USAF / USA / USN / USMC Vision

[deaddebate]

I will be turning 26 in August and wanted to know what my chances would be like for a pilot slot. As far as i know I have no disqualifying medical conditions except my vision. I am around 20/400 uncorrected with a stable -6.50/-6.00 prescription (i am myopic). I was planning on getting PRK or LASIK within the next month to get within the vision requirements. I originally wanted to join the Air Force or Navy but I decided to not pursue USAF Academy years ago because at the time vision requirements for flying positions were more strict. This has always been something I wanted to do but I chose to follow the safe path instead of going for what I really wanted.

What is the timetable like between having the surgery and seeing a military doctor? From what I understand I need to make sure the doctor doing my surgery fully documents everything. Are there differences in the documentation needed for Air Force and Navy on the day of surgery and through the recovery process? Also, what should I be doing to prepare while recovering to maximize my chances of making this happen?

Please read through the numerous other posts on the board that explain the standard.

[City_Wok]

Have my FC1 coming up in August and have a question about cataracts that has come up from reading previous posts. I had PRK two years ago and the ophthalmologist found what I remember to be a cataract in my right eye and is only visible when dilated (this was before the procedure). It was kind of surprising to me because I've had numerous eye people look at my eyes and have never found anything before that point. She said it wasn't a factor and saw no need to put it in my medical records...which kind of has me worried now. Just wondering if I should go to my optometrist and get it fully checked out? Because as of now I really have no idea even what type of opacity she found.

I just want to go to the FC1 prepared with no surprises...I realize I'm probably fretting over nothing since I'm asymptomatic, but you never know. Thanks for any input.

[deaddebate]

Have my FC1 coming up in August and have a question about cataracts that has come up from reading previous posts. I had PRK two years ago and the ophthalmologist found what I remember to be a cataract in my right eye and is only visible when dilated (this was before the procedure). It was kind of surprising to me because I've had numerous eye people look at my eyes and have never found anything before that point. She said it wasn't a factor and saw no need to put it in my medical records...which kind of has me worried now. Just wondering if I should go to my optometrist and get it fully checked out? Because as of now I really have no idea even what type of opacity she found.

I just want to go to the FC1 prepared with no surprises...I realize I'm probably fretting over nothing since I'm asymptomatic, but you never know. Thanks for any input.

You're fretting over nothing. If it isn't in your vision, you won't need a waiver. Don't say anything about it, and if asked, say that your don't notice anything in your daily life. Read the waiver guide for cataracts if you want to further obsess about it.

[AV1AT0R]

Hi!

I posted about two years ago I think regarding my vision. Y'all said I don't have a shot with my current prescription and stuff. Well, I secretly never gave up. I have all my ducks in a row regarding my application, and I think I would at least score an interview. I still have the vision thing to deal with, though.

My question is this: I have the means to get PRK. My guess is if I turn in my application by the end of this month, the interview panel wouldn't be until maybe October or so. Do y'all think it would be a bad idea to go ahead and get PRK done now? I found the Air Force Refractive Surgery documentation and I'm sure I could get a hold of some forms somewhere. My figuring is that I'd be ahead of the game so when it came time for FC1, I'd be good to go or very close to it. What are your thoughts?

Thanks in advance, and have a happy Fourth of July!

Pete

[mp5g]

I'd say if you have the means and really want better vision, not just as a means to get a pilot slot, then do it.

Best case, you score an interview and get selected. By the time it takes for your packet to go through NGB and get dates for your FCI, you would probably be very close to being over the wait period. Deaddebate can correct if needed, but I thought you had to have a minimum of 6 months between surgery and your FCI.

[AV1AT0R]

I think it's actually a year for the wait period. I figure I want to get PRK, anyway, because I'm sick of buying contacts every year.

[uhhello]

Anyone have any experience with keratoconus? Just diagnosed initially during a contact lens appt. Doc is saying a trip to Wright Patt is required for the waiver. 5 year class 3 flyer.

[Guest]

My doctor gave me medical advice, so I came here to ask strangers what they think.

Had to give you some AFEF love.

This completely syncs with the waiver guide. Link in my sig block if you care to read it yourself--it's very comprehensive.

[uhhello]

Had to give you some AFEF love.

This completely syncs with the waiver guide. Link in my sig block if you care to read it yourself--it's very comprehensive.

Yeah read the guide as soon as I got back to the computer but was looking for first hand experience. I'm hoping to not have to go to Ohio but if thats what it takes to get the waiver, then of course.

[Guest]

Yeah read the guide as soon as I got back to the computer but was looking for first hand experience. I'm hoping to not have to go to Ohio but if thats what it takes to get the waiver, then of course.

OK, OK, here's a more complete answer. Hopefully 81L BLR will also add to the conversation.

The waiver guide entry for this condition was updated in Jul 2014. I can't find the previous standard from Apr 2010, but I suspect ACS wasn't mandated at that time. Since Jan 2013, 35 people were evaluated for a FCIII waiver for keratoconus. 19 cases were dispositioned between Jan 2013 and Dec 2014. Of those 19, 7 were DQ'd and didn't go to ACS, 2 were approved without ACS, and 10 did go to ACS. From Jan 2014 to present, 14 did go to ACS and the other 2 were DQ'd without ACS.

Of those DQ's, many waivers have multiple conditions also requiring waiver, so they weren't ever really considered for waiver approval and were DQ'd locally. Separately, ACS will oftentimes identify other conditions which may or may not also require a waiver (they are VERY thorough). Don't sweat it too much because they will only do an examination of the organ system for which you need the waiver (i.e. you'll only see an ophthalmologist/optometrist, not a cardiologist, gastroenterologist, etc.). So hopefully your eyes are the only thing that needs waiving, and that you meet all other flying standards. If so, your chances are very good.

[uhhello]

OK, OK, here's a more complete answer. Hopefully 81L BLR will also add to the conversation.

The waiver guide entry for this condition was updated in Jul 2014. I can't find the previous standard from Apr 2010, but I suspect ACS wasn't mandated at that time. Since Jan 2013, 35 people were evaluated for a FCIII waiver for keratoconus. 19 cases were dispositioned between Jan 2013 and Dec 2014. Of those 19, 7 were DQ'd and didn't go to ACS, 2 were approved without ACS, and 10 did go to ACS. From Jan 2014 to present, 14 did go to ACS and the other 2 were DQ'd without ACS.

Of those DQ's, many waivers have multiple conditions also requiring waiver, so they weren't ever really considered for waiver approval and were DQ'd locally. Separately, ACS will oftentimes identify other conditions which may or may not also require a waiver (they are VERY thorough). Don't sweat it too much because they will only do an examination of the organ system for which you need the waiver (i.e. you'll only see an ophthalmologist/optometrist, not a cardiologist, gastroenterologist, etc.). So hopefully your eyes are the only thing that needs waiving, and that you meet all other flying standards. If so, your chances are very good.

Cool thanks. What is the ACS process like. Fly in, hit appt and then back out? I'm in the UK already making multiple trips over over 2 month period so want to get this shit over with.

[Guest]

Cool thanks. What is the ACS process like. Fly in, hit appt and then back out? I'm in the UK already making multiple trips over over 2 month period so want to get this shit over with.

Before ACS consideration, your local flight doctor and optometrist must first write the waiver and locally route it to the "Senior Reviewer" (usually the AMDS Commander). This takes about 1-4 weeks for simple cases and depending on how quickly your doctor and his/her boss manages the administrative headaches of being Flight Surgeons.

Then it is sent to your MAJCOM Aerospace Medicine office for review. The MAJCOM could conceivably DQ right here, however that is only done in very obvious cases where the member definitely doesn't meet the waiver standard and usually on the recommendation of the local FS. MAJCOM will usually take 1-3 weeks to review, and then submit the request for ACS to review.

ACS then must review the package and schedule the appointment. Members can request later dates, but not sooner, if they have some mission conflict with scheduling. A review of a few recent ACS consult timelines for Ophthalmology is around 3-5 weeks from date MAJCOM requests to date member is seen. Then ACS takes another week to finalize their report and recommendation.

MAJCOM reviews the ACS report and follows the recommendation 99% of the time. MAJCOM finalized the waiver disposition within a week and returns the completed waiver to the base level.

Then the local clinic must review the disposition, notify the patient, and complete a new AF 1042 for the record/member/HARM office. This takes between 1 day to 2 weeks, again dependent on how well the local clinic completes administrative tasks.

-----

So in summation, the fastest you could possibly be at WPAFB is probably 5 weeks and a final disposition (hopefully with RTFS w/ approved waiver) in 6 weeks. More likely, you will be at WPAFB in about 8 weeks and a disposition in 10 weeks. These timeline estimates are from the date of first diagnosis, and only my best estimate (using case history as a guide, but still an estimate). If there are complications, this could easily become a longer process, especially with the Christmas season.

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Note to other folks reading this, obviously the different specialty clinics have different scheduling averages. Neuropsychiatry ≠ Ophthalmology ≠ Internal Medicine, etc. Also, the Waiver Guide directs many cases to only need ACS review and advisement, but not actually physically evaluate the patient.

[uhhello]

Copy. Thanks for thoroughly depressing me.

[81L BLR]

If you don't meet vision standards with spectacles,the ACS evaluation will most likely take 3-4 days because you may need a rigid gas permeable (RGP) contact lens fitting. If you meet standards with spectacles, you may only be there for 2 days. Their goal will be to get you to meet standards as quickly and easily as possible so you can be returned to flight duties. For a trained flyer it is almost impossible to not get a waiver.

[uhhello]

If you don't meet vision standards with spectacles,the ACS evaluation will most likely take 3-4 days because you may need a rigid gas permeable (RGP) contact lens fitting. If you meet standards with spectacles, you may only be there for 2 days. Their goal will be to get you to meet standards as quickly and easily as possible so you can be returned to flight duties. For a trained flyer it is almost impossible to not get a waiver.

Thanks. I meet the standards now so I'm not perceiving that to be an issue. Thanks for the info.

[Sankacoffie]

I just want to clarify something. So say I got PRK surgery a while back (before any intentions of flying) and my current vision is 20/20 in each eye and has been steady. Yet my pre surgery refractive error was greater than the +3 diopters for Hyperopia. This means I'm wasting my time even though I'm seeing perfect right?

Also I found http://static.e-publishing.af.mil/production/1/af_sg/publication/afi48-123/afi48-123.pdf and that seems to list in Chapter 6.2 that it is at the discretion of the flight surgeon. So I'm confused if it is based off that or if it's based off predetermined "Limits" like the Pre-Surgery +3 diopters of Hyperopia. And obviously the limits are there because they are indicators of when disqualifying conditions pose a risk but are they set in stone or is it up to the descrition of the Flight Surgeon?

I swear I've been reading and lurking for so long but I get confused with all the different cases I look at and just wanted a little clarification so hopefully it's not too much.

Edited March 3, 2015 by Sankacoffie

[uhhello]

If you don't meet vision standards with spectacles,the ACS evaluation will most likely take 3-4 days because you may need a rigid gas permeable (RGP) contact lens fitting. If you meet standards with spectacles, you may only be there for 2 days. Their goal will be to get you to meet standards as quickly and easily as possible so you can be returned to flight duties. For a trained flyer it is almost impossible to not get a waiver.

Started appt monday morning and was back on the plane Tuesday night. In and out. Thanks.

[81L BLR]

If you had PRK and your pre-surgery refractive error exceeded +3.00 diopters, then a waiver for any USAF flying class cannot be recommended. There is no flight doc discretion involved.

The waiver authority can choose to waive whatever they want, but it is very unlikely if a waiver is not recommended at the IFC I physical.

[Sankacoffie]

If you had PRK and your pre-surgery refractive error exceeded +3.00 diopters, then a waiver for any USAF flying class cannot be recommended. There is no flight doc discretion involved.

The waiver authority can choose to waive whatever they want, but it is very unlikely if a waiver is not recommended at the IFC I physical.

Looks like I better join the Navy

[deaddebate]

If you had PRK and your pre-surgery refractive error exceeded +3.00 diopters, then a waiver for any USAF flying class cannot be recommended. There is no flight doc discretion involved.

The waiver authority can choose to waive whatever they want, but it is very unlikely if a waiver is not recommended at the IFC I physical.

This.

I tried to compare with other waivers submitted but the data was difficult to tease apart without individually reading them all independently. From the waiver guide reference already discussed and the few waivers I did review, waiver likelihood is very poor.

Looks like I better join the Navy

Probably a good idea. Good luck.

Started appt monday morning and was back on the plane Tuesday night. In and out. Thanks.

I'd be interested to see what your total time frame will be compared to my guesstimate, from when you were first notified of the need to refer to ACS to new 1042 in hand.

[uhhello]

This.

I tried to compare with other waivers submitted but the data was difficult to tease apart without individually reading them all independently. From the waiver guide reference already discussed and the few waivers I did review, waiver likelihood is very poor.

Probably a good idea. Good luck.

I'd be interested to see what your total time frame will be compared to my guesstimate, from when you were first notified of the need to refer to ACS to new 1042 in hand.

Mid December start DNIF and end of Feb off.

[Sankacoffie]

Just got a form from my base to give to my ophthalmologist to fill out regarding pre-op and post-op refractions.

Anyways the form states the pre-op cycloplegic refraction limits cannot be over +/- 5.50 (FCI) or +/- 8.00 (FCIA/III). I've read the waiver guide and know this disagrees so I'm just curious if anyone had insight on this.

edit: I work at and got selected by a guard base. Figured might as well let you know that if it makes a difference, even though I doubt it, you never know.

Edited March 10, 2015 by Sankacoffie

[deaddebate]

The waiver guide is what matters. Further, standards for IFC I/IA are uniformly enforced because the certification and waiver authority are MFS/AETC (AFI 48-123 Attch 2). Meaning that ANG may be the ones sponsoring you, so you are more likely to get a waiver requested, but almost no better chance at getting it actually approved. This only differs if you are an existing flyer/inter-service transfer, meaning you would only need an IFC II, and ANG would then be your approval authority. In short, you are "untrained," and therefore at much lower likelihood for approval.

[Sankacoffie]

The waiver guide is what matters. Further, standards for IFC I/IA are uniformly enforced because the certification and waiver authority are MFS/AETC (AFI 48-123 Attch 2). Meaning that ANG may be the ones sponsoring you, so you are more likely to get a waiver requested, but almost no better chance at getting it actually approved. This only differs if you are an existing flyer/inter-service transfer, meaning you would only need an IFC II, and ANG would then be your approval authority. In short, you are "untrained," and therefore at much lower likelihood for approval.

Thanks for taking the time out to explain. I know you don't gotta but I think I speak for a lot of people when I say its appreciated.

[81L BLR]

The form you were given is an old form that was never correct. Attached is the current form.

CRS_Checklist(Feb 15).pdf