG/AFRC unit and getting IFC I done? I'm aware of the average time from hire to start of training based on other topics on this site, but I've seen less about when medical exams typically occur. 

[cagg011]

13 minutes ago, dsharpless said:

That makes sense. Just curious, is there a fairly standard wait time between receiving an offer from an ANG/AFRC unit and getting IFC I done? I'm aware of the average time from hire to start of training based on other topics on this site, but I've seen less about when medical exams typically occur. 

The search function is your friend: 

 

[stuckindayton]

41 minutes ago, dsharpless said:

That makes sense. Just curious, is there a fairly standard wait time between receiving an offer from an ANG/AFRC unit and getting IFC I done? I'm aware of the average time from hire to start of training based on other topics on this site, but I've seen less about when medical exams typically occur. 

No clue as to that timeline.  They just show up at my door and I do an eye exam.

[BEEPBEEPIMINAJEEP]

53 minutes ago, dsharpless said:

That makes sense. Just curious, is there a fairly standard wait time between receiving an offer from an ANG/AFRC unit and getting IFC I done? I'm aware of the average time from hire to start of training based on other topics on this site, but I've seen less about when medical exams typically occur. 

100% anecdotal (data based off a dozen or so people 6-9 months ago), but it's usually about 3 months between being hired and Wright-Patt. 

[dsharpless]

37 minutes ago, cagg011 said:

The search function is your friend: 

My apologies: I actually read that topic a good while ago and did not put two and two together regarding medicals being administered at Brooks. Thanks for pointing out that topic, as well as the helpfulness of the search function, to me again. 

9 minutes ago, stuckindayton said:

No clue as to that timeline.  They just show up at my door and I do an eye exam.

Sounds about right.

[dsharpless]

7 minutes ago, BEEPBEEPIMINAJEEP said:

100% anecdotal (data based off a dozen or so people 6-9 months ago), but it's usually about 3 months between being hired and Wright-Patt. 

Ok, that's good to know. If that timeline is roughly accurate, then it seems like timing possible eye surgery shouldn't cause any scheduling difficulties.

Thank you all again for your help, and for sharing good, current info!

[dsharpless]

@stuckindayton Final vision question from me: based on the waiver guide, -3.00 total refractive error is the limit for myopia. Does compliance mean strictly greater than -3.00 (i.e. -3.00 is failing) or is it inclusive?

I seem to be hovering right at that edge based on today's (generous) evaluation with my local doctor. He, having done his residency in the USAF way back when, understood that I was trying to determine my medical eligibility for a pilot slot and was levying all of the margin for error that he could in my favor. 

[stuckindayton]

If your refraction is exactly -3.00, it is considered within standards.  -3.25 would be outside of standards.

[dsharpless]

On 8/2/2017 at 5:58 AM, stuckindayton said:

If your refraction is exactly -3.00, it is considered within standards.  -3.25 would be outside of standards.

Ok then! I think by that measure I should be good to go... for now. 

Thanks for clearing that up: knowing that I don't need to take immediate action on my vision, I can now work on my applications with some peace of mind. 

[Blue1029]

Long time lurker here but I can’t seem to find an answer. I am non-prior trying to join the reserves. I live near a base hiring reserve cso’s. I am wanting to apply but my refractive error is -6 in both eyes. I tried to see a civilian doctor about prk and lasik. They said my corneas were too flat and outside the margin of safety for refractive surgery. My eyes are correctable to 20/20 with contacts or glasses. There is no other eye issue.  I don’t want to waste the units time or money if there is no hope of passing the fc1a. I’m slightly confused about the waiver process. The way I understand it is there are no waivers anymore and if you’re out of the margin you’re screwed. Since I cannot get refractive surgery and am outside the refractive error limits is there no hope to be a cso or is there some sort of waiver potential I do not know about? Ive always read make the Air Force tell you no but I didn’t know if I had zero chance.  My recruiter didn’t know the answer and tried to steer me to ABM.  

[GDAL]

@stuckindayton is the expert on this topic, but I do not believe there exists a waiver for refractive error outside of -4.50 for FCIA. Check out the USAFSAM Waiver Guide for more details. I would suggest getting a second opinion regarding refractive surgery.

Edited December 21, 2017 by GDAL

[Blue1029]

I went back over the waiver guide and found my answer I somehow missed earlier, “If refractive errors are greater than those listed in the tables for  fc1/1a, no waiver will be granted.” 

 

I am getting a second opinion. The doctor kinda scared me because he said if I did get the surgery done that I would have issues with vision at night due to flat corneas. I am eligible for the ICL but I’m fairly certain those are not waiverable as well. 

[stuckindayton]

Just now, Blue1029 said:

I went back over the waiver guide and found my answer I somehow missed earlier, “If refractive errors are greater than those listed in the tables for  fc1/1a, no waiver will be granted.” 

 

I am getting a second opinion. The doctor kinda scared me because he said if I did get the surgery done that I would have issues with vision at night due to flat corneas. I am eligible for the ICL but I’m fairly certain those are not waiverable as well. 

Do NOT get ICL's.  Those would be non-waiverable.  As far as flat corneas post PRK/LASIK, how flat are we talking?  Less than 35 D?  The AF has no standard for post op flat K's or corneal thickness for applicants (although we probably should), however, you may be risking your vision for the rest of your life and it's possible you may not meet the AF standards for vision if the outcome is really poor.  Let me know if you want more details.

[GDAL]

36 minutes ago, stuckindayton said:

Do NOT get ICL's.  Those would be non-waiverable.  As far as flat corneas post PRK/LASIK, how flat are we talking?  Less than 35 D?  The AF has no standard for post op flat K's or corneal thickness for applicants (although we probably should), however, you may be risking your vision for the rest of your life and it's possible you may not meet the AF standards for vision if the outcome is really poor.  Let me know if you want more details.

Thanks for being such a great resource for the community.

[stuckindayton]

Just now, GDAL said:

Thanks for being such a great resource for the community.

Happy to help.  Seen too many people make bad decisions based on bad information.

[175driver]

18 hours ago, stuckindayton said:

Do NOT get ICL's.  Those would be non-waiverable.  As far as flat corneas post PRK/LASIK, how flat are we talking?  Less than 35 D?  The AF has no standard for post op flat K's or corneal thickness for applicants (although we probably should), however, you may be risking your vision for the rest of your life and it's possible you may not meet the AF standards for vision if the outcome is really poor.  Let me know if you want more details.

There are no post op standards for corneal thickness? So If I was dq’d for FC1 with no chance of a waiver for corneal thickness then could I in theory get lasik and be good to go? @stuckindayton

[stuckindayton]

1 hour ago, 175driver said:

There are no post op standards for corneal thickness? So If I was dq’d for FC1 with no chance of a waiver for corneal thickness then could I in theory get lasik and be good to go? @stuckindayton

No, different situation.  I'm guessing you were DQ'd because you had an abnormal cornea associated with thinning.  There is a policy for that.  LASIK won't change it.  If you were DQ'd for the reason I suspect, LASIK would not be in your best interest.  If you want more details on your specific situation PM me and I can look into it further.

[DinaMight]

Hi folks, 

I found out last November in my IFC that I had a condition known as Terrien's Marginal Degeneration.  In addition, I have corneal thinning of around 50% of normal thickness.  My CC told me last Friday that because of all this( or because of one of these things), I would not only be DQd from all rated but from also commissioning.  USAFSAM determined that the condition was unstable with some 20% likelihood of worsening but when I sought second opinions, all came back saying that the condition was pretty stable with low probability of worsening since its been there since my youth.  I'm in my early 20s and my vision is fine. 

I understand the risk assessment associated with this situation and them looking at it from a financial perspective but how does it DQ me from rated AND non rated?  I am in my final year of ROTC with an RPA slot and these past few days have what I consider to be the most frustrating days of my life.  I think much remains to be answered and all of the sudden a decision was hurriedly made on my future.  I just thought this would all be a part of an on-going process, not just a talk with the CC and that's it.  Also, all waiver and ETPs are out of the option for some reason.

The big questions I have now is can they decide to drop someone on a dime without looking to get a reevaluation or another opinion?  How did I pass the DODMERB but not the phyical for commissioning?

If anyone could share their 2 cents on the matter I would absolutely appreciate it.  

- DinaMight