Eye surgery

The case by case basis treatment is very interesting.

Emir wrote:

What surprised/scared me the most was that I came with very precise questions and got non-professional advices (btw my brother was stunned when I told him the details).

True, it is scary but I suppose in the last years, fraught with litigation, over regulations by payer and general half baked truths disseminated through internet(which are swallowed as whole by patients), the medical community defers some decision making to patients or tries to engage them to an extent where the benefit to them is reduced.

Glasses are great. Whenever you get blood, oil or sawdust squirted towards your face, you’re more likely to escape unscathed if you’re wearing glasses. Squash balls too. They’re mildly inconvenient in a sauna, or when steaming vegetables, or if you have no ears, but other than that they’re great.

IANAO but I do know that you will never meet an ophthalmologist wearing contact lenses. I don’t know what they think of LASIK, but personally I would avoid. And for specific medical questions I would ask an AME. We often seem to be dismissive of them on the forum but an AME will either know the answer or know who to ask, whereas non-specialists are going to be far more likely to give dodgy answers to such questions.

There was an article in the New Scientist a decade ago about how a new procedure was being used to enable pilots to join the USAF even if they didn’t meet the vision requirements. The reasoning was that it would be cheaper to fix the vision for the pilot you want than to suffer the pilot of lesser calibre but with 20/20 vision. As I recall they lifted a flap of cornea, lasered the cornea underneath, then replaced the flap so that the pilot ended up with a smooth cornea. Laser surgery can otherwise leave lines that cause diffraction effects that interfere with night vision (high contrast).

But my vote is for glasses with polycarbonate lenses.

Rereading my #2 post, I’d like to add that I didn’t mean to dismiss cataract surgery (IOL), which generally works just fine and is the only way to causally treat cataract. It is a routine procedure that doesn’t even need a hospital stay. It is also possible with local anaesthesia. A good ophthalmologist takes only 10 – 15 minutes to perform the operation.

Most people just won’t need it until their mid seventies, so it affects few pilots.

My GF (age 58) just had one done. Local anaesthesia, a (only) 2.5mm long incision, and the new lens is inserted rolled-up and unfolded in situ. Takes uner an hour for the whole thing. Quite amazing! Vision correction stabilised (to within 0.25 dioptre) within a week or two. Cost was a few k, IIRC; one goes to a top recommended surgeon otherwise one might end up with a student under supervision which, based on another one I know about, can be a very different experience.

@Emir Correct. If there is a clear indication, go for the surgery. In your case there wasn’t as far as I understood.

@Peter Is this kind of surgery included in the NHS or do you have to pay yourself?

Yes you can get cataracts done on the NHS but as expected there is a waiting list. The NHS is in heavy demand in most areas.

In the UK, and probably in most other places, anybody with more than 2p to rub together does the sensible thing and goes “private”. Actually most of these have private health insurance, but unless you can get a heart bypass done on it (30-50k) or something similar, you will lose out in the long run. I used to pay for BUPA many years ago…

Peter wrote:

n the UK, and probably in most other places, anybody with more than 2p to rub together does the sensible thing and goes “private”

Peter. Why is it sensible to private?

kwlf wrote:

Glasses are great

Not for high dioptres. Clever NAA’s (aviation regulators) prescribe the use of contact lenses for anyone over +/- 5 dioptres. The amount of distortion and magnification due to the lens in the glasses is just too great. With contacts none of these problems exist.

Emir wrote:

Under EASA regulation MIOL are not allowed

I was told that this is due to the Class 1 medical also applying for fighter pilots, (and I guess aerobatic pilots) as the effects of high G on those implant lenses & resulting vision is not well known.

I too didn’t opt for laser surgery as the outcome whilst perhaps acceptable for life isn’t guaranteed success with pilot medicals due to increased glare sensitivity for one.