PPRuNe Forums - View Single Post - So close, yet so far: Class 1 medical, Crohns Disease & eyesight
Old 31st Oct 2016, 22:59
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Loose rivets
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I'm a retired pilot not a doctor. What I do know about eyes comes from being fanatical about eyesight and having had three operations after a lot of research.

Back to you.

Really, there's not much for a reader on here to go with. i.e., we don't know what is causing the bad eyesight. Do you?

DON'T mess with laser, it could be utterly inappropriate and with the timing certainly counterproductive.

There are various things that cause the human eye to give poor results and the first thing to ascertain is the condition of the retina and associated neurological circuitry. Not always easy when there's a poor optical system in front of it. But first step is to question if there's any reason to believe your retina might be imperfect.

Let's say you can get a reasonable photo of the retina. With all due respect for the folk at SS, have you been to see an eye surgeon? The photos are helpful, but the hospital eye department will also scan your eyes and produce the tomography to simulate a side slice through your macular region. A good one will show the fovea clearly.

Let's say that's all okay.

Now the things that can go wrong at the front. The cornea can cause focussing problems. That is focussing, not clarity. It's that layer, or more correctly the stuff behind it, that they attack with lasers. But, it can also have issues which cause your visual clarity to be affected.

Later, it will be important to get a reasonable assessment of how that layer is performing. For now, an optician will lump it together with the interocular lens and the membrane behind it, as a combined focussing unit. It's all he can do, though his training will cause him to spot some problems. Hopefully.

Now that lens. Clarity, symmetry and let's say, flexibility.

Clarity is obvious.

Symmertry? Astigmatism. "a deviation from spherical curvature". Aviation regs are fairly critical about this one. It might be seen when you hold one lens of your specs in front of your eye and rotate it. Often, you'll see a major change in focus. It should be best with your specs naturally horizontal. With a lot of astigmatism, the image will go from blurred and come sharply into focus at one angle - hopefully, level.

they also found the prescription I was wearing was inaccurate - it's only three months old!
Just a thought.

Cylinder correction is what will show on your script. Or Cyl. You may find this wanders from one check to another If it does, it will probably be you, under tension while struggling to focus. (I did it a lot when I was young. I'd get a 20degree change in cyl., to the great annoyance of my optician. It was only in my dotage I found out I was distorting my eyeball - probably with ocular muscles - to get perfection.


When young, the lens should be nice and flexible. The muscle that alters the focus works counter-intuitively, but tensions the little strands that surround the lens. The ciliary muscles are often confused with these zonular fibers which suspend the lens in position. If it were these that changed the lens' focus by acting as muscles, it would be like pushing a piece of string down the road.

So, the release of tension in the fibres causes the lens to become more spherical. Relaxed = close focus. It seems, "you'll strain your eyes working in that light" is a bit of an old wife's tale.

That behind the lens membrane. At your age hopefully it will be perfectly clear.


My feeling is, explain the problem to you GP. Because you're planning a lifelong career you really need a referral to a specialist and a consultant-level assessment. If it turns out the focussing of your eyes is the only, but say, quite severe problem, you then have to find out where that distortion is coming from. Cornea, or lens, or both? Now the big question. If one or both are career-stoppers, you have to consider what course of action to take. Some people use laser to correct the problem in the lens. A bit like Hubble: just a fix. However with the advent of super new lenses might be implanted years before a cataract, anything is possible, but only a consultant eye surgeon can advise you what steps to take.

However, try hard to get (eventually two pairs) of very good specs that comply with the Class I, since it is possible the strength needed will diminish with age - while technology improves - to the point that in a few years you're back up to 6/6 or 20/20.

Let us know what happens.
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