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Guest doctidy

USAF / USA / USN / USMC Vision

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Guest doctidy

No help for the retinal perforation guy...

UTaviator -- I'd dust off your package.

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Guest clemon220
Originally posted by P27:17:

2. After your 3 month visit, you can begin/complete your IFC 1 (a considerable amount of healing should have taken place by then).

Good luck

If you could expand on this 3 month date, please do. My recruiter has not been entirely useful (as I've stated before) on the grounds that he is/was convinced that my vision already eliminated me from any slots other than FCIII.

I was of the impression that I could apply for the waiver once my 12 month eval. had completed. If you don't have the time to answer this post, don't worry about it (I'm sure it's complicated). I'm lucky enough to have a very dedicated contact with a Col. at an ROTC Det. that has already jumped through hoops to help me wherever my recruiter may fail. Nevertheless, knowledge is power.

Therefore, more knowledge makes me more powerful...

or something like that.

~Corwin

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Guest P27:17

Corwin,

You can get your IFC 1 exam done (anywhere other than Brooks)3 months post-op PRK. It will go through the normal waiver process and once stamped it will say something to the effect "Qualified with waiver for PRK, pending MFS eval". This means you cleared on your IFC 1 but need to go through MFS 1 year post-op at Brooks prior to UPT.

Hope this helps.

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Guest SBKJr

Rage,

I was DQ'd from USAFA's PRK program in 2004 for excessive pupil diameter. Pupils were 8.7 and 9 mm when dilated. My refractive error is now -3.75 and -4.00 in each eye. I applied for an ETP and was shot down by the Vice Chief after graduation in May '06. I'm now in Nav training on a waiver for my eyes. What would the new standards mean for my gettin surgery, particulary would it affect pupil diameter at all? If I could get surgery, could I then re-apply to UPT in the future. Thank for your info, your expertise is priceless in this forum.

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Guest rtstolwo

Rage,

When you answer SBKJr's question will you elaborate on the pupil size restrictions for me. Im sure it has to do with possible post-op halo but I was unaware there was a numerical restriction. I worry because the doc that just did my surgery made a passing comment about me having large pupils. Is the restriction just for those that are to have the PRK done by air force docs as a preventative measure or can a civvie be DQd from going the OTS route for having too large pupils? I've searched but found no specific policy from Google or an educated answer to this question from Baseops.

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Guest P27:17

SBK,

You DO have large pupils...there is no standard that disqualifies you based on the size of the pupils. What the USAFA surgeon basically said is you aren't a good candidate for PRK because of the size of your pupils and the likelihood of night vision problems/halo issues post-op. You could go out and "Doc Shop" until you find a PRK surgeon who will do the surgery but be very cautious...if you are found DQ, it will be the results of the surgery that DQ you...not the pupil size.

Also, as a Nav in training you can't get PRK...once you are done and if you decide to get it you'll have to go through the Aviation CRS Program.

Good luck

rtstolwo,

I hope this clears up your question about pupil size...a passing comment is better than "we won't do your surgery because your pupils are too big"...

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Guest SBKJr

Yea, that is what the USAFA doc said to me. He told me he didn't want to do it because they only had a 6.5mm laser and if it were dark enough for my pupils to dilate up the 9mm, I'd have permanent halo problems that'd DQ me from flying in general. Claimed the largest diameter they had done surgery on was under 8mm. Put a scare in me about the procedure. But I've heard civilian docs have 10mm or better size lasers. What are the odds the AF picks up bigger laser diameters if they haven't already since 2004? I do understand that I'd have to wait for my training to finish and then follow the aviator protocol for surgery.

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Guest 321sevad

Is there any indication that any of the color vision testing rules will be changing or is this just for corrective surgery?

Thanks.

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Guest P27:17

SD,

Rage would know the specifics much better that I on the content of changes coming down the pike.

I suspect though, any changes to the color vision standards would tend to be MORE stringent not less...

SBK,

Here is what one of the specialists I work with have to say about your question...

"When first FDA approved, lasers could only deliver a 5.0 mm ablation zone. Consequently, anyone with a pupil much larger than that was at risk for night problems. Gradually we have expanded ablation zones to 8.0 mm today (there may be some lasers that offer larger zones, but that's where Wilford Hall Medical Center (WHMC) is at with the VISX S4 system). So we still get uncomfortable treating people with pupils much larger than 8.0. I'm sure we will eventually have lasers with larger ablation zones, however, there isn't that much motivation to go beyond 8.0 as very few people have pupils larger than 8.0.

I saw someone note that civilian centers have lasers with ablation zones of somthing like 10.0 mm. As far as I know that's not true."

Hope it helps...good luck.

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Guest doctidy

There is no move afoot to change color vision standards. You've gotta have perfect color vision.

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How come some sources say that the visual acuity requirements for a pilot in the AF is 20/70, and some others such as the AFROTC website say that it is 20/50?

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Guest P27:17

"How come some sources say that the visual acuity requirements for a pilot in the AF is 20/70, and some others such as the AFROTC website say that it is 20/50?"

Dan,

The 20/50 cut-off is for the PPQ (Potential Pilot Qualification)...20/70 is the max (before needing a waiver) for the AF.

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Guest MadMagnus
"How come some sources say that the visual acuity requirements for a pilot in the AF is 20/70, and some others such as the AFROTC website say that it is 20/50?"

Dan,

The 20/50 cut-off is for the PPQ (Potential Pilot Qualification)...20/70 is the max (before needing a waiver) for the AF.

I have a question. I wear a weak pair of glasses (brings me to 20/20, my distance is slightly worse than 20/30 and my near is 20/20, uncorrected) and have seen the eye doctor routinely for basic check ups and whatnot. Beyond my vision, there's a lot of numbers and terms along that requirements list I don't recognize. Is being outside the margin's on those noticable? Anything I could look for in my eyesight to be able to tell if I have any of that?

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Guest P27:17

MM,

If I understand your question correctly, the other numbers have to do with your refraction.

Your glasses have a manifest or by lens refraction. The refraction we use to determine if you meet the standards is called a cycloplegic refraction (dilation of the eyes). The standards have been posted by Rage many times. If your uncorrected distant vision is 20/70 or better and corrects to 20/20 or better you won't need a waiver unless your cycloplegic refraction exceeds the standards (the other numbers you were asking about).

Let me know if this clears the mud...

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Guest MadMagnus
MM,

If I understand your question correctly, the other numbers have to do with your refraction.

Your glasses have a manifest or by lens refraction. The refraction we use to determine if you meet the standards is called a cycloplegic refraction (dilation of the eyes). The standards have been posted by Rage many times. If your uncorrected distant vision is 20/70 or better and corrects to 20/20 or better you won't need a waiver unless your cycloplegic refraction exceeds the standards (the other numbers you were asking about).

Let me know if this clears the mud...

Alright. I think I might know. It's the part of the eye exam when they go through the series of different lenses in their chair attachment and say "Better, or worse? 1 or 2?"

I have no idea what mine is, though. I don't think the doc has ever mentioned it or anything. I can only hope by not mentioning it, it's relatively normal.

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Guest P27:17
Alright. I think I might know. It's the part of the eye exam when they go through the series of different lenses in their chair attachment and say "Better, or worse? 1 or 2?"

I have no idea what mine is, though. I don't think the doc has ever mentioned it or anything. I can only hope by not mentioning it, it's relatively normal.

What you are describing sounds like the "manifest refraction"...the cycloplegic is where they put drops in your eyes to expand (dilate) your pupils. That will be the refraction they measure for certification.

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Gray Beard, you wrote in January 2006 that:

Pre-PRK for USAF Nav is now -8.00.

I am just wondering where i can find information about the current USAF navigator pre-PRK limits. I understand that according to the current policy of the US Air Force Refractive Surgery Program that the pre-CRS limits (or Prk limits) for pilot applicants is set at -5.50 for myopia, hyperopia less than +0.50 diopters. astigmatism less than 3.00 diopters and anisometropia less than 2.50 diopters (Table 4.1 page 14 of 24). My question is that no where does it say that pre-PRK cycloplegic limits are set at -5.50 diopters in any meridian. I am just wondering where i can find that information as well as the information and policies for prePRK limits for USAF navigators and nonpilots. I could not find any information on the US Air Force Refractive Surgery Program website.

I am hoping to have PRK done but looking at all available information i have so far (except that of navigators/others) my vision is very close to the waiver limits.

Sphere Cylinder Axis Prism

OD -4.50 -0.50 158

OS -4.75 -0.50 145

If cyclinder is indeed my correction for astigmatism. Then my current presciption is -5.00 diopters for right eye and -5.25 diopters for left, which is essentially borderline. (mind you that this is just a standard prescription and i did not have a cycloplegic test done or whatever its been called on this forum where they add drops to relax the muscles in the eye) So any help would be great. Hopefully i will be within limits when i have a pre-PRK consult done but i wanted to find out where i could find the limits for nav/others before i had one.

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Guest P27:17
I am hoping to have PRK done but looking at all available information i have so far (except that of navigators/others) my vision is very close to the waiver limits.

Sphere Cylinder Axis Prism

OD -4.50 -0.50 158

OS -4.75 -0.50 145

The pre-op refractive limits for Navs (and soon to be pilots) is -8.00

If the refraction above is a cycloplegic...you should be fine.

Good luck

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The pre-op refractive limits for Navs (and soon to be pilots) is -8.00

If the refraction above is a cycloplegic...you should be fine.

Do you know if there is any time table for when the pre-op refractive limits for pilots will be -8.00? My refraction was no cycloplegic thats why my refraction is probably borderline. I am a civilian with no prior service planning on applying to OTS, are there any checklists, or guides that i should bring when i go in for a consult so that before i have any procedure done the surgeon will know whether or not i am within all the specified refraction limits? and if so, where can i get a copy of them?

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Guest P27:17

I wish I knew when the new standards will be posted...my advice is to go ahead and start anyway...

If you get a cycloplegic and it is -5.50 or less you don't need to worry...if it's more than -5.50 and equal to or less than -8.00 you have to take your chances that they will accept it based on "anticipated" changes to the policy

Good luck

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Guest UWpilot

my situation:

I have a pilot slot, start casual this summer, start UPT June 08 and I have 20/30 20/50 vision due to astigmatism (which i got a waiver for)

my question:

can i get the AF to pay for PRK surgery and not be DQ'ed before UPT?

-Sims

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Guest Corwin
First, let me say that posting this using UBB is a pain in the A@*!!!!

Second, these are the Standards. What they will waiver (which is probably what you want to know) is inappropriate for me to post. You need to ask them.

Visual Acuity

Pilots

USAF 20/70

Refractive Error (any meridian)

Pilot

USAF -1.50 +2.00

Pre-PRK (any meridian)

Pilot

USAF -5.50 -1.00

OK, so this is an abbreviated quote from the very first post. As we know, it seems that the USAF has changed their pre-operative requirements, which is good for me (I think), since under the old regs I didn't make it by a smidge, but I make it by a mile under the new ones. So here's my new issue, and I just want to make sure I understand these numbers exactly.

I had my prk, and am 6.5 months out. PRK went great to affect my nearsightedness, but unfortunately, I was overcorrected somewhat. My eyes are now 20/20 (right) and 20/15 (left)!... BUT, they are NOT perfect once we cycloplegic refract. WITH THE REFRACTION I end up somewhere around a +1.25 (left) and +2.00 (right). This was because they managed to overcorrect me, a sad, but true fact. It would appear, that, so long as my prescription doesn't change from this (it's been pretty stable since post-op began) that these numbers are still within limits. Of course, I need toseek my PRK waiver, but I should be fine as far as raw vision is concerned (ie: I don't need a VISION waiver, just a PRK waiver). Is this the correct understanding of what is going on here? Or is there something else I should know about (like, say, a POST-OPERATIVE PRK requirement I haven't found yet)? As I'm now beginning my letters of reco. for a commision, and am also working on my PPL (which is steadily putting me into financial debt), I really need to get some concrete answers to figure this stuff out, and not end up wasting a lot of money and time.

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Guest Corwin

So.... I finally found those forms I was looking for, so sorry about the post. I got them sent to me by a Col. that's been doing a ton to help me out. If anyone out there needs this same form I was talking about in my above post, shoot me a pm, and I can email it to you. Basically, it's the same as the old one, but with the new vision waiver limits on it for PRK, so it's actually valid. ;)

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Guest bohanny
OK, so this is an abbreviated quote from the very first post. As we know, it seems that the USAF has changed their pre-operative requirements, which is good for me (I think), since under the old regs I didn't make it by a smidge, but I make it by a mile under the new ones. So here's my new issue, and I just want to make sure I understand these numbers exactly.

I had my prk, and am 6.5 months out. PRK went great to affect my nearsightedness, but unfortunately, I was overcorrected somewhat. My eyes are now 20/20 (right) and 20/15 (left)!... BUT, they are NOT perfect once we cycloplegic refract. WITH THE REFRACTION I end up somewhere around a +1.25 (left) and +2.00 (right). This was because they managed to overcorrect me, a sad, but true fact. It would appear, that, so long as my prescription doesn't change from this (it's been pretty stable since post-op began) that these numbers are still within limits. Of course, I need toseek my PRK waiver, but I should be fine as far as raw vision is concerned (ie: I don't need a VISION waiver, just a PRK waiver). Is this the correct understanding of what is going on here? Or is there something else I should know about (like, say, a POST-OPERATIVE PRK requirement I haven't found yet)? As I'm now beginning my letters of reco. for a commision, and am also working on my PPL (which is steadily putting me into financial debt), I really need to get some concrete answers to figure this stuff out, and not end up wasting a lot of money and time.

I'm somewhat in the same situation now as Corwin was at the time of his post last year. I have been given a pilot slot for later this year and am scheduled to go to MFS soon. I just had my 1 year follow-up for my PRK surgery and am anxious to know what the current cycloplegic refraction limits are for post-op (I haven't seen it posted on this forum).

Currently, my Auto Refraction is:

OD: +.25 - .25 x145

OS: +.25 - .25 x105

Manifest Refraction:

+.25 - SPN x(blank)

+.25 - SPN x(blank)

Cycloplegic Ref is:

+.50 - SPN x(blank)

+.75 - SPN x(blank)

I'm fortunate enough to be seeing 20/15 in both eyes.

P27 and Rage, can you guys tell me if I'm in range? I'd be extremely grateful if you could share some of your wisdom (if you're allowed to share concerning this on an open forum). And thanks in advance for any help.

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Guest Corwin

An update, which goes with a question:

First, clarification. I'm going the USAF OTS route, meaning I have to go through MEPs first, and then through the FC1 physical AFTER I pass through my MEPs physical and get selected. Seems scary to me, since I can actually be allotted a pilot slot, but then lose it (and, I'm guessing it just gets wasted then) because MEPs is much let thorough then the FC1, which I'll have done at Wright Pat.

Now, the update:

Went through MEPs about a week ago. I felt like I was dodging bullets the whole time, which makes me more nervous when it comes to my (yet to be taken) FC1 physical. I'm honestly starting to get "Gloom and Doom"-y, thinking that I'll never pass what's been described to me as a "4-day long marathon" physical (FC1), but, all I can do is hope and pray at this point. I find the whole situation ironic, since I'm in better shape now than I was at 18, and since at 18, I was winning USAF physical fitness awards for my exceptional PFT performances in ROTC. Anyway, just goes to show... something, though I'm not sure what.

So, MEPs went through, and the LEAST problems I had was with vision. Eyes are 20/20 (I could actually read 20/15, but they never asked me to, so I didn't) in both near and far. Of course, that's without the cyclo refraction, so... They LOVED the checklist I'd received WAY back when from my ROTC USAF Col., so they didn't even ask me questions, even after I checked I'd had PRK done (of course, the doctors already had ALL my paperwork, so...)

BUT!!! Now I'm a bit nervous. My recruiter, as much as he's trying, hasn't mentioned the Waiver once, despite me speaking of it to him EVERY time I see him. My guess is that he just sent my paperwork to MEPs for review, and never applied for a waiver (I think I'm his first OTS guys EVER). Then, I get to MEPs, and the doctor pulls out a regulations manual (enormous in size) and starts looking through it concerning my PRK. He says everything looks good both pre and post-operatively, and then he says something like

Well, the way I read the regulation, you aren't disqualified for your PRK. And the way I'm reading this regulation, you also don't seem to need to go see the surgeon general for a waiver, so I'm just going to clear you.

At the end of MEPs, I walked out being told I've been "Medically Cleared" to be selected as a USAF officer. When I went through my interview, of course, the Captain wanted me to understand that I had gotten through MEPs and the board would now review my file for selection and that, IF I WAS SELECTED, I would be sent to Wright Pat for my FC1 physical.

Question:

Can the MEPs doctor really hold all this power? The way I read the Regs, I do need a waiver (though I'm hardly a doctor). Should bells and whistles be going off in my head now, telling me to hound my recruiter? Is it possible now that I could be selected and get to Wright Pat and they just throw me out the door due to something like this?

If you're confused, so am I. I was certain I understood MOST of this process, but being told this about a "Surgeon General" "waiver" (Surgeon General was a phrase I didn't recall ever hearing before when discussing this process, so maybe it's something entirely different) definitely threw me for a loop. Anyone's knowledgeable thoughts would, as usual, do wonders to ease my busy mind.

OH, and one last thing. I've received so many requests for the PRK checklist, I've attached it to this post.

EyeSurgeryChecklist.doc

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