Here is the website for London Vision Clinic, where I had my eyes done. You should find the answers about Lasik and Lasek here.
http://www.londonvisionclinic.com/
Steve
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The PRK process from start to finish
- Thread starter mxracer19
- Start date
Here is the website for London Vision Clinic, where I had my eyes done. You should find the answers about Lasik and Lasek here.
http://www.londonvisionclinic.com/
Steve
DBDubbs
Registered User
Thanks mxracer19, this thread is extremely helpful, I am getting my PRK at the end of this month (June 28).
When you talk about a comprehensive pre-op exam, will the one that the laser eye center is giving me a week before the procedure cover this. Should I stress to them that I need it to be comprehensive? Also should I get any forms from the OSO to be filled out before/during the procedure? I heard that I only need to get forms for the post-op checks.
And please keep the updates coming, they're very useful.
Thanks and goodluck healing up,
dbdubbs
When you talk about a comprehensive pre-op exam, will the one that the laser eye center is giving me a week before the procedure cover this. Should I stress to them that I need it to be comprehensive? Also should I get any forms from the OSO to be filled out before/during the procedure? I heard that I only need to get forms for the post-op checks.
And please keep the updates coming, they're very useful.
Thanks and goodluck healing up,
dbdubbs
mxracer19
Hanging out in K-Vegas.
Trey3U-
Your eye has several layers of 'cornea'. The outer most layer, or epithelial layer is the layer that regenerates itself over time. LASEK stands for laser assisted sub-epithelial keractectomy. In this process according to wikipedia, the outter corneal layer is removed, preserved in a chemical solution, the under-layer of cornea is reshaped with the laser, and the outer layer is replaced. I had LASEK, but my outer layer was not replaced - instead, my doctor put in a soft protective contact lense that was removed today (3 days post-op). If PRK is different from LASEK, my guess would be that a contact lense is not applied. Can anyone who has had PRK clarify this? According to my doctor, when he described LASEK to me, I said "so this is basically PRK?" and he said "Yes. It would be impossible for anyone to tell the difference". Epi-LASIK, from my understanding, is LASEK where the outer layer is not completely removed - it is retained by a small corneal hinge. Please comform this with your doctor, im almost positive, but only fools are positive and I don't want to give bad gouge.
DBDubbs-
For my pre-op exam, I called my OSO and had them fax a copy of the BUMED corrective surgury requirements straight out of the book and to my eye doctor's office. The fax was placed in my file, and when I had my pre-op for the surgury, the doc pulled out that sheet and literally went down the entire page checking things off, noting them in my file. I would recommend doing this. At your 3rd day or one week check-up, ask for a copy of your medical file and send that to your OSO. He will send that up to division medic when he sends your 30, 60, and 90 day post-ops. This is what I am doing. I figure I stand a better chance of getting my waiver approved if I send them EVERYTHING. You have to remember, they know nothing about you except for what they read, so send them as much as you can.
As a slight side-note for anyone, sometimes people say they hear all about applicants getting screwed by the military. In my honest personal opinion, if you do all of the research and you REALLY know what's going on and you take the time to dot your i's and cross your T's, you stand a much better chance of making it through without getting jerked around too much. To me, it seems as though the people who got screwed were the people who went in without a clue to begin with. Glad you all are taking the time and interest to read with me! I've learned SO MUCH from this site.
Day 3 after the surgury:
I CAN SEE. I had my day 3 post-op, my eyes are healing excellantly, and the contacts were taken out. This was a huge relief, as if you were a contact wearer, you know what it's like to keep the same pair in for 3 days straight. At that point, having the contacts in was causing more discomfort than my actual shaved eyeball. It feels GREAT to have them out. My antibiotic drops have been reduced, I don't need the pain drops (which were basically useless anyway), my steroid drops have been reduced and my eyes are feeling fine. I have a slight dry feeling in them, but nothing too shabby. My right is slightly cloudy, my left is clear. Vision in both is slightly blurred. Based on my out-dated glasses prescription and test-wearing them, I'd judge my vision to be around 20/40ish. I've turned the contrast and brightness on my monitor back up. Backlighting in the room also helps that. Outdoors is easily possible with sunglasses, and the sheets are off the windows in my room. All in all, I'd say the painfull part of this process is well behind me. This entire ordeal was NOT as bad as anticipated, and if the after-effects of this surgury are holding you back, don't let that be a factor. My vision isn't all that great, but already I feel as though the process was WELL worth it. It's actually quite thrilling - best way to describe it. I'll be checking this every day for new questions.
Your eye has several layers of 'cornea'. The outer most layer, or epithelial layer is the layer that regenerates itself over time. LASEK stands for laser assisted sub-epithelial keractectomy. In this process according to wikipedia, the outter corneal layer is removed, preserved in a chemical solution, the under-layer of cornea is reshaped with the laser, and the outer layer is replaced. I had LASEK, but my outer layer was not replaced - instead, my doctor put in a soft protective contact lense that was removed today (3 days post-op). If PRK is different from LASEK, my guess would be that a contact lense is not applied. Can anyone who has had PRK clarify this? According to my doctor, when he described LASEK to me, I said "so this is basically PRK?" and he said "Yes. It would be impossible for anyone to tell the difference". Epi-LASIK, from my understanding, is LASEK where the outer layer is not completely removed - it is retained by a small corneal hinge. Please comform this with your doctor, im almost positive, but only fools are positive and I don't want to give bad gouge.
DBDubbs-
For my pre-op exam, I called my OSO and had them fax a copy of the BUMED corrective surgury requirements straight out of the book and to my eye doctor's office. The fax was placed in my file, and when I had my pre-op for the surgury, the doc pulled out that sheet and literally went down the entire page checking things off, noting them in my file. I would recommend doing this. At your 3rd day or one week check-up, ask for a copy of your medical file and send that to your OSO. He will send that up to division medic when he sends your 30, 60, and 90 day post-ops. This is what I am doing. I figure I stand a better chance of getting my waiver approved if I send them EVERYTHING. You have to remember, they know nothing about you except for what they read, so send them as much as you can.
As a slight side-note for anyone, sometimes people say they hear all about applicants getting screwed by the military. In my honest personal opinion, if you do all of the research and you REALLY know what's going on and you take the time to dot your i's and cross your T's, you stand a much better chance of making it through without getting jerked around too much. To me, it seems as though the people who got screwed were the people who went in without a clue to begin with. Glad you all are taking the time and interest to read with me! I've learned SO MUCH from this site.
Day 3 after the surgury:
I CAN SEE. I had my day 3 post-op, my eyes are healing excellantly, and the contacts were taken out. This was a huge relief, as if you were a contact wearer, you know what it's like to keep the same pair in for 3 days straight. At that point, having the contacts in was causing more discomfort than my actual shaved eyeball. It feels GREAT to have them out. My antibiotic drops have been reduced, I don't need the pain drops (which were basically useless anyway), my steroid drops have been reduced and my eyes are feeling fine. I have a slight dry feeling in them, but nothing too shabby. My right is slightly cloudy, my left is clear. Vision in both is slightly blurred. Based on my out-dated glasses prescription and test-wearing them, I'd judge my vision to be around 20/40ish. I've turned the contrast and brightness on my monitor back up. Backlighting in the room also helps that. Outdoors is easily possible with sunglasses, and the sheets are off the windows in my room. All in all, I'd say the painfull part of this process is well behind me. This entire ordeal was NOT as bad as anticipated, and if the after-effects of this surgury are holding you back, don't let that be a factor. My vision isn't all that great, but already I feel as though the process was WELL worth it. It's actually quite thrilling - best way to describe it. I'll be checking this every day for new questions.
A contact lens is applied after surgery for PRK. At least that's the way it was done for me. I think the main difference in PRK and its variants have to do with what happens to the epithelium.
mxracer19
Hanging out in K-Vegas.
That takes care of that. Thanks for the update MettGT. I have no clue on the differences between LASEK and PRK. I just know that its 6 days post-op, I have no pain or discomfort, halos, haze or cloudiness, and I'm not sensitive to light. Sweet deal..if only my vision would improve. My guess is 20/50.
This is official hopes it helps
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PAGE 02 RUENMED2387 UNCLAS
RULYSCC/FOURTH MAW
RULSABC/USNA ANNAPOLIS MD//JJJ//
RHMFIUU/USNA ANNAPOLIS MD//JJJ//
BT
***THIS IS A 2 SECTIONED MSG COLLATED BY MDS***
UNCLAS //N13520//
MSGID/GENADMIN/MED-23//
SUBJ/LASER EYE SURGERY PRK IN NEW ACCESSIONS TO NAVY AND MARINE CORPS
/AVIATION CLINICAL STUDY CHANGE IN STUDY ENROLLMENT CRITERIA//
REF/A/GENADMIN/BUMED WASHINGTON DC/121600ZAPR2000//
REF/B/DOC/BUMEDNOTE 6410/YMD:19991014//
REF/C/GENADMIN/BUMED WASHINGTON DC/101244ZOCT2000//
REF/D/GENADMIN/SECNAV WASHINGTON DC/112050ZMAY2001//
NARR/REF A IS THE REFRACTIVE SURGERY POLICY FOR THE NAVY AND MARINE
CORPS. REF B IS THE MANUAL OF THE MEDICAL DEPARTMENT ARTICLE 15-65.
REF C IS LASER EYE SURGERY PRK IN NEW ACCESSIONS TO NAVY AND MARINE
CORPS ANNOUNCEMENT OF AVIATION CLINICAL STUDY. REF D IS AVIATION
VISION STANDARDS CHANGE TO REF B.//
POC/ANNA STALCUP/LCDR/MED-23/LOC
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POC/KEN UYESUGI/LCDR/MED-23/LOCENSACOLA FL/TEL:850-452-2257//
RMKS/1. THE PURPOSE OF THIS MESSAGE IS TO CLARIFY AND DELINEATE
PAGE 03 RUENMED2387 UNCLAS
CHANGES IN ENROLLMENT CRITERIA FOR NEW ACCESSIONS TO THE NAVY AND
MARINE CORPS AVIATION CLINICAL STUDY WHO HAVE UNDERGONE
PHOTOREFRACTIVE KERATECTOMY SURGERY (PRK). THESE CHANGES TO THE
CRITERIA THAT WERE PREVIOUSLY DEFINED IN REF C ENSURE THAT CURRENT
ENROLLMENT CRITERIA ARE CONSISTENT WITH THE NEW AVIATION VISION
STANDARDS DEFINED IN REF D. BUMED WILL CONTINUE TO STUDY AND
EVALUATE FLIGHT PERFORMANCE OF STUDENT NAVAL AVIATORS (SNA) AND
STUDENT NAVAL FLIGHT OFFICERS (SNFO) WHO HAVE UNDERGONE PRK. AT
PRESENT, HISTORY OF PRK REMAINS DISQUALIFYING FOR ALL AVIATION DUTY,
BUT A WAIVER OF STANDARDS SHALL BE CONSIDERED FOR CANDIDATES WHO
MEET STUDY ENROLLMENT CRITERIA. PRK REMAINS THE ONLY WAIVERABLE
FORM OF REFRACTIVE SURGERY FOR ALL AVIATION DUTY. WAIVERS WILL NOT
BE CONSIDERED FOR CANDIDATES WHO HAVE HAD ANY TYPE OF REFRACTIVE EYE
SURGERY OTHER THAN PRK.
2. STUDY ENROLLMENT CRITERIA FOR SNA AND SNFO CANDIDATES ARE:
INCLUSION CRITERIA (APPLIES TO BOTH SNA AND SNFO CANDIDATES UNLESS
OTHERWISE SPECIFIED):
A. MALE OR FEMALE, OF ANY RACE, WHO IS AT LEAST 18 YEARS OLD AT THE
TIME OF THE EXAMINATION.
B. APPLYING FOR AVIATION TRAINING EITHER AS A STUDENT NAVAL AVIATOR
PAGE 04 RUENMED2387 UNCLAS
(SNA) OR STUDENT NAVAL FLIGHT OFFICER (SNFO).
C. UNDERWENT PHOTOREFRACTIVE KERATECTOMY PRK AT LEAST 3 MONTHS PRIOR
TO ENROLLMENT.
D. HAD A PREOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS OR MINUS 8.00 TOTAL DIOPTERS IN ANY MERIDIAN WITH LESS
THAN OR EQUAL TO PLUS OR MINUS 3.00 DIOPTERS OF CYLINDER AND
ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS.
E. DEMONSTRATED REFRACTIVE STABILITY AS CONFIRMED BY CLINICAL
RECORDS. NEITHER THE SPHERICAL NOR THE CYLINDRICAL PORTION OF THE
REFRACTION MAY HAVE CHANGED MORE THAN 0.50 DIOPTERS DURING TWO OF
THE MOST RECENT POSTOPERATIVE EXAMINATIONS SEPARATED BY AT LEAST ONE
MONTH.
F. BEST SPECTACLE CORRECTED DISTANCE AND NEAR VISUAL ACUITY OF AT
LEAST 20/20 IN EACH EYE.
G. NORMAL COLOR VISION. FOR FALANT, MUST GET 9/9 CORRECT TO PASS.
IF FAILED ONE OR MORE, MUST REPEAT TWO SERIES OF 9 WITH 16/18
CORRECT TO PASS. FOR PIP OR ISHIHARA PLATES, TO PASS MUST GET 12/14
CORRECT ON A 16 PLATE TEST.
H. ABLE TO PROVIDE DETAILED CLINICAL RECORDS OF THE PREOPERATIVE
REFRACTIVE ERROR, OPERATIVE REPORT INCLUDING TYPE OF PROCEDURE, AND
PAGE 05 RUENMED2387 UNCLAS
AT LEAST TWO POSTOPERATIVE EYE EXAMINATIONS SEPARATED BY AT LEAST
ONE MONTH INCLUDING VISUAL ACUITY AND REFRACTION THAT DEMONSTRATE
REQUIRED REFRACTIVE STABILITY.
I. MEET ALL OTHER AVIATION APPLICANT ENTRANCE CRITERIA AS DELINEATED
IN REFS B AND D.
J. (SNA ONLY) POSTOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS 3.00 OR MINUS 1.50 DIOPTERS SPHERE IN ANY MERIDIAN,
LESS THAN OR EQUAL TO 1.00 DIOPTER TOTAL CYLINDER, AND ANISOMETROPIA
LESS THAN OR EQUAL TO 3.50 DIOPTERS.
K. (SNA ONLY) UNCORRECTED VISUAL ACUITY OF AT LEAST 20/40 EACH EYE.
L. (SNA ONLY) HETEROPHORIA OF LESS THAN OR EQUAL TO 6 PRISM DIOPTERS
ESOPHORIA, 6 PRISM DIOPTERS OF EXOPHORIA OR 1.5 PRISM DIOPTERS OF
HYPERPHORIA.
M. (SNA ONLY) NORMAL STEREOPSIS. FOR VERHOEFF, 8/8 CORRECT TO PASS.
IF FAILED ONE OR MORE, MUST REPEAT TWO SERIES OF 8 WITH 16/16
CORRECT TO PASS. FOR AFVT, A-D CORRECT TO PASS. FOR TITMUS OR
RANDOT STEREO, MUST GET TO 40 SECONDS OF ARC TO PASS.
N. (SNFO ONLY) POSTOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN
OR EQUAL TO PLUS OR MINUS 8.00 TOTAL DIOPTERS IN ANY MERIDIAN WITH
LESS THAN OR EQUAL TO PLUS OR MINUS 3.00 DIOPTERS OF CYLINDER AND
PAGE 06 RUENMED2387 UNCLAS
ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS.
O. (SNFO ONLY) NO OBVIOUS HETEROTROPIA OR SYMPTOMATIC HETEROPHORIA
(NOHOSH).
EXCLUSION CRITERIA (APPLIES TO BOTH SNA AND SNFO CANDIDATES):
A. ANY TYPE OF REFRACTIVE SURGERY OTHER THAN PRK. LASER IN-SITU
KERATOMILEUSIS (LASIK) IS SPECIFICALLY PROHIBITED.
B. CURRENT USE OF TOPICAL OPHTHALMIC STEROID DROPS.
C. VISUAL SYMPTOMS RELATED TO THE PROCEDURE.
3. AN INDIVIDUAL INTERESTED MUST SUBMIT AN APPLICATION FOR AVIATION
TRAINING THROUGH THE USUAL ESTABLISHED APPLICATION PROCESS FOR THE
CANDIDATE'S ACCESSION SOURCE AND INCLUDE A WAIVER REQUEST FOR
"HISTORY OF PHOTOREFRACTIVE KERATECTOMY (PRK)." WAIVER REQUEST MUST
INCLUDE CLEAR AND COMPLETE DOCUMENTATION OF THE ABOVE ENROLLMENT
CRITERIA.
A. CIVILIAN ACCESSION:
POTENTIAL SNA/SNFO CANDIDATE CIVILIAN APPLICANTS WHO HAVE PREVIOUSLY
UNDERGONE PRK WILL WORK WITH THEIR RECRUITER IN THE USUAL FASHION
TO DETERMINE AERONAUTICAL ACCEPTABILITY AND TO ASCERTAIN
ELIGIBILITY STATUS FOR THE STUDY. ALL OF THE NECESSARY PAPERWORK
INCLUDING THE PRK PREOPERATIVE REFRACTION, THE OPERATIVE REPORT, AND
PAGE 07 RUENMED2387 UNCLAS
THE POSTOPERATIVE FOLLOW-UP WILL BE ASSEMBLED. IF SELECTED FOR
FURTHER PROCESSING, THE CANDIDATE WILL BRING THIS PACKAGE TO THE
NAVAL AEROSPACE MEDICAL INSTITUTE (NAMI) FOR HIS/HER SCREENING
MEDICAL EXAMINATION. INVESTIGATORS AT THE DEPARTMENT OF
OPHTHALMOLOGY/OPTOMETRY AT NAMI WILL DETERMINE IF THE CANDIDATE
MEETS ACCESSION STUDY PARAMETERS, ASCERTAIN THAT HE/SHE IS OTHERWISE
MEDICALLY QUALIFIED FOR THE APPLICATION PROGRAM, AND THEN OFFER
ENROLLMENT INTO THE STUDY.
B. NROTC ACCESSIONS:
SNA/SNFO CANDIDATE NROTC APPLICANTS WILL OBTAIN APPROVAL FROM THEIR
COMMANDING OFFICER TO UNDERGO PRK AT THEIR OWN EXPENSE AT A
CIVILIAN INSTITUTION. THE NROTC UNIT WILL DETERMINE AERONAUTICAL
ACCEPTABILITY AND ASCERTAIN ELIGIBILITY STATUS FOR THE STUDY. ALL
OF THE NECESSARY PAPERWORK INCLUDING THE PRK PREOPERATIVE
REFRACTION, THE OPERATIVE REPORT, AND THE POSTOPERATIVE FOLLOW-UP
WILL BE ASSEMBLED AND FORWARDED TO NAMI CODE 42/MED-236 AS AN
ATTACHMENT TO THE PRE-COMMISSIONING AND AVIATION PROGRAM APPLICATION
PHYSICAL EXAM. IF A WAIVER OF STANDARDS FOR HISTORY OF PRK IS
RECOMMENDED AND THE CANDIDATE IS SELECTED FOR AVIATION, THE CANDIDATE
WILL BRING HIS/HER PACKAGE TO THE NAVAL AEROSPACE MEDICAL INSTITUTE
(NAMI) FOR HIS/HER SCREENING MEDICAL EXAMINATION. INVESTIGATORS AT
THE DEPARTMENT OF OPHTHALMOLOGY/OPTOMETRY AT NAMI WILL DETERMINE IF
THE CANDIDATE MEETS ACCESSION STUDY PARAMETERS, ASCERTAIN THAT
HE/SHE IS OTHERWISE MEDICALLY QUALIFIED FOR THE APPLICATION PROGRAM,
AND THEN OFFER ENROLLMENT INTO THE STUDY.
C. USNA ACCESSIONS:
SNA/SNFO CANDIDATE MIDSHIPMEN APPLICANTS WILL OBTAIN APPROVAL FROM
THE COMMANDANT TO UNDERGO PRK EITHER AT A NAVY MEDICAL CENTER OR AT
THEIR OWN EXPENSE AT A CIVILIAN INSTITUTION. THE ACADEMY WILL
DETERMINE AERONAUTICAL ACCEPTABILITY AND ASCERTAIN ELIGIBILITY
STATUS FOR THE PRK ACCESSION STUDY DURING THE PRE-AVIATION SCREENING
PROCESS. ALL OF THE NECESSARY PAPERWORK INCLUDING THE PRK
PREOPERATIVE REFRACTION, THE OPERATIVE REPORT, AND THE POSTOPERATIVE
FOLLOW-UP WILL BE ASSEMBLED. STUDY INVESTIGATORS WILL DETERMINE IF
THE CANDIDATE MEETS ACCESSION STUDY PARAMETERS, ASCERTAIN THAT
PAGE 03 RUENMED2388 UNCLAS
HE/SHE IS OTHERWISE MEDICALLY QUALIFIED FOR THE APPLICATION PROGRAM,
AND THEN OFFER ENROLLMENT INTO THE STUDY.
D. ACTIVE DUTY ACCESSIONS:
SNA/SNFO CANDIDATE ACTIVE DUTY PERSONNEL WILL OBTAIN APPROVAL FROM
THEIR COMMANDING OFFICER TO UNDERGO PRK VIA ESTABLISHED GUIDELINES.
THEY WILL APPLY FOR AVIATION TRAINING AND OR REDESIGNATION IN
ACCORDANCE WITH NAVY REGULATIONS. ALL OF THE NECESSARY PAPERWORK
INCLUDING THE PRK PREOPERATIVE REFRACTION, THE OPERATIVE REPORT, AND
THE POSTOPERATIVE FOLLOW-UP WILL BE ASSEMBLED. STUDY INVESTIGATORS
WILL DETERMINE IF THE CANDIDATE MEETS ACCESSION STUDY PARAMETERS,
ASCERTAIN THAT HE/SHE IS OTHERWISE MEDICALLY QUALIFIED FOR THE
APPLICATION PROGRAM, AND THEN OFFER ENROLLMENT INTO THE STUDY.
4. MEETING ALL ENROLLMENT CRITERIA DOES NOT GUARANTEE
ENROLLMENT INTO THE STUDY, NOR ACCEPTANCE INTO NAVAL AVIATION
TRAINING. ENROLLMENT INTO THE STUDY AND ACCEPTANCE INTO AVIATION
TRAINING DOES NOT GUARANTEE COMPLETION OF TRAINING NOR
DESIGNATION AS A NAVAL AVIATOR OR NAVAL FLIGHT OFFICER.//
BT
#2387
NNNN
RTD:000-000/COPIES:
Section 1: PSN 981607J31
Section 2: PSN 981610J25
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PAGE 02 RUENMED2387 UNCLAS
RULYSCC/FOURTH MAW
RULSABC/USNA ANNAPOLIS MD//JJJ//
RHMFIUU/USNA ANNAPOLIS MD//JJJ//
BT
***THIS IS A 2 SECTIONED MSG COLLATED BY MDS***
UNCLAS //N13520//
MSGID/GENADMIN/MED-23//
SUBJ/LASER EYE SURGERY PRK IN NEW ACCESSIONS TO NAVY AND MARINE CORPS
/AVIATION CLINICAL STUDY CHANGE IN STUDY ENROLLMENT CRITERIA//
REF/A/GENADMIN/BUMED WASHINGTON DC/121600ZAPR2000//
REF/B/DOC/BUMEDNOTE 6410/YMD:19991014//
REF/C/GENADMIN/BUMED WASHINGTON DC/101244ZOCT2000//
REF/D/GENADMIN/SECNAV WASHINGTON DC/112050ZMAY2001//
NARR/REF A IS THE REFRACTIVE SURGERY POLICY FOR THE NAVY AND MARINE
CORPS. REF B IS THE MANUAL OF THE MEDICAL DEPARTMENT ARTICLE 15-65.
REF C IS LASER EYE SURGERY PRK IN NEW ACCESSIONS TO NAVY AND MARINE
CORPS ANNOUNCEMENT OF AVIATION CLINICAL STUDY. REF D IS AVIATION
VISION STANDARDS CHANGE TO REF B.//
POC/ANNA STALCUP/LCDR/MED-23/LOC
ENSACOLA FL/TEL:850-452-2257//POC/KEN UYESUGI/LCDR/MED-23/LOC
ENSACOLA FL/TEL:850-452-2257//RMKS/1. THE PURPOSE OF THIS MESSAGE IS TO CLARIFY AND DELINEATE
PAGE 03 RUENMED2387 UNCLAS
CHANGES IN ENROLLMENT CRITERIA FOR NEW ACCESSIONS TO THE NAVY AND
MARINE CORPS AVIATION CLINICAL STUDY WHO HAVE UNDERGONE
PHOTOREFRACTIVE KERATECTOMY SURGERY (PRK). THESE CHANGES TO THE
CRITERIA THAT WERE PREVIOUSLY DEFINED IN REF C ENSURE THAT CURRENT
ENROLLMENT CRITERIA ARE CONSISTENT WITH THE NEW AVIATION VISION
STANDARDS DEFINED IN REF D. BUMED WILL CONTINUE TO STUDY AND
EVALUATE FLIGHT PERFORMANCE OF STUDENT NAVAL AVIATORS (SNA) AND
STUDENT NAVAL FLIGHT OFFICERS (SNFO) WHO HAVE UNDERGONE PRK. AT
PRESENT, HISTORY OF PRK REMAINS DISQUALIFYING FOR ALL AVIATION DUTY,
BUT A WAIVER OF STANDARDS SHALL BE CONSIDERED FOR CANDIDATES WHO
MEET STUDY ENROLLMENT CRITERIA. PRK REMAINS THE ONLY WAIVERABLE
FORM OF REFRACTIVE SURGERY FOR ALL AVIATION DUTY. WAIVERS WILL NOT
BE CONSIDERED FOR CANDIDATES WHO HAVE HAD ANY TYPE OF REFRACTIVE EYE
SURGERY OTHER THAN PRK.
2. STUDY ENROLLMENT CRITERIA FOR SNA AND SNFO CANDIDATES ARE:
INCLUSION CRITERIA (APPLIES TO BOTH SNA AND SNFO CANDIDATES UNLESS
OTHERWISE SPECIFIED):
A. MALE OR FEMALE, OF ANY RACE, WHO IS AT LEAST 18 YEARS OLD AT THE
TIME OF THE EXAMINATION.
B. APPLYING FOR AVIATION TRAINING EITHER AS A STUDENT NAVAL AVIATOR
PAGE 04 RUENMED2387 UNCLAS
(SNA) OR STUDENT NAVAL FLIGHT OFFICER (SNFO).
C. UNDERWENT PHOTOREFRACTIVE KERATECTOMY PRK AT LEAST 3 MONTHS PRIOR
TO ENROLLMENT.
D. HAD A PREOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS OR MINUS 8.00 TOTAL DIOPTERS IN ANY MERIDIAN WITH LESS
THAN OR EQUAL TO PLUS OR MINUS 3.00 DIOPTERS OF CYLINDER AND
ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS.
E. DEMONSTRATED REFRACTIVE STABILITY AS CONFIRMED BY CLINICAL
RECORDS. NEITHER THE SPHERICAL NOR THE CYLINDRICAL PORTION OF THE
REFRACTION MAY HAVE CHANGED MORE THAN 0.50 DIOPTERS DURING TWO OF
THE MOST RECENT POSTOPERATIVE EXAMINATIONS SEPARATED BY AT LEAST ONE
MONTH.
F. BEST SPECTACLE CORRECTED DISTANCE AND NEAR VISUAL ACUITY OF AT
LEAST 20/20 IN EACH EYE.
G. NORMAL COLOR VISION. FOR FALANT, MUST GET 9/9 CORRECT TO PASS.
IF FAILED ONE OR MORE, MUST REPEAT TWO SERIES OF 9 WITH 16/18
CORRECT TO PASS. FOR PIP OR ISHIHARA PLATES, TO PASS MUST GET 12/14
CORRECT ON A 16 PLATE TEST.
H. ABLE TO PROVIDE DETAILED CLINICAL RECORDS OF THE PREOPERATIVE
REFRACTIVE ERROR, OPERATIVE REPORT INCLUDING TYPE OF PROCEDURE, AND
PAGE 05 RUENMED2387 UNCLAS
AT LEAST TWO POSTOPERATIVE EYE EXAMINATIONS SEPARATED BY AT LEAST
ONE MONTH INCLUDING VISUAL ACUITY AND REFRACTION THAT DEMONSTRATE
REQUIRED REFRACTIVE STABILITY.
I. MEET ALL OTHER AVIATION APPLICANT ENTRANCE CRITERIA AS DELINEATED
IN REFS B AND D.
J. (SNA ONLY) POSTOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS 3.00 OR MINUS 1.50 DIOPTERS SPHERE IN ANY MERIDIAN,
LESS THAN OR EQUAL TO 1.00 DIOPTER TOTAL CYLINDER, AND ANISOMETROPIA
LESS THAN OR EQUAL TO 3.50 DIOPTERS.
K. (SNA ONLY) UNCORRECTED VISUAL ACUITY OF AT LEAST 20/40 EACH EYE.
L. (SNA ONLY) HETEROPHORIA OF LESS THAN OR EQUAL TO 6 PRISM DIOPTERS
ESOPHORIA, 6 PRISM DIOPTERS OF EXOPHORIA OR 1.5 PRISM DIOPTERS OF
HYPERPHORIA.
M. (SNA ONLY) NORMAL STEREOPSIS. FOR VERHOEFF, 8/8 CORRECT TO PASS.
IF FAILED ONE OR MORE, MUST REPEAT TWO SERIES OF 8 WITH 16/16
CORRECT TO PASS. FOR AFVT, A-D CORRECT TO PASS. FOR TITMUS OR
RANDOT STEREO, MUST GET TO 40 SECONDS OF ARC TO PASS.
N. (SNFO ONLY) POSTOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN
OR EQUAL TO PLUS OR MINUS 8.00 TOTAL DIOPTERS IN ANY MERIDIAN WITH
LESS THAN OR EQUAL TO PLUS OR MINUS 3.00 DIOPTERS OF CYLINDER AND
PAGE 06 RUENMED2387 UNCLAS
ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS.
O. (SNFO ONLY) NO OBVIOUS HETEROTROPIA OR SYMPTOMATIC HETEROPHORIA
(NOHOSH).
EXCLUSION CRITERIA (APPLIES TO BOTH SNA AND SNFO CANDIDATES):
A. ANY TYPE OF REFRACTIVE SURGERY OTHER THAN PRK. LASER IN-SITU
KERATOMILEUSIS (LASIK) IS SPECIFICALLY PROHIBITED.
B. CURRENT USE OF TOPICAL OPHTHALMIC STEROID DROPS.
C. VISUAL SYMPTOMS RELATED TO THE PROCEDURE.
3. AN INDIVIDUAL INTERESTED MUST SUBMIT AN APPLICATION FOR AVIATION
TRAINING THROUGH THE USUAL ESTABLISHED APPLICATION PROCESS FOR THE
CANDIDATE'S ACCESSION SOURCE AND INCLUDE A WAIVER REQUEST FOR
"HISTORY OF PHOTOREFRACTIVE KERATECTOMY (PRK)." WAIVER REQUEST MUST
INCLUDE CLEAR AND COMPLETE DOCUMENTATION OF THE ABOVE ENROLLMENT
CRITERIA.
A. CIVILIAN ACCESSION:
POTENTIAL SNA/SNFO CANDIDATE CIVILIAN APPLICANTS WHO HAVE PREVIOUSLY
UNDERGONE PRK WILL WORK WITH THEIR RECRUITER IN THE USUAL FASHION
TO DETERMINE AERONAUTICAL ACCEPTABILITY AND TO ASCERTAIN
ELIGIBILITY STATUS FOR THE STUDY. ALL OF THE NECESSARY PAPERWORK
INCLUDING THE PRK PREOPERATIVE REFRACTION, THE OPERATIVE REPORT, AND
PAGE 07 RUENMED2387 UNCLAS
THE POSTOPERATIVE FOLLOW-UP WILL BE ASSEMBLED. IF SELECTED FOR
FURTHER PROCESSING, THE CANDIDATE WILL BRING THIS PACKAGE TO THE
NAVAL AEROSPACE MEDICAL INSTITUTE (NAMI) FOR HIS/HER SCREENING
MEDICAL EXAMINATION. INVESTIGATORS AT THE DEPARTMENT OF
OPHTHALMOLOGY/OPTOMETRY AT NAMI WILL DETERMINE IF THE CANDIDATE
MEETS ACCESSION STUDY PARAMETERS, ASCERTAIN THAT HE/SHE IS OTHERWISE
MEDICALLY QUALIFIED FOR THE APPLICATION PROGRAM, AND THEN OFFER
ENROLLMENT INTO THE STUDY.
B. NROTC ACCESSIONS:
SNA/SNFO CANDIDATE NROTC APPLICANTS WILL OBTAIN APPROVAL FROM THEIR
COMMANDING OFFICER TO UNDERGO PRK AT THEIR OWN EXPENSE AT A
CIVILIAN INSTITUTION. THE NROTC UNIT WILL DETERMINE AERONAUTICAL
ACCEPTABILITY AND ASCERTAIN ELIGIBILITY STATUS FOR THE STUDY. ALL
OF THE NECESSARY PAPERWORK INCLUDING THE PRK PREOPERATIVE
REFRACTION, THE OPERATIVE REPORT, AND THE POSTOPERATIVE FOLLOW-UP
WILL BE ASSEMBLED AND FORWARDED TO NAMI CODE 42/MED-236 AS AN
ATTACHMENT TO THE PRE-COMMISSIONING AND AVIATION PROGRAM APPLICATION
PHYSICAL EXAM. IF A WAIVER OF STANDARDS FOR HISTORY OF PRK IS
RECOMMENDED AND THE CANDIDATE IS SELECTED FOR AVIATION, THE CANDIDATE
WILL BRING HIS/HER PACKAGE TO THE NAVAL AEROSPACE MEDICAL INSTITUTE
(NAMI) FOR HIS/HER SCREENING MEDICAL EXAMINATION. INVESTIGATORS AT
THE DEPARTMENT OF OPHTHALMOLOGY/OPTOMETRY AT NAMI WILL DETERMINE IF
THE CANDIDATE MEETS ACCESSION STUDY PARAMETERS, ASCERTAIN THAT
HE/SHE IS OTHERWISE MEDICALLY QUALIFIED FOR THE APPLICATION PROGRAM,
AND THEN OFFER ENROLLMENT INTO THE STUDY.
C. USNA ACCESSIONS:
SNA/SNFO CANDIDATE MIDSHIPMEN APPLICANTS WILL OBTAIN APPROVAL FROM
THE COMMANDANT TO UNDERGO PRK EITHER AT A NAVY MEDICAL CENTER OR AT
THEIR OWN EXPENSE AT A CIVILIAN INSTITUTION. THE ACADEMY WILL
DETERMINE AERONAUTICAL ACCEPTABILITY AND ASCERTAIN ELIGIBILITY
STATUS FOR THE PRK ACCESSION STUDY DURING THE PRE-AVIATION SCREENING
PROCESS. ALL OF THE NECESSARY PAPERWORK INCLUDING THE PRK
PREOPERATIVE REFRACTION, THE OPERATIVE REPORT, AND THE POSTOPERATIVE
FOLLOW-UP WILL BE ASSEMBLED. STUDY INVESTIGATORS WILL DETERMINE IF
THE CANDIDATE MEETS ACCESSION STUDY PARAMETERS, ASCERTAIN THAT
PAGE 03 RUENMED2388 UNCLAS
HE/SHE IS OTHERWISE MEDICALLY QUALIFIED FOR THE APPLICATION PROGRAM,
AND THEN OFFER ENROLLMENT INTO THE STUDY.
D. ACTIVE DUTY ACCESSIONS:
SNA/SNFO CANDIDATE ACTIVE DUTY PERSONNEL WILL OBTAIN APPROVAL FROM
THEIR COMMANDING OFFICER TO UNDERGO PRK VIA ESTABLISHED GUIDELINES.
THEY WILL APPLY FOR AVIATION TRAINING AND OR REDESIGNATION IN
ACCORDANCE WITH NAVY REGULATIONS. ALL OF THE NECESSARY PAPERWORK
INCLUDING THE PRK PREOPERATIVE REFRACTION, THE OPERATIVE REPORT, AND
THE POSTOPERATIVE FOLLOW-UP WILL BE ASSEMBLED. STUDY INVESTIGATORS
WILL DETERMINE IF THE CANDIDATE MEETS ACCESSION STUDY PARAMETERS,
ASCERTAIN THAT HE/SHE IS OTHERWISE MEDICALLY QUALIFIED FOR THE
APPLICATION PROGRAM, AND THEN OFFER ENROLLMENT INTO THE STUDY.
4. MEETING ALL ENROLLMENT CRITERIA DOES NOT GUARANTEE
ENROLLMENT INTO THE STUDY, NOR ACCEPTANCE INTO NAVAL AVIATION
TRAINING. ENROLLMENT INTO THE STUDY AND ACCEPTANCE INTO AVIATION
TRAINING DOES NOT GUARANTEE COMPLETION OF TRAINING NOR
DESIGNATION AS A NAVAL AVIATOR OR NAVAL FLIGHT OFFICER.//
BT
#2387
NNNN
RTD:000-000/COPIES:
Section 1: PSN 981607J31
Section 2: PSN 981610J25
MasterBates
Well-Known Member
WVUBetaHornet
Sweep the leg..
Nor are you the last...
Search IS your friend. :magnify_1
Cheers boys it's drinking time. :icon_zbee
Search IS your friend. :magnify_1
Cheers boys it's drinking time. :icon_zbee
mxracer19
Hanging out in K-Vegas.
ALRIGHT guys...I had my 10 day post-optoday and thought ahead to ask the question that so many people have wondered about. The difference between PRK, LASEK, and Epi-LASEK is in the surface (corneal epithelium) removal technique. One uses a brush, one uses a chemical solution, and one uses a microkeratome. All remove the outer layer. I had LASEK, and he used a microkeratome.
Post Surgury plus 10 days
Right eye - 20/30
Left eye - 20/30
Both eyes together - near 20/20 (sub 20/30)
Keeping your eyes moist helps greatly in comfort and visual aquity. I was "prescribed" vitamin C to aid in the healing process and prevent haze, with a step reduction pattern of steroidal eye drops to taper off 4 weeks post-op. My next post-op is also my 30-day post-op.
-Matt
Post Surgury plus 10 days
Right eye - 20/30
Left eye - 20/30
Both eyes together - near 20/20 (sub 20/30)
Keeping your eyes moist helps greatly in comfort and visual aquity. I was "prescribed" vitamin C to aid in the healing process and prevent haze, with a step reduction pattern of steroidal eye drops to taper off 4 weeks post-op. My next post-op is also my 30-day post-op.
-Matt
Hmmm...I thought just regular PRK did not remove the epithelium at all, which was why the Navy wanted it. I thought it just did the laser burns on the surface...I guess I was incorrect.
Congrats on your progess! That's awesome news. What was your vision before you went in? (20/?)
Congrats on your progess! That's awesome news. What was your vision before you went in? (20/?)
mxracer19
Hanging out in K-Vegas.
ryanber
I did forget the laser process of removal. I'm pretty sure all forms of laser eye correction remove the corneal epithelium as the goal is to alter the shape of the corneal stroma underneath. While the epithelium heals and replaces itself, the stroma has limited regeneracy, which is the reason why your vision does not generally change after surgury. The only common laser surgury I know of where the epithelium is not removed is LASIK...in that case a flap is made. I think the Navy wants the epithelium removed because a brand new solid layer is formed...whereas with LASIK, the flap heals back to the eye and you have stratification of layers (think avalanche slope).
My vision was:
L: 20/50
R:20/60
or -1.25, -1.50
Thanks for the congrats!
-Matt
I did forget the laser process of removal. I'm pretty sure all forms of laser eye correction remove the corneal epithelium as the goal is to alter the shape of the corneal stroma underneath. While the epithelium heals and replaces itself, the stroma has limited regeneracy, which is the reason why your vision does not generally change after surgury. The only common laser surgury I know of where the epithelium is not removed is LASIK...in that case a flap is made. I think the Navy wants the epithelium removed because a brand new solid layer is formed...whereas with LASIK, the flap heals back to the eye and you have stratification of layers (think avalanche slope).
My vision was:
L: 20/50
R:20/60
or -1.25, -1.50
Thanks for the congrats!
-Matt