Ortho-K

[Dubford5]

I know that it is possible to make Class 1
using Ortho-K.
Does anyone know the Military medics stance on its use?
Am i crazy to try to pass an aircrew mecical
and not tell the examiner i'm using Ortho-k?

[willbav8r]

If Ortho-K is Lasik, or involves any operation to the eye (s) then you will not have to tell them, the quack will be able to see it.

This is just from information posted on this site some time ago.

[inverted flatspin]

here is a link to one of the foremost authorities on Ortho-K. this guy is very helpful. He told me that pilots make up about half of his practice. Ortho-K is practically undetectable, A lot of US military pilots have been fooling the military for years, however I don't think that would be a good way to go. If they find out later then it would really hit the fan.

Best thing to do is to wait for corneaplasty. It is Ortho-K without the need to use retainer lenses.

Here is the link to the Ortho-K specialist

http://www.eyeimprovement.com/

And here is a link regarding Corneaplasty

http://www.supervisioncenter.com/future_corneaplasty.htm

[ASI]

To all those visiting this thread;

Has anybody had any experience of using ortho-k, and more importantly has anybody managed to get through an initial class 1 medical using this procedure.

If so how did you mangage to get around the fact that the CAA ask you to remove any lenses atleast 48 hours before the examination - hence no retainer lenses? Also isn't a corneal topographical map done during the eye tests , if so surely the flattening of the cornear in the centre of the pupil will be detected???

Would be extremely interested to hear about anyones experiences.

Regards

ASI

[This message has been edited by ASI (edited 19 March 2001).]

[Sabo]

I used the ortho-k lenses for around six or seven years. I used them strictly for passing a class one medical and to gain entry to a program requiring 20/20 uncorrected vision. It has been more then ten years since I used them. The doctors did the basic peering at my eyes, but I don't recall any corneal topographical map test, but imagine testing is more rigorous these days. They served their purpose, at the time, but I found wearing the hard lenses very uncomfortable. It was like having a speck of dust in your eye all the time. I used to check my watch all the time to see how much longer I had to wear them. Later on when 20/20 uncorrected vision was not a medical requirement, I gave up the lenses, as they were very impractical. The promises of eventually only having to wear the lenses once a week as a retainer never happened. I had to wear them for a minimum of 4 hours everyday, to be lense free the rest of the time. If I didn't wear them for a few days, it would take a few days to reach 20/20 again. My prescription was only 20/50 in the first place.

Good luck

[Rogaine addict]

Wore them for at least 10 miserable years. I wouldn't recommend unless it's only a temporary or occasional requirement. My eyes were terrible, they were able to get me to where I didn't need a waiver for 1st class. A couple of years ago I had a small chip in the edge of one and went to the Dr., he started me on a series of soft disposable lenses and let the ortho-K correction deteriorate back to a stabilized condition, (about 6 weeks)then glasses for about 4 weeks until I had LASIK done. I don't think you could do it if you're planning for the military, but I feel that it's the single best thing I've ever done for myself. I can see all of the time, 1st class without correction or squinting and I don't have my fingers in my eyes or contacts in my mouth anymore. Wearing contacts is definitely not risk free as critics of the LASIK would have you believe.

[Satis]

good question ASI. I never heard of anyone actually using orthok to get a class 1 pass. Are you sure they do a corneal topography? Where would i find out?
my optition said that if you wore lenses up to a few hours before the test they would not know unless there was something wrong with your eyes

[ASI]

Satis;

Send me an email so I can mail you back with some details.

ASI

[batu]

Could someone send me some information about those lenzez! I am about -5,5/-4,5 and I need to be a pilot...!!!! CAA ==>> -5 so only -0,5 dioptries! Thx bye bye batu (ba-2)
E-mail: [email protected]
Cheers mate

[BigTimeWannabe]

Buta

Go to www.orthok.co.uk (http://www.orthok.co.uk)

BTW

[Blindside]

Had my Class 1 this week and can definitely say there is no Corneal Topography performed.

regards

------------------
Half man, Half jalfrezi.

[ravenx]

I managed a JAR class 1 after PRK (Lasik) but I told them about it because I thought they may do a map - but I don't think they have the kit to do it and they certainly can't find out without it

[Dubford5]

Thanx for confirming the class 1 info
but anyone in the know regards OASC medical?
I don't mean the FS quicky, but the full monty aircrew medical? Flashing lights etc
Is Topograpy used?

Those using Lasik, i heard concerning news
about damage to the eyes as a result of a car air-bag 'going off' in the face. Any info?

[Blindside]

Any refractive laser procedure works because it ablates corneal tissue, reshaping and therefore thinning the cornea. This corneal tissue is removed forever, it does not grow back.

A thinner corneal is a weaker cornea and is therefore more susceptible to damage due to trauma.

There have been instances where corneal transplant patients have sneezed causing their cornea to fall out. Incisional refractive techniques such as RK and AK can lead to problems with incisions splitting after treatment. LASIK and PRK have their associated potential problems.

As with all things medical, there are associated risks with refractive surgery. The procedures are far safer these days than ever before, but the practitioners are human, and as you get good plumbers and bad plumbers, so you get dodgy surgeons and excellent surgeons.

regards

------------------
Half man, Half jalfrezi.

[ravenx]

Thankfully the Lasik procedure is taken almost completely out of the hands of the surgeon. The information gathered about your presciption by the automated machinery is cross checked with standard eye tests. This information is the entered into the laser and bingo - you're blind - no only kidding, the machine does it all for them apart from the prep work and that's only a bit of cleaning - could do it youself really :-)

[eject]

Losing a cornea through sneezing! You're more likely to laugh your leg off!! - HONEST!

[Blindside]

eject - 'tis true. There is sometimes very little holding the donated corneal button in place once the sutures are removed.

The nomograms programmed into the lasers do mean that the surgeons do less than they did. They still cut the flap though, and that is done with a micro-keratome, basically an oscillating surgical blade. If you have a dodgy flap, you get a dodgy result.

It is far safer now than it was 5 years ago. However, what are the long term implications??

regards

------------------
Half man, Half jalfrezi.

[This message has been edited by Blindside (edited 31 March 2001).]

[Rogaine addict]

>>Any refractive laser procedure works because it ablates corneal tissue, reshaping and therefore thinning the cornea. This corneal tissue is removed forever, it does not grow back.<<

Blindside you are correct. However, the LASIK procedure ablates no more than 10% of the thickness of the corneal tissue where the RK cut as deep as 90% of the corneal thickness. I don't think you have to be an engineer to figure out which procedure will leave your eye much less susceptable to injury.

[Blindside]

Absolutely, but how many UK Consultant Ophthalmologists have had LASIK or PRK or RK or AK or Intacs?? Answer - they all wear glasses or contact lenses.

A fairly strong indication of their confidence of refractive procedures reversible or not.

There will be a glut of problems in the next five years associated with LASIK and PRK. Most noticeably ectasia.

All it will take for the market to collapse, is a high profile recipient such as Tiger Woods having a major problem.

regards

------------------
Half man, Half jalfrezi.

[eject]

Blindside

how many eye people then have had lasik
Corneal ectasia - where's the evidence of a link with lasik
Problems in 5 years. Based on evidence?

[Rogaine addict]

>>There are many others such as the incidence of scleral and retinal detachments due to the high vacuums required for the micro-keratomes to cut the corneal flap.<<

I remember the vacuum used for mine was .5 psi, I couldn't even feel it. For a 1/2" corneal flap this would be less than 3 oz. of pull. It seem that any retinal detachments caused by the procedure would have to happen during the procedure rather than down the road several years. My brother is an airline mechanic instead of a pilot because of his keratokonis, I thought that was a childhood disease. It sure seems to me that the biggest risk is not following the exact post op instructions of the Dr. (Drop regimen, no pools or hottubs, washing the hands and care not to move the flap while healing) because of the risks associated with infection while healing. I visited my optometrist yesterday for my yearly thorough eye exam (2 yrs after the LASIK) Absolutely no problems, 20/20 or better in each and 20/15 in both, a hint of astigmatism in one but the topography was identical to 1 year ago. I'm not saying that it's impossible but I can't understand how my eyes today are any different than natural, healthy 20/20 eyes. How much greater are these occurrances than that of the general population?

[eject]

Blindside
Like Rogaine, I had lasik a couple of years ago and now have 6/6 vision. I passed initial Class 1 coming well inside required standards on all scores. I asked you for evidence of the research you refer to. Where is it? How about some links! I share your view that decisions to go for lasik should not be taken lightly. I certainly spent a great deal of time carrying out extensive research over a number of years before deciding to go ahead. I suspect Rogaine is no different. At the end of the day, no surgical procedure is totally without risk. The key point is to manage that risk by making oneself aware of exactly what is involved through study of technical papers, speaking to people who have undergone the procedure and AVOIDING PUTTING TOO MUCH CREDENCE ON UNSUBSTANTIATED HEARSAY. Bear the following in mind. The CAA now accept laser corrected vision for initial Class 1 and have been accepting it for renewals for a number of years. Do you not think they have carried out extensive research; of course they have. They are not going to agree to someone with some sort of latent visual defect taking charge of an aircraft are they? One final point; I discovered that the opthalmologist who was responsible for my Class 1 eyesight evaluation was in fact also a lasik practitioner. These people do not take the decision to practice such techniques any more lightly than those of us who entrust our eyesight and future career prospects to them.

[Blindside]

Fellas

My experiences and knowledge are based on almost ten years of selling ophthalmic products, including micro-keratomes and excimer lasers.

Luckily,I have never had a serious problem with my eyesight that has meant that I could not fulfil a dream, such as flying commercially. I have never woken up and been unable to see the alarm clock. You guys probably have. These are powerful motivators to having refractive surgery. It appears that you have all had excellent results and you are all extremely happy. Great.

I agree with you, the vast majority of LASIK procedures result in happy patients. However, you do not get patients shopping around for low cost heart surgery in the same way that some do for refractive surgery, this driving down of prices cannot be good for the patient. It is a serious game and should be treated as such. It sounds as if you guys gave it the respect that it deserves and I am sure that your attitude contributed to your successful outcomes.

If I had to have it done, I would have the benefit of knowing who to go to and perhaps more importantly who to avoid. In the correct hands a micro-keratome and excimer laser can produce wonderful results. In the wrong hands, it is a disaster waiting to happen.

I would also suggest that the reason that some consultants are getting involved in refractive procedures is primarily financial. They are adding to their portfolio in order to create another revenue stream from private patients with gross refractive error. If they do not perform the procedure then the patient will go down the road to the surgeon who will.

I am not saying that the majority of patients are not experiencing fantastic results. My point is that there are worrying signs from earlier patients that are returning with unforeseen problems that are leading to some doctors asking whether the procedure is flawed. Now undoubtedly a proportion of these returning patients are due to doctors honing their skills, previously poor patient selection criteria, and the rapid development of the procedure. A number are being attributed to the procedure itself.

This is information I have gleaned from conversations with consultants, the trade and from doctor’s presentations at meetings. I hope I am wrong. The consequences of a serious flaw in the procedure will include a large number of unhappy patients and a huge increase in corneal transplants. A situation which none of us would like to witness.

Regards


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Half man, Half jalfrezi.

[eject]

Blindside

thanks for that. I think you have raised a serious issue. As in any profession, people are sadly often motivated by greed rather than the good of their patient or indeed their profession. I paid dear (financially)for my lasik. However, I was totally convinced of the professionalism of the surgeon. His reluctance, indeed refusal to perform the surgery bilaterally, his use of what, at the time was the best microkeratome and laser equipment available (according to my research at that time), his practice of using a new blade each time he performed the surgery etc., all helped persuade me that the risks would be as low as possible. I was fortunate. I know that some people, thankfully a small minority, have suffered complications. I was made aware of these by the surgeon at the outset. Unfortunately people do go into this with their eyes closed sometimes so it is important to keep the debate alive and give good advice to those for whom lasik and similar procedures perhaps offer the only opportunity for many people to progress to careers in aviation.