LASIK (General Discussion)
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Interesting question.
I can't answer it, but some encouraging news is that in April 2006 the UK's National Institute for Clinical Excellence issued guidelines for laser treatment through the NHS, effectively endorsing laser treatment as effective and safe (bar the normal surgical risk)... http://www.nice.org.uk/download.aspx?o=308514
I'll be writing to the CAA to point this out. It will be interesting to see whether they push at the next meeting of the medical sub-committes for the 'pre-operative dioptre limit' restriction to be lifted...
I'm not holding my breath, though...
waterpau
I can't answer it, but some encouraging news is that in April 2006 the UK's National Institute for Clinical Excellence issued guidelines for laser treatment through the NHS, effectively endorsing laser treatment as effective and safe (bar the normal surgical risk)... http://www.nice.org.uk/download.aspx?o=308514
I'll be writing to the CAA to point this out. It will be interesting to see whether they push at the next meeting of the medical sub-committes for the 'pre-operative dioptre limit' restriction to be lifted...
I'm not holding my breath, though...
waterpau
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My AME looked it up in sweden, it's not against regulations to do it but the method has to be approved by the aviation authorities and one year after the procedure you have to get evaluated by an aviation approved eye examiner. If you get the green light you retain your medical, otherwise no more flying. This also means as I understand it that from the time you have lasic to the examination one year later you're not allowed to fly which basically means you'd have to quit your job while waiting.
I'd say stick with glasses.
I'd say stick with glasses.
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slightly off topic but has anyone tried orthokeratology? You wear gas permeable contact lenses during the night which reshape your cornea, meaning you can see without lenses/glasses the next day.
I don't know what the CAA think of this, but some opticians seem to be marketing it towards pilots/people who need good stable vision and sports players who find contacts get in the way.
All sounds too good to be true I think, but I might ask my optometrist next time I go!
I don't know what the CAA think of this, but some opticians seem to be marketing it towards pilots/people who need good stable vision and sports players who find contacts get in the way.
All sounds too good to be true I think, but I might ask my optometrist next time I go!
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Glasses / contact lenses obviously work for most people, but if the level of correction is beyond the limits, even though your sight may correct to 6/6, you won't acheive class 1.
This is potentially where the value of laser treatment lies: It is possible to correct your underlying vision and therefore meet acuity standard, without the levels of correction which previously prevented your eyes meeting the standards.
The CAA currently accepts certain methods for laser treatments, but on the proviso that if they're to give you a class 1, the pre-operative correction must've been within limits. This makes laser treatment useless for acheiving class 1 if you couldn't do so before your operation.
With any luck, NICE's acceptance of laser treatment as an effective and safe alternative to spectacles and contact lenses should put pressure on the CAA to lobby for removal of the pre-operative limit requirement. If there are no long term adverse effects of treatment, it's difficult to justify holding your previous correction levels against you.
Having said that, the grounding for one year is pretty onerous and could deter those that are already flying; I suppose it depends whether your career is at risk due to deteriorating sight.
waterpau
This is potentially where the value of laser treatment lies: It is possible to correct your underlying vision and therefore meet acuity standard, without the levels of correction which previously prevented your eyes meeting the standards.
The CAA currently accepts certain methods for laser treatments, but on the proviso that if they're to give you a class 1, the pre-operative correction must've been within limits. This makes laser treatment useless for acheiving class 1 if you couldn't do so before your operation.
With any luck, NICE's acceptance of laser treatment as an effective and safe alternative to spectacles and contact lenses should put pressure on the CAA to lobby for removal of the pre-operative limit requirement. If there are no long term adverse effects of treatment, it's difficult to justify holding your previous correction levels against you.
Having said that, the grounding for one year is pretty onerous and could deter those that are already flying; I suppose it depends whether your career is at risk due to deteriorating sight.
waterpau
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female wannabe,
Would be interesting to hear the opinion of your optometrist. I've got an Ortho-K consultation booked for next week, but as you say, it all depends on the authorities...
At the risk of sounding cynical, I can only guess that the CAA's response will be negative given that Ortho-K is relatively new...
waterpau
Would be interesting to hear the opinion of your optometrist. I've got an Ortho-K consultation booked for next week, but as you say, it all depends on the authorities...
At the risk of sounding cynical, I can only guess that the CAA's response will be negative given that Ortho-K is relatively new...waterpau
niknak
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As Fairweather says, the CAA require a minimum of one year between laser treatment and issuing a Class one medical certificate.
My understanding is that the reason for this is to allow for any adverse reaction which may occur, their research has concluded that there is no "normal" recovery afterwards i.e. everyone is different in that respect.
In this world of "sue at a drop of hat", you can hardly blame them for wanting to be absolutely sure.
To put it bluntly, if you pay £2 - £3K for the treatment, expect a year off work.
My understanding is that the reason for this is to allow for any adverse reaction which may occur, their research has concluded that there is no "normal" recovery afterwards i.e. everyone is different in that respect.
In this world of "sue at a drop of hat", you can hardly blame them for wanting to be absolutely sure.
To put it bluntly, if you pay £2 - £3K for the treatment, expect a year off work.
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Originally Posted by waterpau
The CAA currently accepts certain methods for laser treatments, but on the proviso that if they're to give you a class 1, the pre-operative correction must've been within limits. This makes laser treatment useless for acheiving class 1 if you couldn't do so before your operation.
waterpau
waterpau
Also niknak - are you sure it takes a year after LASIK to get your class 1 issued? I was under the impression it was 3 months.
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AlexEvans
The guidance on refractive surgery states that "the certification limits of eye correction with glasses and the limits of refraction before surgery are the same (+/- 5 diopteres) so it is not possible to gain a medical certificate by having refractive surgery, that you would not have obtained by wearing glasses".
Your point about astigmatism is interesting (astigmatism is what is stopping me from getting a class 1). I've never discussed this with the CAA, and it doesn't actually mention astigmatic correction in any of the guidance. Have you had experience of this, and know that you can correct astigmatism with LASIK and obtain a class 1?
The same guidance states that class 1 will not be considered until three months after LASIK, and one after other types of operation.
http://www.caa.co.uk/docs/49/SRG_MED...isual_Stds.pdf
waterpau
The guidance on refractive surgery states that "the certification limits of eye correction with glasses and the limits of refraction before surgery are the same (+/- 5 diopteres) so it is not possible to gain a medical certificate by having refractive surgery, that you would not have obtained by wearing glasses".
Your point about astigmatism is interesting (astigmatism is what is stopping me from getting a class 1). I've never discussed this with the CAA, and it doesn't actually mention astigmatic correction in any of the guidance. Have you had experience of this, and know that you can correct astigmatism with LASIK and obtain a class 1?
The same guidance states that class 1 will not be considered until three months after LASIK, and one after other types of operation.
http://www.caa.co.uk/docs/49/SRG_MED...isual_Stds.pdf
waterpau
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Yeah, I'm sure about this. I've seen those guidence notes before and I remember thinking that they should re-write that part because it is misleading.
I've been to see gatwick AMD and I have it in writing that should I will get a class 1 after LASIK if it goes ok. My astigmatism is -3.5 which is .5 over the renewal limit and 1.5 over the initial limit.
Hope that helps - I think you should speak to Gatwick AMD.
Get LOTS of qualified advice before having refractive surgery and don't expect the CAA to encourage you.
I hope this is good news and good luck.
I've been to see gatwick AMD and I have it in writing that should I will get a class 1 after LASIK if it goes ok. My astigmatism is -3.5 which is .5 over the renewal limit and 1.5 over the initial limit.
Hope that helps - I think you should speak to Gatwick AMD.
Get LOTS of qualified advice before having refractive surgery and don't expect the CAA to encourage you.
I hope this is good news and good luck.
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My astigmatism was about the same as yours alex i.e. above the limits. They still let me in. It took time and patience though. It was the only way I had any chance of obtaining the Class 1.
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Please tell me more! 
Did you have refractive surgery or did you just persist? If the latter, it's very interesting to me... Did prior experience sway their decision? I was advised that because my astigmatism in my left eye is beyond renewal limits they would not be able to bend the rules.
Please elaborate.
Did you have refractive surgery or did you just persist? If the latter, it's very interesting to me... Did prior experience sway their decision? I was advised that because my astigmatism in my left eye is beyond renewal limits they would not be able to bend the rules.
Please elaborate.
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Ah - I see from your post above that you did have refractive surgery. How long did your eyes take to stabilise, were there any complications and how long after everything settled down did it take for them to issue your medical?
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Thanks chaps, that's really encouraging news. My astigmatism in one eye has varied over the last few years between 2.5 and 4 (not entirely sure why). The retinoscopy I had yesterday at the Institute of Optometry gave 2.5, and I only discovered recently about the restricted class 1 with a limit of 3.
If I have no joy with the restricted class 1 (I guess the wide variation won't help my case), then I will definitely re-consider LASIK now that I know the CAA accept correction for astigmatism.
Thanks for your advice AlexEvans - you might have just made my weekend!
waterpau
If I have no joy with the restricted class 1 (I guess the wide variation won't help my case), then I will definitely re-consider LASIK now that I know the CAA accept correction for astigmatism.
Thanks for your advice AlexEvans - you might have just made my weekend!
waterpau
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The eyes were stable pretty much straight away. I never had any complications of any kind and I have been free of corrective lenses for six years now.
How to sway the CAA? I can't be 100% sure. First up if you ask them prior to surgery if they will certify you the answer will probably be no, but you should try anyway. I had the surgery and obatined an FAA Class 1. This entailed getting my surgeon to fill in the appropriate FAA form. This meant that I was able to send the CAA an official surgeons report to the CAA in a format which was relevant to aviation. They invited me along to Gatwick and after some deliberation they agreed to give me the Class 1. This is a very abreviated version of what happened and it wasn't all smooth. Still, I'm living proof that the CAA can be swayed. Have the procedure fully documented, with all your notes and perscriptions prior to LASIK and that will help your case.
Oh, by the way, the only experience that I had before I obatined the Class 1 was glider time. I'm still in my twenties as well.
How to sway the CAA? I can't be 100% sure. First up if you ask them prior to surgery if they will certify you the answer will probably be no, but you should try anyway. I had the surgery and obatined an FAA Class 1. This entailed getting my surgeon to fill in the appropriate FAA form. This meant that I was able to send the CAA an official surgeons report to the CAA in a format which was relevant to aviation. They invited me along to Gatwick and after some deliberation they agreed to give me the Class 1. This is a very abreviated version of what happened and it wasn't all smooth. Still, I'm living proof that the CAA can be swayed. Have the procedure fully documented, with all your notes and perscriptions prior to LASIK and that will help your case.
Oh, by the way, the only experience that I had before I obatined the Class 1 was glider time. I'm still in my twenties as well.
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I just would like to point out that the legislation even in the JAA states is NOT always the same. I will give you an example:
The German JAR-FCL 3 'Medicals' is supposedly writting i.a.w. the JAR 3 regulations. Even in the foreword it states 'This is a translation of the original ...'
But if you have a closer look (no pun intended at the EYE section, you would find that most eye surgerys are EXCLUDED from being approved! Currently in Germany you can get only have an excemption permit after a PRK Laser treatment - one year after the surgery - of course
So if we have any ppl from outside the UK, just beware to check the facts in your country once more.
All the best,
~b
The German JAR-FCL 3 'Medicals' is supposedly writting i.a.w. the JAR 3 regulations. Even in the foreword it states 'This is a translation of the original ...'
But if you have a closer look (no pun intended
at the EYE section, you would find that most eye surgerys are EXCLUDED from being approved! Currently in Germany you can get only have an excemption permit after a PRK Laser treatment - one year after the surgery - of course So if we have any ppl from outside the UK, just beware to check the facts in your country once more.
All the best,
~b
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If it helps anybody, I visited the institute of Optometry this morning for a consultation for Ortho-K.
I might be stating what has already been said elsewhere, but it seems that it is only suitable for those with asigmatic and myopic errors. Because the cornea is flattened, it is not suitable for those with hyperopia.
I've hyperopia and astigmatism; if I were to pursue a course of Ortho-K, my long-sightedness would become more acute. I pushed the consultant to see if they would treat the astigmatic component, as it's this that is stopping me getting a class 1; a side-effect of this woud be to increase my long-sightedness, meaning I would need to continue to wear spectacles during the day to correct this. However, she advised against this as, although she would anticipate that my long-sightedness would still be within limits, natural variation in the treatment may push it beyond the initial class 1 limits, thus rendering the treatment pointless.
She wasn't aware of whether the CAA issue class 1 medicals to individuals who use Ortho-K. Also given the flattening of the cornea, it would be obvious to any examiner so you would have to disclose the fact that you had attemped to treat your eyesight. The rule about all lenses being removed would not in itself prevent you from correcting to the standards, as if the lenses are used over a period of time, the flattening of the the cornea can be maintained for considerable periods of time.
Strictly speaking, Ortho-K is only designed to treat those with astigmatism upto -1.5D and short-sightedness upto -4.5D. Although errors may be reduced for errors beyond this, total correction is not usually possible. These are within the limits required for a CAA class 1, so anybody who is actually suitable for Ortho-K will probably already be able to a gain a class 1...
waterpau
I might be stating what has already been said elsewhere, but it seems that it is only suitable for those with asigmatic and myopic errors. Because the cornea is flattened, it is not suitable for those with hyperopia.
I've hyperopia and astigmatism; if I were to pursue a course of Ortho-K, my long-sightedness would become more acute. I pushed the consultant to see if they would treat the astigmatic component, as it's this that is stopping me getting a class 1; a side-effect of this woud be to increase my long-sightedness, meaning I would need to continue to wear spectacles during the day to correct this. However, she advised against this as, although she would anticipate that my long-sightedness would still be within limits, natural variation in the treatment may push it beyond the initial class 1 limits, thus rendering the treatment pointless.
She wasn't aware of whether the CAA issue class 1 medicals to individuals who use Ortho-K. Also given the flattening of the cornea, it would be obvious to any examiner so you would have to disclose the fact that you had attemped to treat your eyesight. The rule about all lenses being removed would not in itself prevent you from correcting to the standards, as if the lenses are used over a period of time, the flattening of the the cornea can be maintained for considerable periods of time.
Strictly speaking, Ortho-K is only designed to treat those with astigmatism upto -1.5D and short-sightedness upto -4.5D. Although errors may be reduced for errors beyond this, total correction is not usually possible. These are within the limits required for a CAA class 1, so anybody who is actually suitable for Ortho-K will probably already be able to a gain a class 1...
waterpau
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Astigmatism and LASIK
YES or NO 
I learned yesterday that LASIK is accepted only if your astigmatism level, before this procedure, was less than the allowed by ICAO
.
Isn't it a bit ( i don't want to use the words stupid, idiotic....) weird?
I learned yesterday that LASIK is accepted only if your astigmatism level, before this procedure, was less than the allowed by ICAO
. Isn't it a bit ( i don't want to use the words stupid, idiotic....) weird?
Last edited by bebe188; 13th May 2006 at 22:27.