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-   -   Merged Keratoconus thread (https://www.pprune.org/medical-health/428408-merged-keratoconus-thread.html)

qnh78 13th Dec 2007 09:48

Stable & slight keratoconus (prospect)
 
Hi,

I have diagnosed slight but stable Keratoconus (right eye) but have perfect vision with normal glasses. It is not even clear if it is Keratoconus but they assume so. I also have good vision without glasses. I have PPL(A) with NVFR and I'm active private pilot. I feel kind of frustrated as my vision is great but regulations say I can't have Med Class 1.

Have you guys heard any changes for this issue as it says in original post? I really would like to go through ATPL-scheme as I'm now 29 years old.

Will EASA ease these regulations? Anyone? Please, keep us updated.

Thank You!
-Qnh78

bucks 21st Dec 2007 12:49

The dreaded "K" (keratoconus)
 
Hey all,

Does anyone else on here suffer from this ?

I have it in my left eye, im 26 and it doesnt effect me when using my both eyes, i have glasses but only use them on the computer and they give me normal vision in the effected eye.

My question, is it possible to get a commercial pilots licence with this condition ?

If its not possible with the JAA then how about the FAA ?

Idealy im looking for advice from pilots out there who also have this condition, as flying for a career has being my dream for years, i started training on fixed wing when i was 17 but stopped when i was 18 as i noticed a change in my left eye and was afraid of spending a fortune on training and then being told down the line that i couldnt fly anymore.

Any help would be great.

Blues&twos 21st Dec 2007 21:52

I used to suffer from kc, fixed back in the eighties by corneal grafting, but there is another treatment these days - there was a thread about this a few months ago. I'll try to find it for you...

Edited to add link to previous thread:

http://www.pprune.org/forums/showthr...ht=keratoconus

In fact, use of the Search facility has turned up a surprising number of other kc threads/sufferers on PpRuNe, some with medical/licence issues...give it a try!

:ok:

Howey 24th Dec 2007 21:58

Hi folks. Failed my medical there about four months ago after being diagnosed on the day with keratoconus. Real shock as I'm sure some will know. Could anyone who has had a similar experience shed light on any steps I could now take? I've been seeing an opthamologist, but that's still in the early stages. What's the consensus on how likely it is to pass an initial medical having previously failed one? All and any musings appreciated...

bluesfan 29th Dec 2007 12:45

I just came across the following and I quote it from page 4 of Vol.42, No. 1 of the "Federal Air surgeon's medical Bulletin" issued by the US FAA. It's a bit dated as it goes back to 2004 but it indicates that it is possible for pilots with Keratoconus to continue flying provided certain requirements are met. Below is the relevant excerpt. If you want to read the whole thing you can go to:
http://www.faa.gov/library/reports/m...ia/F2004_1.pdf


"The Aerospace Medical Certification
Division has also been in discussions
with the Medical Specialties Division in
Washington about the use of Orthokeratolgy
for correction of refractive error.
This procedure is already permitted for
the treatment of keratoconus in airmen
upon receipt of a favorable FAA Eye
Exam (Form 8500-7). The guidance is
as follows:
Orthokeratology is acceptable for medical
certification purposes, provided
the airman can demonstrate corrected
visual acuity in accordance with medical
standards defined in 14 CFR Part
67. When corrective contact lenses are
required to meet vision standards, the
medical certificate must have the appropriate
limitation annotated (MUST
WEAR CORRECTIVE LENSES).
Advise airmen that they must follow
the prescribed or proper use of orthokeratology
lenses to ensure compliance
with vision standards. Airmen should
think about how they wear their lenses
to modify their corneas in relation to
their flying habits so that their visual
acuity is within standards during the
time period of flight. Airmen should
also consider changes or extensions of
their work schedules when deciding on
orthokeratology retainer lens use.
Another inquiry since the last Bulletin
concerned the Crystalens, a model AT-45
accommodative intraocular lens (IOL).
Per the Ophthalmology Times, the lens affords
patients clear, uncorrected vision at
near, intermediate, and distance. Once
inserted, it was found that the ciliary
muscle allows it to adjust the vision.
The lens was approved in November
of 2003. Now that it is in wide use,
there have been some issues with glare.
Prior to accepting it for flying, we are
going to wait one year to evaluate the
secondary effects.
We also need to reiterate that the uses
of multifocal lenses, either as contacts or
as intraocular lenses, are unacceptable
at this time. They can cause glare and
halos at night, even requiring the use
of the unacceptable topical medication
Pilocarpine!
Now, let’s do some cases. Note, only
the Federal Air Surgeon or his designees,
the Regional Flight Surgeons, and the
Manager, Aerospace Medical Certification
Division, can authorize a waiver or
special issuance."

qnh78 7th Jan 2008 12:28

Hi,

any news form anyone about EASA side? I'm looking forward to these liberalizations http://www.caa.co.uk/default.aspx?ca...90&pageid=4764 speaking of Keratoconus.

Thanks!
-QNH78

Casablanca85 13th Jan 2008 12:04

Hi,

I am really interested in working as a pilot!!!! Actually I am cabin crew in the Middlea East and I have a slight keratoconus whoch is treated with high gas permable rigid contact lenses! I do not have any problems and my prescription has not changed within the last 4 years after I was diagnosed with this condition! I fullfill the visula acuity standards and I understand in the CAA Homepag ethat Keratoconus will no longer be disqualifying if applicants meet the visual acuity!!! Who can help me by confirming this? I just checked the above link in the last posting!

Thank you and all the best for our eyes:-)))))

mau mau 13th Jan 2008 12:14

Hello guys.... as my experience.... keratoconus is a little thin into cornea.
To identify it, is necessary a corneal topography as to identify any laser surgery as well.
At Gatwick they didn't use corneal topography when they've check my eyes and I didn't saw any equipment for this test.
So I think if you have a keratoconus they will never know it.

bucks 19th Jan 2008 19:38

Whats the CASA stance on Keratoconus ?

I heard that once you can get 20/20 with glasses you can pass the class 1 eyesight test for the australian medical, any truth to this ?

zondaracer 27th Jan 2008 17:54

You can fly FAA Class I with keratoconus as long as you still meet the vision requirements. Check out C3-R corneal collagen crosslinking, it's not approved yet in the states but it is in europe and I hear it will stop the progression of keratoconus

qnh78 3rd Mar 2008 12:47

Great Bucks,

I'm going to have mine crosslinking done in a month. Was it any painful? Did you get any kind of eyeband or anything? How was the following day?

Anyways, I heard that EASA will release new flight crew licensing rules (ex- JAR-OPS3) in March 2008. Have anyone has any news if Keratoconus will be no more disqualifing for initial Class1 medical?

BR,
QNH78

bucks 11th Mar 2008 00:33

Any idea on what the new regulations will include ( removing keratoconus as a fail for initial class 1 perhaps ?? )

qnh78 11th Mar 2008 09:35

Hi,

I would also like to know about keratoconus "removal". I'm suffering keratoconus but I have perfect vision with eyeglasses and good vision (Class 2) without eyeglasses. I will go for C3-R crosslinking operation soon and still wanting to fly for living.

Any news about new regulations...please, share!
Thanks!

-Qnh78

Phenom100 1st Apr 2008 20:14

Just found today that i have Keratoconus
 
Guys and Girls,

Just about to start my IR next week but been for an eye test today as i felt my vision is degrading and have been told i have Keratoconus in both eyes.

My Eyes are

SPH CYL AXIS

RIGHT +1.75 -2.50 65
LEFT +3.25 -3.50 105


:mad: :mad::mad:

They are refering me to the eye hospital next week. I had my initial C1 medical 1 year ago and i cant believe this was not detected. What i would like to know is:

Is this going to be a problem, should i continue with my IR. Is their anyone else out there with this rare problem??.

Any help advice would be much appreciated.

Cheers
Danny

Blues&twos 1st Apr 2008 22:15

Danny, Welcome to the KC club! (PPRuNe chapter).

There have been a number of threads covering KC (a couple quite recent). You could search for 'keratoconus' or I'll find some links and post them here.....

Treatment is available these days which seems to be very successful. If you get the chance to get it treated (i.e. stop it progressing) I'd definitely do it.

When I had mine treated back in the eighties I was told it was a "very rare condition" but thanks to the power of the internet, I've discovered quite a number of pilots and ATCOs have this condition...

EDIT: Actually, having just used the Search function, there are a large number of KC related threads, so probably best to check it out that way. :ok:

colt_pa22 18th May 2008 02:15

Hi Bucks,

It's been a few month since your treatment, how are your eyes going?

I'm 23 and was first diagnosed with this condition at the age of 17, and was then only just was able to obtain my initial Class 1 medical without eye correction. I obtained my CASA PPL(a) when I was 19, but have not flown for the past 18 months due to angst caused by this condition. My current vision is 6/7.5 left and 6/6 right corrected with spectacles. As you can see my vision has deteriorated over the past 5 years.

Distance correction: SPH CYL AXIS

RIGHT -0.25 -1.00 80
LEFT -0.50 -1.75 105

My question is directed to professional pilots who have keratoconus in regards to night flying. While driving at night I see halos extending down from around the head lights of on coming traffic, from around a distance of 200-500 metres. I work airside at Melbourne Airport, which includes driving on the taxiways and aprons but these lower intensity lights don't seem to produce any significant halos at all. I'm wondering if anybody else has similar problems with their keratoconic eyes from lights they encounter while flying at night?

I have 250 hrs TT and would like to begin flying again and study for a CPL. My condition is not advanced enough to be considered for intacs surgery due to the associated risks and I will have an initial consultation in the coming months for C3-R collagen cross linking.

mm

bucks 30th May 2008 20:23

Hey colt_pa22,

I just had another checkup two days ago and the increase in vision in my affected eye has been amazing. I dont have my current exact figures to hand but i can now see 6/9 un corrected in the eye with keratoconus.

(I got a small bit of laser followed by the crosslinking)

The doctor was very impressed at the improvement and as my eye is not 100% healed yet there is a chance of further improvment.

Im delighted i got the procedure done and it was worth every cent. It pays to go to the best aswell !!

bucks 31st May 2008 12:46

Hey Danny,

I was training for my PPL when i was first diagnosed with the condition, one day my eyesight was fine then the next my left eye had become weaker then my right. Gradually over time it became worse.

I assume there is a "no fly time" following the procedure but you would be best to find out from Gatwick as to what length of time this is and whether they approve the procedure or not.

If your condition has only recently started then i would suggest getting crosslinking done as soon as possible to ensure your sight doesnt degrade further. Im sure you already know but rubbing your eyes will help deteriorate your eyesight so its a big no no..

I got the procedure carried out in the Wellington Eye Clinic in Dublin and its costs around €1500 per eye, the procedure is quick and pain free.

http://www.wellingtoneyeclinic.com/treatments/cccl.asp

Luckily you already have a class 1 so getting a renewal with this condition should not be a problem, unfortunately for me i have to live in the hope that the CAA will one day allow initial class 1 applicants who have keratoconus gain a medical.

Regards,
John.

bluesfan 26th Aug 2008 20:51

Hi guys, just an update... I just learned from a friend who is also a pilot in Canada that people with Keratoconus can pass a Category 1 medical provided that they meet the Visual and medical requirements as set by the standards of Transport Canada. Therefore, just like in the US, Keratoconus is not a disqualifying factor. I am not sure if the JAA in Europe still considers it a disqualifying factor??

DingerX 26th Aug 2008 22:32

I've have keratoconus symptoms since I was teenager, but wasn't diagnosed until my mid-20s. It's been over a dozen years since then, and my condition has not degraded. Of course, I've never flown anything.

Keratoconus as a disease has enjoyed a renaissance of late. Corneal topography has allowed even minor forms to be diagnosed with incredible accuracy, whereas in the past, only severe cases would be noted. I'm serious: I went through several years of being told it was "normal" to see ghost images of everything. At the same time, they now make keratoconic RGP lenses that are considerably more comfortable than the old bog-standard ones, so they don't pop out or bring dust right to the cornea as easily as they used to. Although, to be honest, I've done just fine with glasses the last three years, and my job requires extreme visual acuity.

Effectively, the increase in diagnosis rate has revealed that, alongside the "old school" keratoconus, the chronic, degenerative cornea disease that ultimately requires transplants, there's a much more common version with an onset in the teenage years that stabilizes in the mid-twenties with minor cornea degradation. It's a nuisance, but shouldn't be an obstacle.


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