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Optometry help. Clusterf*ck at flight physical


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Hello there,

Newb here at the forum. First time posting, though I've been lurking for the last year. This Forum has been a lifesaver when I needed answers and I could read other applicant's experiences, so thank you all so far. 

I am a WOFT applicant. Street to seat, with college, my own business, ppl almost done, 30yo and hoping to make the JAN board (or so I was until yesterday). Went to get my flight physical yesterday at Ft Hood and it was a cluster f**k.

For starters my recruiter bailed last minute. He was on leave but the arrangement was for him to meet me at the clinic. The day before I call to confirm and he was like "well about that..." long story short, he has to babysit because his wife wanted to go shopping with her sister (what in the f**k) and did not find anyone from recruiting command to drive me there or even meet me. (It sucked balls to drive 1.5h back to Austin with my eyes nuked, on my own. Not happy. No longer working with him)

At Ft Hood, as soon as I walked for my check in, the flight nurse chewed my ass for being alone. Pretty much every clinic questioned why I did not have a recruiter with me and the bedside manner was just not there.

It all was going fine though, until I go to optometry. My prescription has not changed in a couple years. I got -2.00 and -1.50. What screwed me is that somehow in vissual accuity I got 20/80 which I have never gotten before in my life. (Usually 20/40 or 20/50 at most). So right then and there they told me oh well too bad, your eyes are non waiverable, get lasik, go home and come back in a few months. 

The flight nurse was super rude again. Didn't let me finish the rest of the physical and, though, I was nothing but polite she was flippant again, etc. I guess I better get used to it.

Anyway, I guess the good thing is my flight physical wasn't submitted, so my recruiters command (who didn't know recruiter just bailed and now will take care of my packet) is suggesting we go to a different post try again and bring all the documentation I have from previous eye exams and I'm planning on getting one Monday or Tuesday and make sure I am good to go and under 20/70. 

In the case I did get something over 20/70 what are the options if any besides lasik or prk? It seems ridiculous that so little diopter would make me so blind, I always have read way more lines than just the first few letters lol

Has anyone dealt with something similar?

Thanks in advance!

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2 hours ago, Thedude said:

There are no options. The standard is 20/50 or better corrected to 20/20. If you don't meet that you are disqualified. From the Army's perspective there was no reason to continue on with your physical at that point because you would not qualify regardless of everything else being perfect. 

I am aware people put ETPs for this and more. I know pilots with childhood seizures who have gotten ETPs for that. People in physical therapy with ETPs, etc. That was not helpful. I am asking for advice from people who have put ETPs for 20/70 or more.

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1 hour ago, Influke said:

You can complain about it or make it so they have no option but to complete it man. The Army is a bad business, make it impossible for them to deny you. Welcome to the military if you aren’t prior service!

Thank you! That's what I got from other pilots. Honestly I needed a recruiter there to push the issue.. at a serious disadvantage against a witchy nurse.... interested to hear from other people's with ETPs for vision though if there are any in this forum 😕

 

Btw... IT'S MA'AM 

2q6wih.jpg

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So 3 things.

1. Yeah I understand the vision standards  Doesn't mean I can't get an ETP or submit one.

2. I'm a chick with good sense of humor. Not a tranny. In case someone thought so from my joke.

3. Folks, I guess you've never worn glasses. I can drive without mine. It is a mild prescription. The 20/80 was not accurate and does not match any prior records. Yet when I questioned it, I wasn't offered a retake or anything. Also, does not match the prescription they confirm I have. I can't have a mild prescription but at the same time be blind as a bat. I got chewed and blasted the whole time for not having a recruiter with me.. The day before Christmas Eve. These people wanted to go home. The nurse admitted I was her only part 2 and was canceling my appointment!

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31 minutes ago, inquisitor90 said:

I am aware people put ETPs for this and more. I know pilots with childhood seizures who have gotten ETPs for that. People in physical therapy with ETPs, etc. That was not helpful. I am asking for advice from people who have put ETPs for 20/70 or more.

I have never seen an ETP for vision below the required standard. For other vision defects, yes, below 20/50, no. I was in the same boat as you back in the day and failed my first physical for 20/70 vision and was disqualified until after I had PRK (LASIK wasn't an option then). Like you I could drive and see well enough to get by in daily life without my glasses on. 

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51 minutes ago, inquisitor90 said:

Thank you! That's what I got from other pilots. Honestly I needed a recruiter there to push the issue.. at a serious disadvantage against a witchy nurse.... interested to hear from other people's with ETPs for vision though if there are any in this forum 😕

 

Btw... IT'S MA'AM 

2q6wih.jpg

Lmao sorry, happy holidays! Hope you get a new**** square away recruiter!

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23 minutes ago, Thedude said:

I have never seen an ETP for vision below the required standard. For other vision defects, yes, below 20/50, no. I was in the same boat as you back in the day and failed my first physical for 20/70 vision and was disqualified until after I had PRK (LASIK wasn't an option then). Like you I could drive and see well enough to get by in daily life without my glasses on. 

Well guess things have changed since because they told me 20/70 is waiverable ¯\_(ツ)_/¯

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3 minutes ago, inquisitor90 said:

Well guess things have changed because they told me 20/70 is waiverable ¯\_(ツ)_/¯. 

I always hear about $250 per eye lasik on the radio. I really got PRK from the military and it’s definitely worth it. If you don’t want to go that route and there isn’t any ETPs rn then maybe you should wait it out? But if not definitely get the surgery!

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5 minutes ago, Influke said:

I always hear about $250 per eye lasik on the radio. I really got PRK from the military and it’s definitely worth it. If you don’t want to go that route and there isn’t any ETPs rn then maybe you should wait it out? But if not definitely get the surgery!

Also if you truly are invested, look for options far far far away from fort hood. 

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10 minutes ago, Influke said:

Also if you truly are invested, look for options far far far away from fort hood. 

Thank you. Yes, I went to FT hood because I knew I would probably need a cockpit test being right at the minimum height so I thought, well they will probably do it there so may as well do it there...  I am going next to Ft. Sam Houston (San Antonio), where the commander of my recruiter station wanted me to go initially...

Getting a lasik evaluation on Tuesday to get some real numbers just in case and if my visual accuity is 20/70 or below i will have supporting documentation from another doctor... unfortunately it is more like 2k per eye.. total of 4k... starts at 250 if you really actually don't even need it haha.

I honestly am terrified of doctors and surgeries. I am a healthy individual but Murphys Law loves me. I'd be the 1% chance of getting their eyes blasted forever and then not be able to fly at all lol. So... if I can avoid the surgery, I will. If I can't, I may have to get it... but I will exhaust all my other options first.

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43 minutes ago, Influke said:

I always hear about $250 per eye lasik on the radio. I really got PRK from the military and it’s definitely worth it. If you don’t want to go that route and there isn’t any ETPs rn then maybe you should wait it out? But if not definitely get the surgery!

Btw would love to hear your experience with PRK, healing process, etc. I would probably prefer PRK than Lasik from what I've read.

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It sucks what happened but getting through and not giving up from these hurdles really show that you want to be a pilot. 

Submit an ICE complaint about the clinic/nurse. 

A friend of mine was disqualified for visual acuity. Came back with prk and he was all good. My vision was way worse than his so I didn't even try. So I got LASIK. Flight physical was approved with ETP related to pre-operation visual acuity and post-op eye related problem. 

Also, submitting an ETP is the flight surgeons discretion. Some will flat out say no while some will try and submit it. They know what's most likely will get approved and what's actually a waste of time. 

When was your last vision test? How recent is it? 

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1 hour ago, inquisitor90 said:

Btw would love to hear your experience with PRK, healing process, etc. I would probably prefer PRK than Lasik from what I've read.

Overall the experience was not that bad. They say PRK hurts more than lasik simply because it’s like a burn on your eyes rather than a cut(lasik). You are awake the entire time and it takes maybe 30 seconds per eye. You instantly have 20/20 vision afterwards. They give you heavy duty pain meds and generally it takes about two weeks for all pain to subside. Dry eyes & etc will persist for about 2-3 months. (They give you handy eye drops) You will be light sensitive for 6+ months. Personally I still have a huge amount of astigmatism from the surgery that never went away, but consistently get around 20/15-20/10 on eye exams. 
 

you win some you lose some I guess 

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1 hour ago, inquisitor90 said:

Btw would love to hear your experience with PRK, healing process, etc. I would probably prefer PRK than Lasik from what I've read.

Worst part of PRK is smelling your own eyeball burning when they do it. For a couple weeks it felt like there was sand in my eyes and they were itchy, uncomfortable without eye drops and very sensitive to bright light. Sixteen years later and my vision is still 20/15 with no problems. 

 

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1 hour ago, inquisitor90 said:

Well guess things have changed since because they told me 20/70 is waiverable ¯\_(ツ)_/¯

I would ask for a source in writing for that. The most current regulation I am aware of covering this is AR 40-501 published 27 June 2019.

 

4–5. Vision Conditions that do not meet the standards of medical fitness for flying duty Classes 1, 2, 2F, 2P, 3, and 4 are the following:

a. Class 1. Any disqualifying condition must be referred to optometry or ophthalmology for verification.
(1) Uncorrected distant visual acuity worse than 20/50 in either eye. Each eye must be correctable to 20/20 with no more than one error per five presentations of 20/20 letters, in any combination, on either the Armed Forces vision tester (AFVT) or any projected Snellen chart set at 20 feet.

(2) Uncorrected near visual acuity worse than 20/20 in each eye; with no more than one error per five presentations of 20/20 letters, in any combination, on the AFVT or any Snellen near visual acuity card.

(3) Cycloplegic refractive error using the method in aeromedical technical bulletins under cycloplegic refraction.
(a) Hyperopia greater than +3.00 diopters of sphere in any meridian by transposition in either eye. (Spherical equivalent method does not apply.)
(b) Myopia greater than -1.50 diopters of sphere in any meridian by transposition in either eye. (Spherical equivalent method does not apply.)
(c) Astigmatism greater than +/-1.00 diopter of cylinder in either eye.

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The section covering PRK/LASIK requirements:

(6) Corneal refractive surgery is generally acceptable for aviation duties, but cases must be reviewed for final approval. PRK, LASIK, and LASEK are approved corneal refractive surgery procedures. Implantable collamer lens (ICL) is disqualifying and not waived for Class 1 or Class 2 (pilots). ICLs will be considered on a case by case basis for Class 2F, 2P, 3, and 4, and all cases will require a waiver. Corneal refractive surgery is disqualifying if any of the following conditions are met:
(a) Pre-surgical refractive error in either eye exceeds a spherical equivalent of -6 diopters or +4 diopters. Waivers are considered up to -8 diopters to +4 diopters spherical equivalent.
(b) Pre-surgical astigmatism (cylinder) exceeds +3.00 or -3.00 diopters. Any astigmatism greater than this is not waiverable.
(c) A recovery period of at least 3 months for initial applicants already in the military or 6 weeks for current aviation personnel has not occurred from the date of the last refractive surgery or augmenting procedure. New accessions to the military must have at least 180 days recovery period from the last refractive surgery or augmenting proceed and accession medical examination.
(d) There have been complications and/or medication or ophthalmic solutions or any other therapeutic interventions such as sunglasses, are required.
(e) Post-surgical refraction in each eye is not stable as demonstrated by at least 2 separate refractions at least 1 month apart. New accessions must wait at least 90 days post procedure to complete the initial refraction. The most recent refraction demonstrates more than +/- 0.50 diopters difference for spherical vision and/or more than +/- 0.50 diopters for cylinder vision.
(f) Slit lamp examination shows residual haze.
(g) Low contrast sensitivity testing exceeds 20/60 in either eye. 

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13 minutes ago, Thedude said:

The section covering PRK/LASIK requirements:

(6) Corneal refractive surgery is generally acceptable for aviation duties, but cases must be reviewed for final approval. PRK, LASIK, and LASEK are approved corneal refractive surgery procedures. Implantable collamer lens (ICL) is disqualifying and not waived for Class 1 or Class 2 (pilots). ICLs will be considered on a case by case basis for Class 2F, 2P, 3, and 4, and all cases will require a waiver. Corneal refractive surgery is disqualifying if any of the following conditions are met:
(a) Pre-surgical refractive error in either eye exceeds a spherical equivalent of -6 diopters or +4 diopters. Waivers are considered up to -8 diopters to +4 diopters spherical equivalent.
(b) Pre-surgical astigmatism (cylinder) exceeds +3.00 or -3.00 diopters. Any astigmatism greater than this is not waiverable.
(c) A recovery period of at least 3 months for initial applicants already in the military or 6 weeks for current aviation personnel has not occurred from the date of the last refractive surgery or augmenting procedure. New accessions to the military must have at least 180 days recovery period from the last refractive surgery or augmenting proceed and accession medical examination.
(d) There have been complications and/or medication or ophthalmic solutions or any other therapeutic interventions such as sunglasses, are required.
(e) Post-surgical refraction in each eye is not stable as demonstrated by at least 2 separate refractions at least 1 month apart. New accessions must wait at least 90 days post procedure to complete the initial refraction. The most recent refraction demonstrates more than +/- 0.50 diopters difference for spherical vision and/or more than +/- 0.50 diopters for cylinder vision.
(f) Slit lamp examination shows residual haze.
(g) Low contrast sensitivity testing exceeds 20/60 in either eye. 

Not saying you are wrong. I will try to find the actual Reg. But the optometrist pulled the reg and table in front of me and showed me up to 20/70 waiverable. Standard is to 20/50

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35 minutes ago, NineLingBling said:

It sucks what happened but getting through and not giving up from these hurdles really show that you want to be a pilot. 

Submit an ICE complaint about the clinic/nurse. 

A friend of mine was disqualified for visual acuity. Came back with prk and he was all good. My vision was way worse than his so I didn't even try. So I got LASIK. Flight physical was approved with ETP related to pre-operation visual acuity and post-op eye related problem. 

Also, submitting an ETP is the flight surgeons discretion. Some will flat out say no while some will try and submit it. They know what's most likely will get approved and what's actually a waste of time. 

When was your last vision test? How recent is it? 

About 10 months ago but they confirmed prescription there. So... if my prescription hasn't changed my visual accuity cannot have changed because I can see the exact same with my glasses as I did my last eye exam. I also passed my FAA first class physical back in May. Went to get records today but uncorrected visual accuity is not noted (picture below). Worst case I could go and get another one and make sure they notated this time and at least I would have something signed by an AME (aviation medical examiner) displaying my visual accuity.

And yeah! Been fighting all year to become a pilot and get my training through covid, etc. Most of all I want to be a pilot in the army. Not interested in commercial. I am down to bang and be in the mission. Maybe in Ft Sam Houston they will be nicer... we will see what my eye exam this coming Tuesday says.

20201224_171831.thumb.jpg.264c3c4fac63ecb9744e33cb8daba7ab.jpg

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9 hours ago, Thedude said:

There are no options. The standard is 20/50 or better corrected to 20/20. If you don't meet that you are disqualified. From the Army's perspective there was no reason to continue on with your physical at that point because you would not qualify regardless of everything else being perfect. 

I got a waiver for 20/70.  

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