Eyeworld

47 EW FEATURE July 2016 • Refractive surgery in military personnel and first responders Contact information Caldwell: matthew.c.caldwell.mil@mail.mil Stolldorf: hunter.s.stolldorf.mil@mail.mil meet standard, conservative corne- al/medical criteria, such as normal topography scans along with a stable refraction, Dr. Stolldorf said. A per- son also needs to have greater than 1 year on his or her contract with the Navy, he added. "We want to prioritize the surgery for sailors and marines who will use the surgery to perform better in harm's way while in uniform," he said. Dr. Stolldorf added that the Navy performs LASIK and PRK on about 10,000 to 15,000 eyes annually. Are pilots allowed to undergo refractive surgery? Pilots and other aviators are au- thorized to undergo both PRK and LASIK. However, Dr. Caldwell said, they lose their flying status at the time of surgery and then have to undergo a thorough waiver process to demonstrate that their vision is adequate prior to their return to fly- ing. "There are specific requirements regarding where pilots can have sur- gery, what exactly can be done, and who can do it," he said. "They also have specific requirements in their pre- and postoperative evaluations, such as 5% low contrast testing." It is very important that aviators are treated at Department of Defense facilities familiar with these require- ments, he added. Additional information Dr. Caldwell said that except for a small community of closely mon- itored aviators, contact lenses are strictly forbidden in the deployed setting due to the very significant risk of corneal infections. "A patient with a –8 D refractive error wearing glasses or special lens inserts will have a hard time using essential equipment like gas masks/chemical gear, night vision goggles, heads up displays, and even the blast suites that the explosive ordinance dis- posal people have to wear," he said. "When these people lose their glass- es after an explosion or fire fight, they are immediately incapacitated, essentially blind without glasses." Not only are their own lives at risk, Dr. Caldwell said, but they become a liability to the team that now has to make sure they get to safety. "In cases like this, having had refractive surgery can be the differ- ence between life and death," he said. Refractive surgery can literally be a life-saving surgery, and this is clearly a big deal to our patients, he said. EW Editors' note: Drs. Caldwell and Stolldorf have no financial interests related to their comments.

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