Punctal Plug

[slo_goin]

History -> I had PRK back in April of 2007, everything went well and I passed my FC1 in January of this year. My FC1 states "pending completion of MFS" as I expected it to, and I know that there will be add'l PRK testing done there since it had not been quite a year since surgery at the time of my flight physical.

In anticipation of MFS (and since it has been 11 months since my FC1), I scheduled an eye exam with a local ophthalmologist who also happens to be a recently retired AF flight surgeon. I had the full exam done to include corneal topographies, etc.. Everything looked fantastic. His only comment was that my right eye seemed dry under the microscope (a common side effect of PRK) and he offered to put a punctul plug in to help. I asked him if he thought Brooks would care about this, and he said no way - in the event that they did it could be taken out in a minute.

Anyway, I've got the plug in and wanted to double check that it won't be an issue. I have noticed a positive difference with it in - although since I lived without it for a year and half now, I know I would do fine without it as well.

Thanks!

[Guest goducks]

History -> I had PRK back in April of 2007, everything went well and I passed my FC1 in January of this year. My FC1 states "pending completion of MFS" as I expected it to, and I know that there will be add'l PRK testing done there since it had not been quite a year since surgery at the time of my flight physical.

In anticipation of MFS (and since it has been 11 months since my FC1), I scheduled an eye exam with a local ophthalmologist who also happens to be a recently retired AF flight surgeon. I had the full exam done to include corneal topographies, etc.. Everything looked fantastic. His only comment was that my right eye seemed dry under the microscope (a common side effect of PRK) and he offered to put a punctul plug in to help. I asked him if he thought Brooks would care about this, and he said no way - in the event that they did it could be taken out in a minute.

Anyway, I've got the plug in and wanted to double check that it won't be an issue. I have noticed a positive difference with it in - although since I lived without it for a year and half now, I know I would do fine without it as well.

Thanks!

I'm not aware of anyone going for their FCI who was using punctal plugs. I don't think it would be viewed favorably and it may jeopardize your waiverability. As there is no precedence I can't say for sure, but it's not a road I would go down. If you're doing fine with artificial tears as needed, I would stick with them. I also don't think the history of using a plug "just to see if it would help" will be an issue as long as you aren't having severe dry eye issues without it and as long as your eye doesn't look excessively dry under the scope. Lots of eyes show a little dryness without major symptoms and this has never been an issue.

Your call, but it's not something I'd want to complicate matters myself.

[slo_goin]

I'm not aware of anyone going for their FCI who was using punctal plugs. I don't think it would be viewed favorably and it may jeopardize your waiverability. As there is no precedence I can't say for sure, but it's not a road I would go down. If you're doing fine with artificial tears as needed, I would stick with them. I also don't think the history of using a plug "just to see if it would help" will be an issue as long as you aren't having severe dry eye issues without it and as long as your eye doesn't look excessively dry under the scope. Lots of eyes show a little dryness without major symptoms and this has never been an issue.

Your call, but it's not something I'd want to complicate matters myself.

I'd prefer to leave it alone, honestly. Is this something I should call Brooks on?

[Guest goducks]

I'd prefer to leave it alone, honestly. Is this something I should call Brooks on?

Don't know if you would get any better info than I just gave you. Keep in mind that waivers are handled by a committee. You can talk to any single person and they can give you their opinion, but in the end it's a concensus recommendation made to AETC. So calling isn't going to get you anything more than one person's opinion and they don't formally represent the ACS who makes the recommendation.

[slo_goin]

Don't know if you would get any better info than I just gave you. Keep in mind that waivers are handled by a committee. You can talk to any single person and they can give you their opinion, but in the end it's a concensus recommendation made to AETC. So calling isn't going to get you anything more than one person's opinion and they don't formally represent the ACS who makes the recommendation.

Understood, thanks. I went ahead and re-read the policy letter on PRK/LASIK. There is no mention of anything regarding the use of a punctal plug or lubricating eye drops. Their only related area concern would be cases of "severe dry eye" and use of medicated drops, and I fit neither scenario - what I have is just a simple convenient alternative to a couple lubricating drops in the morning (what I was doing before). I'll just have to trust my doc on this one I guess; he was a flight surgeon at Brooks / Wilford Hall so he is the best resource I have in addition to this forum.

It seems to me that the PRK waiver process at this point has got to be pretty streamlined.

[Guest goducks]

Understood, thanks. I went ahead and re-read the policy letter on PRK/LASIK. There is no mention of anything regarding the use of a punctal plug or lubricating eye drops. Their only related area concern would be cases of "severe dry eye" and use of medicated drops, and I fit neither scenario - what I have is just a simple convenient alternative to a couple lubricating drops in the morning (what I was doing before). I'll just have to trust my doc on this one I guess; he was a flight surgeon at Brooks / Wilford Hall so he is the best resource I have in addition to this forum.

It seems to me that the PRK waiver process at this point has got to be pretty streamlined.

You are right, there is no specific mention of punctal plugs in the waiver and I belive there are other aircrew flying with them so they are not disqualifying. I'm simply pointing out that no one has ever applied for an FCI waiver who was using punctal plugs. Does that mean you won't get a waiver- probably not. But, it's uncharted territory.

[slo_goin]

You are right, there is no specific mention of punctal plugs in the waiver and I belive there are other aircrew flying with them so they are not disqualifying. I'm simply pointing out that no one has ever applied for an FCI waiver who was using punctal plugs. Does that mean you won't get a waiver- probably not. But, it's uncharted territory.

I had it pulled out... no sense in complicating things.

Thanks for the advice!

[jimbobpow13]

Hello, after some dry eye symptoms my doctor recently put in these plugs as well. I already have my FC1 certification with a waiver for excessive refraction. I just commissioned and I'm going to pilot training soon. When I go to UPT, I know that I have to have another flight physical done (FCII I believe). Do you think these plugs will be a problem? If they are I would rather just take them out. I'm also getting put on Restasis along with another lubricating eye drop for a couple of months to see if the problem persists or not. Thanks for the help!

[Guest goducks]

Hello, after some dry eye symptoms my doctor recently put in these plugs as well. I already have my FC1 certification with a waiver for excessive refraction. I just commissioned and I'm going to pilot training soon. When I go to UPT, I know that I have to have another flight physical done (FCII I believe). Do you think these plugs will be a problem? If they are I would rather just take them out. I'm also getting put on Restasis along with another lubricating eye drop for a couple of months to see if the problem persists or not. Thanks for the help!

I don't think the plugs will be an issue if you've already finished your FCI and have all your waivers in place, however, last I heard Restasis was not approved for aircrew. There shouldn't be a problem using it temporarily, but you'll likely be required to d/c it at UPT.

BTW- you are still classified as FCI until you complete UPT, then you transition to FCII status.

[jimbobpow13]

I don't think the plugs will be an issue if you've already finished your FCI and have all your waivers in place, however, last I heard Restasis was not approved for aircrew. There shouldn't be a problem using it temporarily, but you'll likely be required to d/c it at UPT.

BTW- you are still classified as FCI until you complete UPT, then you transition to FCII status.

Thanks a lot for the help! Yeah, the Restasis is just temporary... a couple of months... but the plugs actually seem to be working and making it more comfortable so I just want to make sure it will be alright to leave them in. Thanks again!