AirGuy
Member
That's reassuring. I appreciate your help. I'll definitely consider LASIK now, as I previously haven't.
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For nearsightedness, can we get ICL instead of PRK?
- Thread starter AirGuy
- Start date
Doc B-dorf
No FY15 Program for me! Almost done w/school!
I will concur with JB. I am a surgical technologist that works in the refractive clinic at Naval Hospital Bremerton. The ICL is a newer procedure and is not authorized for aviators. Plus you have to realize that an IOL sits farther back in the eye whereas the ICL sits forward and closer. We JUST started these procedures at the Naval Hospital. I would not worry about the flap with LASIK, with custom view the flap is cut in such a way that it will not dislodge. Heck it is authorized for divers to get. JB is right on the pain scale as well, I had PRK in 2005 and the post surgery day 1 and 2 were horrible whereas LASIK patients are up and moving around. However, you MAY NOT be a candidate for LASIK and may only be able to have PRK., but that is up to your optometrist and ophthalmologist who refer you and perform the procedure.
AirGuy
Member
Thank you for the info and references. I'm continuing the post on this thread because JB is on here too. But anyways, I'm forgetting about ICL and going for PRK / LASIK, depending on the doctor's recommendation for which is best. Can you tell me what CRS prior to OCS means? I couldn't find the meaning of it.
I have had stable eyes for the past 1.5 yrs and the doctor says it is ok to get PRK...do you think this is bad advice? He's been doing it for over 26 years or so. I also haven't gotten any taller for the past couple of years, if it matters at all. The only thing is going OCS instead of ROTC / PLC will allow me to graduate early. If I can get PRK after getting into OCS, then I would be able to hold of until I'm 20.5 yrs old. But if that is not possible, I'm going to have to do in a few months at 19.5 yrs old. I wouldn't mind waiting, but what would I be doing in the leftover time? I figured I could always get touchups if my vision changes again right? I heard vision can go to 20/400 after flight school but no further. Also I heard there was a soft contact lens waiver, but upon further research taken out. What's the deal with that now?
Doc B-dorf
No FY15 Program for me! Almost done w/school!
My bad, CRS is Corneal Refractive Surgery, a fancy medical abbreviation for PRK/LASIK. I take it you are looking at a civilian provider since you have not been to OCS. Remember, ophthalmologists need to make money too, and PRK/LASIK is really their bread and butter. Perhaps if JB comes back he can shed more light on that, but the ophthalmologists I work with here agree that refractive surgery is a money maker. I would personally wait until you have stable presctiption for 3 years, but that is the optometrist and ophthalmologists recommendations. I highly encourage LASIK over PRK, the healing time is far less.
You are able to get touchups, if you get it in the Navy, but the refractive surgery centers WILL NOT do a touch up if you had it done in the civilian world prior to commissioning.
For the Soft Contact Lens waiver;
http://www.med.navy.mil/sites/nmotc...uide/12_Waiver_Guide_Ophthalmology_120629.pdf
You are able to get touchups, if you get it in the Navy, but the refractive surgery centers WILL NOT do a touch up if you had it done in the civilian world prior to commissioning.
For the Soft Contact Lens waiver;
http://www.med.navy.mil/sites/nmotc...uide/12_Waiver_Guide_Ophthalmology_120629.pdf
AirGuy
Member
The waiver for Lasik can be submitted just 2 weeks after surgery but for PRK the wait if 3 months. So it's a consideration for sure. I'm not going to let pain be a considerations though. From what I read, overall PRK entails less risk and a chance to have it once or twice again after the initial surgery. In addition in the waiver guide it says two things that are contradicting: Here:http://www.med.navy.mil/sites/nmotc/nami/arwg/Documents/WaiverGuide/Waiver_Guide_Complete_130114.pdf Pages 22
1) Civilians must pay for themselves and have the surgery done at a civilian place.
2) Class I aviators must have their surgery done at a USN designated center...
So...which do I follow, is it even possible for a civilian to get surgery done at a USN center? Cause this would allow me to get touchups by a Navy doctor down the road, if need be.
About Contact Lenses- after reading around on AirWarriors, it seems the waiver is discontinued. But the threads are a few years old, so anyone have recent info on the status of contact lens waiver?
exNavyOffRec
Well-Known Member
Be advised the NAMI regulations don't come into play until AFTER you are in the USN, until then it is the N3M regulations, and they are different.
jbweldon04
Eye Guy
AT 19 years old I would suggest not getting surgery. Your eye prescription doesn't stabilize until you're in your mid-20's. Then again, your prescription is definitely out of SNA limits. It's up to you how you want to handle it, but if there's a problem with your surgery you have to pay for it, not the Navy.
As far as getting CRS at a Navy clinic instead of a civilian while you're not in, that's just not going to be an option. The surgical centers are there to give surgery to sailors, not civilians. I won't tell you that your options are none, but if you want to be a SNA, you're going to face an uphill battle because of your vision.
You can get Soft Contact Lens waivers to fly. I see them in medical records daily. Pilots and NFO's wear them. Again, your prescription sets you at a disadvantage to be a pilot, but NFO would be fine. I honestly don't know the exact specifics with how a waiver would be submitted for someone outside of the Navy who gets CRS and tries to be an SNA. Academy guys get it, but you're not an Academy guy. If you want a definitive answer, call Naval Air Station Pensacola optometry clinic. I bet they would know. That's where NAMI is housed.
As far as getting CRS at a Navy clinic instead of a civilian while you're not in, that's just not going to be an option. The surgical centers are there to give surgery to sailors, not civilians. I won't tell you that your options are none, but if you want to be a SNA, you're going to face an uphill battle because of your vision.
You can get Soft Contact Lens waivers to fly. I see them in medical records daily. Pilots and NFO's wear them. Again, your prescription sets you at a disadvantage to be a pilot, but NFO would be fine. I honestly don't know the exact specifics with how a waiver would be submitted for someone outside of the Navy who gets CRS and tries to be an SNA. Academy guys get it, but you're not an Academy guy. If you want a definitive answer, call Naval Air Station Pensacola optometry clinic. I bet they would know. That's where NAMI is housed.
exNavyOffRec
Well-Known Member
I forgot to mention, but N3M goes by diopters so before you go and get surgery find out if you are -4 or -7 or ??? as if you vision is bad enough even with surgery that corrects you to perfect vision you might not be able to get in.
jbweldon04
Eye Guy
NavyOffRec is right. There are preoperative limits you must be within before surgery that could prevent you from ascending to the SNA status. I don't know what they are, but the Navy has been more flexible with these limits, but they still do exist.
Doc B-dorf
No FY15 Program for me! Almost done w/school!
Try this:
http://www.med.navy.mil/sites/nmotc.../1_Waiver_Guide_Physical_Standards_130114.pdf
Section 1, Physical Standards for Naval Aviation.
I do not see the preoperative diopters except for anisometropia (which is where one eyes power is different from the other eye, meaning one eye is in focus and the other is not).
Here is what I have found from DOD instructions:
Distant visual acuity, of any degree that does not correct with spectacle lenses to at least one of the following (367):
(1) 20/40 in one eye and 20/70 in the other eye.
(2) 20/30 in one eye and 20/100 in the other eye.
(3) 20/20 in one eye and 20/400 in the other eye. However, for entrance into a military academy, distant visual acuity that does not correct to 20/20 in each eye is disqualifying. For entrance into ROTC programs and OCS/OTS, distant visual acuity that does not correct to 20/20 in one eye and 20/100 in the other eye is disqualifying.
b. Near visual acuity, (367) of any degree that does not correct to 20/40 in the better eye.
c. Refractive error (hyperopia (367.0), myopia (367.1), astigmatism, (367.2)), in any spherical equivalent of worse than -8.00 or + 8.00 diopters; if ordinary spectacles cause discomfort by reason of ghost images or prismatic displacement; or if corrected by orthokeratology or keratorefractive surgery. However, for entrance into a military academy or ROTC programs, the following conditions are disqualifying:
(1) Astigmatism, all types over 3 diopters.
(2) Hyperopia over 8.00 diopters spherical equivalent.
(3) Myopia over 6.75 diopters spherical equivalent.
(4) Refractive error corrected by orthokeratology or keratorefractive surgery.
d. Contact lenses. Complicated cases requiring contact lenses for adequate correction of vision, such as corneal scars (371) and irregular astigmatism (367.2).
e. Color vision, (368.5). Although there is no standard, color vision will be tested because adequate color vision is a prerequisite for entry into many military specialties. However, for entrance into a military academy or ROTC or OCS/OTS programs, the inability to distinguish and identify without confusion the color of an object, substance, material, or light that is uniformly colored a vivid red or vivid green is disqualifying.
Derived from Department of Defense (DOD) Directive 6130.3, Physical Standards for Appointment, Enlistment, and Induction, and DOD Instruction 6130.4, Criteria and Procedure Requirements for Physical Standards for Appointment, Enlistment, or Induction in the Armed Forces.
Now for PRK/LASIK:
LASIK for nearsigthedness: 0 to -14.0 Diopters with or without -0.5 to -5.0 Diopters of astigmatism
LASIK for farsightedness: +0.5 to +5.0 Diopters with up to +3.0 Diopters of astigmatism
Mixed Astigmatism patients: < or = to 6.0 diopters of astigmatism
PRK:
Nearsighted -1.0 to -12.0 diopters or 0 to -12.0 with up to -4.0 diopters astigmatism
Farsighted +1.0 to +6.0 diopters with no more than 1.0 diopter of astigmatism OR +0.5 to +5.0 diopters with +0.5 to +4.0 diopters of astigmatism.
Hope this helps.
http://www.med.navy.mil/sites/nmotc.../1_Waiver_Guide_Physical_Standards_130114.pdf
Section 1, Physical Standards for Naval Aviation.
I do not see the preoperative diopters except for anisometropia (which is where one eyes power is different from the other eye, meaning one eye is in focus and the other is not).
Here is what I have found from DOD instructions:
Distant visual acuity, of any degree that does not correct with spectacle lenses to at least one of the following (367):
(1) 20/40 in one eye and 20/70 in the other eye.
(2) 20/30 in one eye and 20/100 in the other eye.
(3) 20/20 in one eye and 20/400 in the other eye. However, for entrance into a military academy, distant visual acuity that does not correct to 20/20 in each eye is disqualifying. For entrance into ROTC programs and OCS/OTS, distant visual acuity that does not correct to 20/20 in one eye and 20/100 in the other eye is disqualifying.
b. Near visual acuity, (367) of any degree that does not correct to 20/40 in the better eye.
c. Refractive error (hyperopia (367.0), myopia (367.1), astigmatism, (367.2)), in any spherical equivalent of worse than -8.00 or + 8.00 diopters; if ordinary spectacles cause discomfort by reason of ghost images or prismatic displacement; or if corrected by orthokeratology or keratorefractive surgery. However, for entrance into a military academy or ROTC programs, the following conditions are disqualifying:
(1) Astigmatism, all types over 3 diopters.
(2) Hyperopia over 8.00 diopters spherical equivalent.
(3) Myopia over 6.75 diopters spherical equivalent.
(4) Refractive error corrected by orthokeratology or keratorefractive surgery.
d. Contact lenses. Complicated cases requiring contact lenses for adequate correction of vision, such as corneal scars (371) and irregular astigmatism (367.2).
e. Color vision, (368.5). Although there is no standard, color vision will be tested because adequate color vision is a prerequisite for entry into many military specialties. However, for entrance into a military academy or ROTC or OCS/OTS programs, the inability to distinguish and identify without confusion the color of an object, substance, material, or light that is uniformly colored a vivid red or vivid green is disqualifying.
Derived from Department of Defense (DOD) Directive 6130.3, Physical Standards for Appointment, Enlistment, and Induction, and DOD Instruction 6130.4, Criteria and Procedure Requirements for Physical Standards for Appointment, Enlistment, or Induction in the Armed Forces.
Now for PRK/LASIK:
LASIK for nearsigthedness: 0 to -14.0 Diopters with or without -0.5 to -5.0 Diopters of astigmatism
LASIK for farsightedness: +0.5 to +5.0 Diopters with up to +3.0 Diopters of astigmatism
Mixed Astigmatism patients: < or = to 6.0 diopters of astigmatism
PRK:
Nearsighted -1.0 to -12.0 diopters or 0 to -12.0 with up to -4.0 diopters astigmatism
Farsighted +1.0 to +6.0 diopters with no more than 1.0 diopter of astigmatism OR +0.5 to +5.0 diopters with +0.5 to +4.0 diopters of astigmatism.
Hope this helps.
AirGuy
Member
Are OCS applicants actually picked based on vision?
Thanks for the info. I'm definitely within pre-op limits.
exNavyOffRec
Well-Known Member
Those are not the non AD entrance limits for OCS, DOD sets limits then the USN has stricter ones, the Medical Manual that N3M uses specifies Unrestricted line pre op no worse than +/- 6 and other designators +/- 8
jbweldon04
Eye Guy
Alright, you made me go get the waiver guideline for confirmation. This should be the end of the discussion. According to the
U.S. Navy Aeromedical Reference and Waiver Guide :
"SNA applicants: pre-operative refractive error must not exceed -8.00 to + 3.00 (SE) and 3.00 diopters of cylinder, with no more than 3.50D of anisometropia. They must additionally have a post-operative cycloplegic refraction using cyclopentolate performed at a military installation."
What does this mean for you? Well, if I remember correctly you said your prescription was -4.00, but you didn't let me know more than that. If it's -4.00 Sphere then you are within limits. You can elect to get either refractive surgery, but you will have to wait 6 months until after the surgery to go to OCS. If you want to be a pilot this is the ONLY option for you. If you want to PM me your prescription I can tell you a little more about what it means.
Be advised that if you get the surgery at your young age, you will probably not stay 20/20 post surgery for the rest of your life. If your prescription changes enough, you could get redesignated. But this is extreme worst case scenario. You would have to fall out of SNA limits. And of course there's always the risk that the ophthalmologies messes your eyes up.
U.S. Navy Aeromedical Reference and Waiver Guide :
"SNA applicants: pre-operative refractive error must not exceed -8.00 to + 3.00 (SE) and 3.00 diopters of cylinder, with no more than 3.50D of anisometropia. They must additionally have a post-operative cycloplegic refraction using cyclopentolate performed at a military installation."
What does this mean for you? Well, if I remember correctly you said your prescription was -4.00, but you didn't let me know more than that. If it's -4.00 Sphere then you are within limits. You can elect to get either refractive surgery, but you will have to wait 6 months until after the surgery to go to OCS. If you want to be a pilot this is the ONLY option for you. If you want to PM me your prescription I can tell you a little more about what it means.
Be advised that if you get the surgery at your young age, you will probably not stay 20/20 post surgery for the rest of your life. If your prescription changes enough, you could get redesignated. But this is extreme worst case scenario. You would have to fall out of SNA limits. And of course there's always the risk that the ophthalmologies messes your eyes up.
exNavyOffRec
Well-Known Member
NAMI guide doesn't come into play until AFTER non AD are past N3M and their guide say 6 for URL
http://www.brooksidepress.org/Products/ManMed/Changes/manmed change 126.pdf Chapter 15 section 36 paragraph 2 (c)
I went round and round with N3M about this on an individual who had PRK surgery but was over 6 pre surgery, and this is specifically what they referenced.
jbweldon04
Eye Guy
Then I have no idea. What is N3M?