LASIK and the Possible Repercussions for Flight Crew – Understanding the Risks

PT 3 M minute read
LASIK and the Possible Repercussions for Flight Crew - Understandingthe Risks

This business aviation blog post is the second part in a series covering the risks of LASIK surgery on flight crew members and continues from our previous post.

This is a post by guest author Dean Andrew Kantis, founder and owner of Micro Jet Network, Inc. Dean was asked to contribute to this blog because of his personal experiences in dealing with the repercussions of LASIK. Any thoughts expressed below are entirely Dean’s and do not necessarily reflect the views of Universal Weather and Aviation, Inc.

In my previous article, I discussed things flight crew should consider before selecting LASIK (or Laser-Assisted In Situ Keratomileusis) as a treatment option for vision correction. For those who have determined that LASIK is the option for them, it’s important to understand the risks involved and options to mitigate that risk.

My goal here is to elevate awareness of the risks associated with LASIK. My intention is not to create fear, but rather an understanding of the known potential long-term injuries that are associated with this elective procedure, so that you and others can make the most informed choice with regards to eye surgery.

1. What’s the process to get laser eye surgery done?

First step is to ensure that you’ve adequately considered all non-surgical options – glasses and contacts – to maximize clarity of vision. Once you’ve made the decision to go forward with laser surgery, consider all options, including photorefractive keratectomy (PRK) – a surface treatment of one eye at a time. Should you find that the treated eye develops permanent problems, or excessive daily dry eye issues, you’ll at least have a second eye for backup. For pilots who are determined to have LASIK for both eyes, consider Epi-LASIK procedures, which are less invasive.

2. What does the FAA require of a crew member receiving such surgery?

See Information for Pilots Considering Laser Eye Surgery, source: FAA [PDF].

3. What are some implications and risks in having this type of surgery?

As a result of laser eye surgery, some patients lose lines of vision on the vision chart that cannot be corrected with glasses, contact lenses or follow-up surgery. Other patients develop debilitating visual symptoms, including glares, halos and/or double vision that can seriously affect nighttime vision. Even with good vision on the vision chart, some patients do not see as well post-LASIK in situations of low contrast, such as at night or in fog, after treatment as compared to before treatment.

You may be under-treated or over-treated with LASIK. Only a certain percent of patients achieve 20/20 vision without glasses or contacts. Keep in mind that you may require additional treatment and may still need glasses or contact lenses after surgery. If you used reading glasses before surgery you may still need reading glasses after surgery. Some patients develop severe dry eye syndrome. As a result of surgery, your eye may not be able to produce enough tears to keep the eye moist and comfortable. Dry eye not only causes discomfort but can reduce visual quality due to intermittent blurring and other visual symptoms. This condition may be permanent. Intensive drop therapy and use of plugs or other procedures may be required.

Results of laser eye surgery are generally not as good in patients with very large refractive errors of any type. If this sounds like your eyes, you should discuss expectations with your doctor and realize that you may still require glasses or contacts after the surgery.

For some farsighted patients, results may diminish with age. If you are farsighted, the level of improved vision you experience after surgery may decrease with age. This can occur if your manifest refraction (a vision exam with lenses before dilating drops) is very different from your cycloplegic refraction (a vision exam with lenses after dilating drops).

4. What options does a crew member have if LASIK surgery fails?

There’s always a risk that the FAA may disqualify a pilot if post-LASIK vision problems occur that cannot be corrected by using contacts and glasses. If you can no longer maintain FAA standards to correctly and accurately perform all tasks needed to safely pilot an aircraft, you may no longer have a flying career.

Closing Thoughts

It’s always important for a pilot – and anyone for that matter – to be skeptical when it comes to any medical procedure that is essentially irreversible and may impact your flying career. Do not believe everything you see or hear regarding LASIK or other forms of laser eye surgery. Do due diligence before making any decision with an appropriate licensed professional. It’s important to consider all the alternatives. Just as you do when planning a complex international flight, be mindful of all available options, be aware of risk potential, and always have Plan B scenarios in place.


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