Go Back  PPRuNe Forums > Ground & Other Ops Forums > Medical & Health
Reload this Page >

VISION THREAD (other than colour vision) 2

Medical & Health News and debate about medical and health issues as they relate to aircrews and aviation. Any information gleaned from this forum MUST be backed up by consulting your state-registered health professional or AME. Due to advertising legislation in various jurisdictions, endorsements of individual practitioners is not permitted.

VISION THREAD (other than colour vision) 2

Reply

Old 21st Jun 2018, 12:17
  #381 (permalink)  
 
Join Date: Feb 2018
Location: Darlington, UK
Posts: 18
Folks, does anyone know if the eye test result is borderline must the UPPER finding be used, or can the LOWER finding be used?

I had a test today by my local optician, he gave me a prescription with 2.00 CYL correction for both eyes. (currently left eye is 2.25 and unfit for class 1)
Because when he went 0.25 higher, I was asking for it to be reduced and when he went 0.25 lower, I was asking for it to be increased. He said even though I am borderline, legally he can give me the 2.00CYL prescription.
But is this the same for the CAA?
Wish I could send this result down to heathrow medical instead of sending myself for a retest..
miller745 is offline  
Reply With Quote
Old 20th Jul 2018, 15:27
  #382 (permalink)  
 
Join Date: Jul 2018
Location: East Sussex
Posts: 1
Cataract

Sooner or later many pilots eyes will develop cataracts and need surgical treatment. However, this is not straightforward and CAA rules prohibit many currently available types of lens implants (IOLs)
I have been trying to make sense of this important and complex topic. Although I am not an expert, I have tried to set out the current position as follows. Input from others would be much appreciated.
Cataract is cloudiness that develops in the eye's lens. It can be treated by surgical removal and replacement with an artificial lens known as an IOL (Intraocular Lens).
There are three basic types of IOL: Monofocal, Mulitfocal and Accommodative.

Monofocals (the only kind provided by the NHS) are simple lenses of single focal length that must be augmented by spectacles to provide a sharp image over the full depth of visual field. Their use is not recommended by the CAA.

Multifocals are (in layman's terms) something like varifocal specs that are implanted and can provide (at least) two foci. For some individuals this can provide spectacle-free vision, although some 'downsides' are known to exist. These can include a lack of sharpness at some visual distances and disturbances such as a 'halo' effect. There are others too. Their use is specifically forbidden by the CAA for pilots.

Accommodatives aim to provide continuously adjustable focus by bending and/or moving the lens along the visual axis. However, they seem to work much better for some individuals than for others, and it is said, can produce spec-free vision. The CAA approves their use. Unfortunately, it seems that many of the currently available Accommodative IOLs don't work as well as had been hoped. Indeed, the Bauch+Lomb 'Crystalens' Accommodative Lens appears to have been withdrawn by it's manufacturer.

This leaves any pilot who wants spectacle-free vision, following cataract surgery in a bit of a jam. I have tried to get further guidance from the CAA but they haven't proved too helpful so far. I have asked for a meeting with a CAA registered 'Consultant Aviation Opthalmology Advisor'.

There is a glimpse of a hope for the future. Developments in design of both Multifocal and Accommodative lenses seem to be addressing shortcomings of existing IOLs. They are starting to become available now but as yet guidance from the CAA has not been updated to allow their use. It seems that the FAA do now allow use of modern Multifocals if the resultant visual performance meets existing requirements.

How many of us in the pilot community are affected? Perhaps if enough of us register our concern the CAA will feel moved to help.
errorman is offline  
Reply With Quote
Old 23rd Jul 2018, 21:53
  #383 (permalink)  
 
Join Date: Jul 2018
Location: Brighton
Posts: 3
Hyperphoria and my Initial Class 1 Medical

Hey all, this is my first post on PPRuNe after being a lurker with no account for nearly half a year.

I had my initial class 1 medical examination today and it did not go as well as I was hoping. We went through my medical history and I had anemia, iron deficiency and hemoglobin deficiency as a child. These were between the ages of 2 and 8, so 6 years of my life. In the space of 11 years, there has been no sign of anemia and the deficiencies. However, the AME would like me to get a full blood test with the analysis and I need to see a specialist regarding a hemoglobin test. However, this is currently looking positive as there were no signs of the medical problems during my blood test performed on the day.

Now the real problem is, although I wear glasses, and I know that since my first optician's eye test that my eyesight is and has been greater than 20/20, I have a slight issue with my hyperphoria. When the optometrist was performing my eye test for the Class 1 Medical, my hyperphoria (vertical eye separation) was 4.0 diopters and the maximum to pass is 2.0 diopters, so essentially I didn't pass the eye test, to say this is really disappointing is an understatement as I would've never expected this to be a problem. I spoke to the optometrist regarding this and I can appeal this, and they recommended I do.

Then I went back to speak to the AME, my next step is to complete the hemoglobin and blood test and send the results to the AME, and if those come back as a pass, I can make the appeal for my class 1 medical. Now I have never had double vision and I notice no difference between both eyes regarding the vertical difference. I don't want to give up on my goal to become a commercial airline pilot, however, I don't want to go through the whole training process and the expense to have a restriction on my class 1 medical that airlines won't accept. When I was speaking to the AME the talk about settling in for a class 2 did come up, but I don't want to throw in the towel, I was told there is a possibility of still getting a class 1 medical, it may require more tests, there was even talk on a possible option where I could continue flying and if I feel comfortable and the CAA agree (I'm sure there is more to it that I don't know as of yet) I may still be issued my class 1. I currently have 8 flying hours and the money I've spent already is not a issue as I've enjoyed every second of it.

I'm currently in a tricky situation, I searched up a little about hyperphoria and the CAA Class 1 but there's not much to it regarding a post on PPRuNe from 2005 and this from the CAA Guidance, where the 4 dioptres are at 6 meters.

h) HeterophoriaApplicants with a heterophoria (imbalance of the ocular muscles) exceeding:
(1) At 6
metres:
2.0 prism dioptres in hyperphoria,
10.0 prism dioptres in esophoria,
8.0 prism dioptres in exophoria;
and
(2) At 33
centimetres:
1.0 prism dioptre in hyperphoria,
8.0 prism dioptres in esophoria,
12.0 prism dioptres in exophoria
should be assessed as unfit. The applicant should be reviewed by an ophthalmologist and if the fusional reserves are sufficient to prevent asthenopia and diplopia a fit assessment may be considered.

Would I have a chance of receiving my class 1 medical, or am I just wasting my time?

Thanks,
Chak.
Chak is offline  
Reply With Quote
Old 23rd Jul 2018, 22:24
  #384 (permalink)  
 
Join Date: Apr 2017
Location: UK
Posts: 32
@Chak I can't give any information regarding the condition, but I'm sure another Ppruner or even an AME will respond soon on that. What I can say is that, don't give up hope just yet. I've read loads of threads on here and around the web of people failing the initial medical due to exceeding one of the regulations only to appeal and be signed off as fit to fly. I believe the guidelines say that some discretion can be made on a case-by-case basis by the CAA upon appeal. They may likely look at your situation, and with further tests, deem you fit too.You're really not going to know until you proceed with the appeal, so don't loose hope yet. I feel for you when reading this as I was just as nervous for my vision in my initial last month. Good luck and keep us updated!
CJS12 is offline  
Reply With Quote
Old 24th Jul 2018, 15:00
  #385 (permalink)  
 
Join Date: Jul 2018
Location: Brighton
Posts: 3
@CJS12 Thank you for your advice, I really appreciate it. I'm trying not to lose hope yet, I'm doing better than I was yesterday and have already started to make a progression on the report the AME requires and booking in a blood test. Once again, thank you! Once I am ready for the appeal I will post an update.
Chak is offline  
Reply With Quote
Old 1st Aug 2018, 10:54
  #386 (permalink)  
 
Join Date: Jul 2018
Location: Dublin
Posts: 3
Hi Guys, I recently did the Ishihara and Lantern test and failed both miserably. Booked in to do the CAD test in Heathrow next week.

Has anyone done the CAD test recently at Heathrow? Or anyone failed the Ishihara and Lantern test but passed the CAD?

Cheers!
ianM737 is offline  
Reply With Quote
Old 28th Aug 2018, 16:15
  #387 (permalink)  
 
Join Date: Oct 2017
Location: birmingham
Posts: 13
i was in the same condition as yours

Originally Posted by Chak View Post
Hey all, this is my first post on PPRuNe after being a lurker with no account for nearly half a year.

I had my initial class 1 medical examination today and it did not go as well as I was hoping. We went through my medical history and I had anemia, iron deficiency and hemoglobin deficiency as a child. These were between the ages of 2 and 8, so 6 years of my life. In the space of 11 years, there has been no sign of anemia and the deficiencies. However, the AME would like me to get a full blood test with the analysis and I need to see a specialist regarding a hemoglobin test. However, this is currently looking positive as there were no signs of the medical problems during my blood test performed on the day.

Now the real problem is, although I wear glasses, and I know that since my first optician's eye test that my eyesight is and has been greater than 20/20, I have a slight issue with my hyperphoria. When the optometrist was performing my eye test for the Class 1 Medical, my hyperphoria (vertical eye separation) was 4.0 diopters and the maximum to pass is 2.0 diopters, so essentially I didn't pass the eye test, to say this is really disappointing is an understatement as I would've never expected this to be a problem. I spoke to the optometrist regarding this and I can appeal this, and they recommended I do.

Then I went back to speak to the AME, my next step is to complete the hemoglobin and blood test and send the results to the AME, and if those come back as a pass, I can make the appeal for my class 1 medical. Now I have never had double vision and I notice no difference between both eyes regarding the vertical difference. I don't want to give up on my goal to become a commercial airline pilot, however, I don't want to go through the whole training process and the expense to have a restriction on my class 1 medical that airlines won't accept. When I was speaking to the AME the talk about settling in for a class 2 did come up, but I don't want to throw in the towel, I was told there is a possibility of still getting a class 1 medical, it may require more tests, there was even talk on a possible option where I could continue flying and if I feel comfortable and the CAA agree (I'm sure there is more to it that I don't know as of yet) I may still be issued my class 1. I currently have 8 flying hours and the money I've spent already is not a issue as I've enjoyed every second of it.

I'm currently in a tricky situation, I searched up a little about hyperphoria and the CAA Class 1 but there's not much to it regarding a post on PPRuNe from 2005 and this from the CAA Guidance, where the 4 dioptres are at 6 meters.

h) HeterophoriaApplicants with a heterophoria (imbalance of the ocular muscles) exceeding:
(1) At 6
metres:
2.0 prism dioptres in hyperphoria,
10.0 prism dioptres in esophoria,
8.0 prism dioptres in exophoria;
and
(2) At 33
centimetres:
1.0 prism dioptre in hyperphoria,
8.0 prism dioptres in esophoria,
12.0 prism dioptres in exophoria
should be assessed as unfit. The applicant should be reviewed by an ophthalmologist and if the fusional reserves are sufficient to prevent asthenopia and diplopia a fit assessment may be considered.

Would I have a chance of receiving my class 1 medical, or am I just wasting my time?

Thanks,
Chak.
Hey i was in the same situation as yours, failed the medical due to the phoria. I have 3 diopters of hyperphoria the limit is 2, and on top of that i have 35 diopters of exophoria at near (the limit for near is 12) and 20 at distance (the limit for distance is 8). So as you can see im wayyyyyy out the limits, but i appealed to the CAA for a secondary review. After 6 months i got a letter from the CAA stating that im fit to fly because i have a strong prism fusion range so i dont have double vision (wich is the risk), the fresh class 1 medical was in the same letter btw.

So if you dont have double vision my advice is that you should elaborate your case well and than appeal to the CAA. They are flexible with phorias if you dont have double vision.

Last edited by abbas786; 28th Aug 2018 at 16:57.
abbas786 is offline  
Reply With Quote
Old 28th Aug 2018, 23:41
  #388 (permalink)  
 
Join Date: Jul 2018
Location: Brighton
Posts: 3
Good news is that my blood test came back normal, no abnormalities in my blood, no traces of anemia or iron deficiency. The report is ready to be picked up tomorrow and I will be sending that to the AME as soon as possible. On track so far.

Originally Posted by abbas786 View Post

Hey i was in the same situation as yours, failed the medical due to the phoria. I have 3 diopters of hyperphoria the limit is 2, and on top of that i have 35 diopters of exophoria at near (the limit for near is 12) and 20 at distance (the limit for distance is 8). So as you can see im wayyyyyy out the limits, but i appealed to the CAA for a secondary review. After 6 months i got a letter from the CAA stating that im fit to fly because i have a strong prism fusion range so i dont have double vision (wich is the risk), the fresh class 1 medical was in the same letter btw.

So if you dont have double vision my advice is that you should elaborate your case well and than appeal to the CAA. They are flexible with phorias if you dont have double vision.
Hey Abbas,

This was a reply I was hoping for, someone who was in a near enough exact position as me, alongside making an appeal/review and everything working out fine in the end. 6 months is a long time to wait for the reply, but the wait was definitely worth the good news. I'm hoping to send the required reports which were asked by my AME, and hopefully, we get the secondary review process started.

Thanks.
Chak is offline  
Reply With Quote
Old 1st Sep 2018, 13:28
  #389 (permalink)  
 
Join Date: Oct 2017
Location: birmingham
Posts: 13
Originally Posted by Chak View Post
Good news is that my blood test came back normal, no abnormalities in my blood, no traces of anemia or iron deficiency. The report is ready to be picked up tomorrow and I will be sending that to the AME as soon as possible. On track so far.



Hey Abbas,

This was a reply I was hoping for, someone who was in a near enough exact position as me, alongside making an appeal/review and everything working out fine in the end. 6 months is a long time to wait for the reply, but the wait was definitely worth the good news. I'm hoping to send the required reports which were asked by my AME, and hopefully, we get the secondary review process started.

Thanks.
Glad that my response was helpful. As for me i was in even worse condition than yours, my AME told me that according to him gaining a class 1 was impossible for me and the best thing to do was changing career. I was destroyed that day but ive promised to my self that i will not give up, because becoming an airline pilot was my dream since childhood. And yess, the day when i recieved the medical that day i realized that nothing is impossible, if you work hard for something, you will achieve it.

Best of luck with the appeal.

Last edited by abbas786; 1st Sep 2018 at 19:17.
abbas786 is offline  
Reply With Quote
Old 15th Sep 2018, 16:59
  #390 (permalink)  
 
Join Date: Sep 2018
Location: London
Posts: 2
Hello PPRuNe, quick query as the only information i can find on this is Part Med.

With regards to the following ...

AMC1 MED.B.070 d,(5)
  1. If the refractive error is +3.0 to +5.0 or Ė3.0 to Ė6.0 dioptres, there is astigmatism or anisometropia of more than 2 dioptres but less than 3 dioptres, a review should be undertaken 5 yearly by an eye specialist.
I've had my Class 1 issued to me 3 years ago by the UK CAA, I have recently transferred it over to the IAA... my only limitation was a VDL restriction however when the IAA reviewed it they decided to apply the RXO restriction as well.

My astigmatism is 2.0 dioptres, surely according the wording above I shouldn't have the RXO limitation?
actionjawa is offline  
Reply With Quote
Old 1st Oct 2018, 07:59
  #391 (permalink)  
 
Join Date: Sep 2018
Location: India
Posts: 1
Getting Faa Class 1 with 6/9 vision in RE. Else normal

I am enrolled in cadet program and going to do my CPL training in Cae USA. But I am going to convert my licenses and fly in my country. So basically my main concern is will I get Faa class 1 with :
Vision without glasses RE 6/9 LE 6/9
Correctable vision : RE 6/9p LE 6/6 BOTH 6/6

please help in getting coercet information because I am going to sign a bond with a huge amount. Also I canít get back my money once itís gone.

I am not going to fly in USA commercially.
Shreyas is offline  
Reply With Quote
Old 3rd Oct 2018, 19:49
  #392 (permalink)  
 
Join Date: Nov 1999
Location: London UK
Posts: 462
Very interesting talk about [email protected] eye surgery at White Waltham club last night. Particularly a technique called 'blended vision' whereby you have one eye set to 6/6 distance vision, but a bit of short sight in the other to remove the need for reading glasses in middle age. The argument was that it's good for pilots because you don't have the intermediate distance issue of bifocals or the problem with seeing instruments above the windscreen. One professional pilot there who is also an AME has been given 6/9 uncorrected distance vision in one eye and 6/5 in the other, but can also read small print with her 'short' eye without correction so has an unrestricted medical in her late 50s. All sounded quite encouraging.
Dr Jekyll is offline  
Reply With Quote
Old 8th Nov 2018, 07:37
  #393 (permalink)  
 
Join Date: Nov 2018
Location: Leicester
Posts: 6
Class I Medical Failure

In 1998 I completed so much flight training and then I failed my class I medical.

I understand now that the medical standard for eyesight has been relaxed a little.

The CAA advocate safety but how can it not be OK one year but then OK the next?

Just curious
phdresearcher is offline  
Reply With Quote
Old 8th Nov 2018, 15:30
  #394 (permalink)  
 
Join Date: Dec 2000
Location: Naughty step
Posts: 1,098
Best to ask them. 0330 022 1500
blue up is offline  
Reply With Quote
Old 8th Nov 2018, 18:58
  #395 (permalink)  
 
Join Date: Jul 2007
Location: West Britain
Age: 68
Posts: 172
Cool Refractive Lens Exchange

I recently had an eye exam with one of the [email protected] outfits who said they could restore glasses-free sight by refractive lens exchange - same procedure as for cataracts but inserting a multifocal lens. I checked EASA FCL-Med and the procedure is completely forbidden. As a retired pilot still practising as a part-time instructor, it's not the end of the world for me but it might be relevant to younger colleagues. I know that our now defunct CAA Medical Department was notoriously conservative with 'new' eye stuff such as contact lenses and varifocals but it does seem to me that allowing a clear lens for cataracts but not a clever one for sight correction is slightly bizarre. I'd be interested to know if anyone else has been down this route.
BristolScout is offline  
Reply With Quote
Old 6th Dec 2018, 13:47
  #396 (permalink)  
 
Join Date: Dec 2018
Location: Toulouse
Posts: 1
Smile Hypermetropia concerns

Hi all,

I took a class 1 initial application test in France, which is more restrictive regarding the vision than the EASA's requirements and got rejected. As asked by the french AME, I had a orthoptic assessment done :

My orthoptic assessment says :

Visual acuity : (Refractive test under cycloplegia)
Right Eye : 10/10 with +2.0 dioptres P
Left Eye : 10/10 with +4.5 (-1.0 at 175į) dioptres P

LAF (I don't know what this means so this might be a french acronym) :
Right Eye : Anterior segment with no fluo- particularity
Left Eye : Anterior segment with no fluo- particularity

Tension :
ODG Normal

Optic Fundus :
Right Eye : Optic fundus and peripheria examination with Goldmann's 3 Mirrors glass
Left Eye : Optic fundus and peripheria examination with Goldmann's 3 Mirrors glass

Am I compliant with the EASA Part Med initial application requirements or is the dream over ?

Many thanks
Pinguin_Furtif is offline  
Reply With Quote
Old 4th Jan 2019, 14:31
  #397 (permalink)  
 
Join Date: Aug 2015
Location: In the air
Posts: 154
Any recent experience with reactive progressives?

I am using progressive lenses which work really well for me. For glare I am using flip-up polarising lenses - also works really well for me with steam dials. But I realise that polarizing will not work with modern displays, and flip-ups are a PITA. Does anyone have experience/advice on reactive lenses inside aircraft in combination with progressives ? I understand that lens quality is critical for good results with progressives. This has been discussed here in the past, but not recently as far as I can see.


Thanks
double_barrel is online now  
Reply With Quote
Old 4th Jan 2019, 20:49
  #398 (permalink)  
 
Join Date: Apr 2008
Location: France
Posts: 862
I've found they only work in a really bright interior. Depends what you fly, but unless there is a lot of natural light they don't go dark. Also depends what the windscreen material is.... Buy a cheap pair and try it, maybe.
Piper.Classique is offline  
Reply With Quote
Old 10th Jan 2019, 14:13
  #399 (permalink)  
 
Join Date: Jan 2019
Location: Norway
Posts: 1
Hello

I have a questiom about the Medical class 1 vision related.

I have been to the examinator and he could not give me the medical class 1 beacause of my vision.

Left eye +5,5 cyl 0,75 axis 33,0
Right eye +1,75

strabisme
5/6m
eso 16
hyper 4

30-50cm
eso 4
hyper 2

So im a bit over what is expected and wonder if anyone have got this approved before and how ?

Best regards , Andreas
Andreas97 is offline  
Reply With Quote
Old 12th Jan 2019, 17:42
  #400 (permalink)  
 
Join Date: Aug 2017
Location: DUS
Posts: 7
Heterophoria

I read here already some guys had some issues with heterophoria. Here is my story. Had my class 1 in Europe for over 10 years, did the initial in one EASA country and as I wanted to fly for another airline in Germany I made the initial again. During these initials no signs of heterophoria were found but as I look back I must had it since my childhood. Then I went for another initial medical in Qatar and they found that hyperphoria was over 5 prism dioptres, so way over the limit. Was quite suprised since it was the first time after so many years of flying that I was told that. Some other test were done, they found out, that I have no double vision and that I have stereopsis (3D vision) and after the Authority reviewd it I also got their medical.

So no need to give up your dream of flying when you are over the limit. During the time the authority was reviewing my case I read tons of articles and watched a lot of videos about phorias. It can be a issue when you see double. A lot of people also donít have stereopsis at all with this condition.

A lot of people think that if you didnít solve this until your 10 years of age there is nothing that can be done about it. However there is a new method which could help. Itís a treatment using Virtual Reality Googles from a company called Vivid Vision. It isnít helpful in all cases, you need to be seen by a specialist but it can be a hope for somebody, mostly without stereopsis. Since I have stereopsis, but not at 100%, I will try it out in the next months and will update you if there was an improvement with my phoria and stereopsis.
bumpy737 is offline  
Reply With Quote

Thread Tools
Search this Thread

Contact Us Archive Advertising Cookie Policy Privacy Statement Terms of Service