About 55% of the civilian pilots in the United States require some sort of vision correction to meet the FAA’s requirements for medical certification, according to the FAA.
While glasses are the most common choice, a growing number of pilots are choosing laser refractive, or LASIK, surgery. The procedure alters the curvature of the cornea by slicing a thin flap from the top of the cornea, folding it aside, and reshaping the corneal connective tissue. The flap is then welded back in its original position. The success rate is better than 90%, defined by the FAA as “20/40 or better distant uncorrected visual acuity…not 20/20 or better.” Minor additional correction using eyeglasses may be necessary, particularly for reading, FAA officials note.
The FAA warns that “operation of an aircraft is a visually demanding activity performed in an environment that is not always user friendly,” and highlights the potential problems resulting from LASIK surgery, including sensitivity to bright light. However, there are very few actual requirements involved.
The FAA requires that flying be discontinued after any refractive surgical procedure until an eye care specialist “has determined that there are no significant adverse effects or complications.”
That determination must be reported directly to the FAA’s Aerospace Medical Certification Division by the pilot’s physician, upon release from medical care, or by the pilot’s Aviation Medical Examiner at the next flight physical. The report should state, apparently in these exact words, that: “…the airman meets the visual acuity standards and the report of eye evaluation indicates healing is complete, visual acuity remains stable, and the applicant does not suffer sequela, such as glare intolerance, halos, rings, impaired night vision, or any other complications.”
The FAA approves LASIK surgery but, nonetheless, includes many dire warnings. On the last page of a brochure on the surgery, for example, it states: “Although the FAA and most major air carriers allow laser refractive surgery, professional aviators should consider how it could affect their occupational and certification status.” It goes on to conclude that, “As with any invasive procedure, there are many variables that can influence the final outcome. You should understand all risks before electing to have a procedure performed that could compromise your visual performance in the cockpit.”
If that isn’t strong enough, the Pilot Medical Solution website (LeftSeat.com) goes into more specific detail about possible problems and offers a long check list for LASIK surgery candidates. If its many questions are answered honestly and seriously, it appears to be a very helpful guide through the decision-making process. It, too, explains the FAA Aeromedical Certificate guidelines, and in simpler language than the FAA. Perhaps most useful of all, it offers sound, realistic advice about preoperative, operative and postoperative expectations.
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