- The Washington Times - Tuesday, January 16, 2001

The military has a new vision for aviators that promises to make a dent in prolonged pilot shortages.
The Navy and Air Force have opened their eyes to a procedure that has been around for a decade corrective laser surgery. Both services have begun allowing a limited number of students and aviators to undergo photorefractive keratectomy (PRK) in hopes it will extend some pilots careers and alleviate the awkwardness of wearing glasses while performing in-flight tasks.
"As refractive surgery becomes mainstream, more and more individuals are going to have refractive surgery," said Cmdr. Steve Schallhorn, an ophthalmologist who is director of cornea and refractive surgery at the Navy Hospital in San Diego. "People ask, 'I've had refractive surgery. Why can't I become a Navy pilot?' "
The Navy enforces the military's strictest eyesight standards for flight students uncorrected 20/30 vision or better due to the demands of putting aircraft on the relatively small carrier landing strips.
"It's a lot easier landing one of those Air Force 'trash hailers' on a 12,000-foot runway than it is putting a fighter down in a rolling and pitching 50-by-50-foot box," said a Navy pilot.
The sea service loses on average eight pilots per year to myopia. It also rejects prospective students solely because they cannot meet the 20/30 eyesight requirement.
"[PRK] may be beneficial for retention and accessing," said Cmdr. Schallhorn. "We may be able to recruit higher quality people into aviation if vision, per se, is no longer a disqualifier."
The Navy pilot added that "This is a sea change in the philosophy of both the Navy's leadership and the Navy's medical folks."
The Air Force, however, is billing its program more in terms of improving the workplace by cutting down on the number of bespectacled aviators. Glasses can slip off, or hinder the wearing of chemical protective clothing.
"It has the potential for operational enhancement because you get folks out of glasses," said Col. Arleen Saenger, chief of physical standards for the Air Force surgeon general.
Both services have embarked on similar trials.
Last March, the Navy started a study of active-duty aviators, with a target of performing PRK on 200 pilots and 300 naval flight officers and enlisted aviators. So far, 128 have undergone surgery, including 12 pilots who flew under some type of flight restrictions.
A separate study that began last fall is admitting PRK patients for the first time into initial flight school. The study will look at 400 incoming flight students, both pilots and naval flight officer candidates such as bombardiers and airborne electronic specialists.
The Navy will compare the performance of PRK students with those who have uncorrected vision of no worse than 20/30.
Between 1987 and 1998, the Navy grounded 87 aviators due to eyesight problems. Although the number is relatively small, in a service that has 1,000 vacant slots among 12,000 aviators, each body counts.
"It's not a huge impact, but the other thing you have to keep in mind, if you can retain one individual that you spend millions of dollars training, the impact is significant," Cmdr. Schallhorn said.
He added, "Reducing the dependence on glasses on aviators can be a benefit."
The Air Force began allowing PRKs for a limited number of pilots this summer. Because of potential side effects such as "halos" and a "starburst" effect, the service will monitor pilot performance before allowing a larger number.
Like the Navy, the Air Force is battling a pilot shortfall, as hundreds jump to commercial airlines for better pay and more time at home with their families. Out of 13,400 pilot slots, 1,200 are vacant, and a "significant shortfall" is projected for the next five years, the Air Force says.
Even if the studies during the next two to three years show PRK pilots are just as competent as aviators with 20/20 vision, the Navy will not make the procedure mandatory for near- and far-sighted personnel.
"The surgery will always rest completely on individual consent and individual participation," Cmdr. Schallhorn said. "I don't ever see a point where someone is being told they have to have the surgery."
The Navy also is making it clear to prospective flight students that enrolling in the PRK study carries no guarantees of success.
"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," states a message from the Navy Bureau of Medicine.
The new military policy excludes the newer corrective surgery known as Lasik.
Lasik uses the same lasers as PRK, but instead of scraping away the outer layer of the cornea, it partially detaches a flap over the cornea.


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