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-   -   Casa and lasik eye surgery (https://www.pprune.org/pacific-general-aviation-questions/543791-casa-lasik-eye-surgery.html)

TheColonel 18th Jul 2014 02:45

Casa and lasik eye surgery
Just a question to the subject. Anyone had this conducted while working in Aus? How does it look from a class one medical point of view and casa? Is there a certain time frame i need off? Any info appreciated about the whole process.


peterc005 18th Jul 2014 03:22

I had LASIK surgery done a few years ago and hold a Class 1 medical.

The LASIK results were fantastic and I haven't need glasses since. Great for driving and sports are well as flying. The only downside is that if takes 10 minutes in the morning before I can focus properly to read my phone.

I used Dr Alpins in Cheltenham because he came recommended and is a CASA approved Ophthalmologist.

Alpins charges twice as much as others, but is very good and has a flawless reputation.

You can't fly for a month after the LASIK surgery, after which you have some eye tests and the results are sent to CASA.

CASA messed me around for another month or so, but a couple of polite phone calls to CASA in Canberra resolved this and a new medical appeared in the mail in a couple of days.

The only other pain is that my Class 1 renewal sometimes requires another Ophthalmologist report in addition to the exercising ECG crap.

ForkTailedDrKiller 18th Jul 2014 05:13

Send 'Flopt' a PM. He will give you an honest view of the benefits and risks - from a "no personal commercial benefit" perspective.

Jack Ranga 18th Jul 2014 05:35

Forkman, can you ask flopt to post his response here rather than via PM, I'm interested too.

goin'flyin 18th Jul 2014 10:11

It will depend greatly on which procedure is used, as to how long you will need off flying. I had mine done about 7 years ago by a Dr who is also CASA ophthalmologist which made the whole process with CASA a lot easier. It was absolutely worth every cent.

TheColonel 19th Jul 2014 02:35

Thanks for the replies guys. Sounds like it's a no goer if your in an active flying position. Can't fly for a month after the op and then CASA screws you around another month, where does one get two months off from work... :{

peterc005 19th Jul 2014 08:48

My experience is that the CASA Medical Section don't have a lot of experience with LASIK and it throws them a bit.

Rather than just getting the surgery done and waiting a month, I'd get straight on to them. With a bit of luck you might be without a medical for one month instead of two.

With me the first person didn't know what to do and stuffed me around for weeks. Eventually I spoke with a supervisor who fixed and updated my medical on the spot.

VH-XXX 19th Jul 2014 22:24

If you don't tell CASA the won't know, however if you get it done and then come back for your next medical and don't need glasses then you are going to raise eyebrows with the medical examiner.

I would not follow the advice of PeterC above but rather seek advice of a qualified professional first, as if you are actively using your class 1 as a commercial pilot and generating an income from it, then you should take it somewhat more seriously. It's very easy to feed us a throw-away line about a class 1 medical when that poster is not actually working as a commercial pilot.

The only downside is that if takes 10 minutes in the morning before I can focus properly to read my phone.
This does not sound normal.

Lasiorhinus 23rd Jul 2014 10:00

It also takes me about ten minutes in the morning to be able to read my phone... but that's nothing to do with my eyes, it's just how long it takes my brain to realise I'm not in bed anymore.

jas24zzk 23rd Jul 2014 11:57

Actually VH-XX, peterc makes a very valid point that should be taken into serious consideration, and i quote..

My experience is that the CASA Medical Section don't have a lot of experience with LASIK and it throws them a bit.
It's very clear that LASIK is new, and the longer term benefits/cons are not truly known.

We know more about CVD than we do about the long term effects of LASIK, and look where that is going with CASA.................. care to prod the beast some more?

The advice given to myself from my CASA Opthamologist on the subject was... Jas...get used to your glasses, most of us regard this as still experimental.

I wear my goggles, and i still hate them!

peterc005 23rd Jul 2014 12:07

I had the LASIK surgery done five years ago and haven't regretted it at all.

Not having a medical for two months and the time taken on the phone to CASA are long forgotten.

Friends who recommended me to Dr Aplins for the LASIK surgery had the same procedure done by him about twenty years ago with no problems.

Not having to wear glasses for football and tennis is great. I really like not having to juggle my glasses when putting a motor bike helmet on. I flew across to Colac on the weekend and spotted the airfield ten miles away,

Wish I could have had LASIK surgery when I was much younger.

peterc005 23rd Jul 2014 12:44

The web site from that link is not any recognised health authority or research body. It looks like another one of those conspiracy theory nutter websites.

It's a bit like the anti-fluoridation or anti-inoculation crazies. Any nutter with $10 to pay for a web domain can setup a web site and make any claim.

It would be more credible if the information was based on peer-reviewed research.

Flopt 24th Jul 2014 13:56

CASA take on LASIK eye surgery...
The Designated Aviation Medical Examiner's Handbook , [approved Dec,2003].....is exactly that...11years out of date...is easily found on the web , and describes PRK as ' new' and LASIK does not get a mention.

Apparently a new one is being drafted but twelve months on it has not appeared.

If I was 25-30years of age and moderately short-sighted I would have LASIK , as at that age I was also playing cricket ,tennis, golf ,rugby league , hockey , basketball and table tennis.....and with luck I would not need glasses until I passed 40+ yrs , and needed them for reading.

It is less suited to longsighted patients as they are more likely to drift off the zero [i.e.plano] correction mark and end up needing glasses again soon.....short sighted patients sometimes have this problem too.

Unfortunately all laser refractive surgery comes with a degree of risk which may be small but may finish a flying career.

Certainly clinics which advertise on low/cut price are to be avoided....nearly always means old machines!

Possible problems are:

1. 'Dry eye' symptoms which may last for 12months or more and can be aggravated by pressurised cabins....and can make you more sensitive to glare.

2.Haze in the cornea [fairly rare these days with better equipment/techniques]...but CASA almost always requests a contrast sensitivity test with grey filters for pilots who have had 'laser surgery'...so significant haze could end your career if you can't meet the Class1 requirement of no worse than 6/9 in the worst eye and 6/6 with both [corrected or uncorrected]....as well as n.5 from 30-50cm at near.

My experience is that slight haze in a young cornea gets worse as you get older , so your career could end before you want it to...

3. Variable vision....for example if you cannot read your phone for 10 minutes in the morning, you probably no longer meet the Class1 standard, but a pair of glasses properly prescribed may solve this problem.

If you come out of the crew rest area on a long haul flight and can't read for ten minutes are you safe to occupy a seat on the flight deck?

4. Refractive error returns due to changes inside the eye....remember lasering only changes the shape of the front surface [cornea].....or very rarely the front surface can go way out of shape if it is too thin...this can mean even spectacles can't help.

As a general rule 'laser surgeons' no longer advise this type of surgery for patients over 47years of age and offer lens replacement [really cataract surgery] instead ....however multifocal intra-ocular lenses would be unlikely to be approved and so-called 'monovision' [distance in one eye and near in the other]does not meet the
Class1 standard unless glasses are worn as well , to give the correct standard of distance vision.

I have always had perfect distance vision myself and only needed near correction from 48 years of age... but I now wear my lightweight progressive multifocal rimless Transition tinted spectacles from sun up till bedtime quite happily... and every day I get to see that my vision is infinitely better than the vain ' old boilers ' that the Laser surgeon next door has extracted dollars from.

To be fair I also see quite a large number of perfectly happy patients who have been lasered and have fortunately maintained good vision...but the percentage of problem/ unhappy/no longer without spectacles patients , is higher than was expected 10 years ago.

I also get to make quite a few dollars myself prescribing spectacles for 'lasered ' patients who can no longer see well enough without glasses!

For career pilots I think if your visual problem is not too great and you are probably going to be wearing sunglasses even after you have Laser surgery...save your dollars, or read the small print on the surgery release form...the bit that says "I am aware this procedure could cause blindness"....It will also save you money on extra Aviation eye medicals but my colleagues and I will get by!

This is just my take on 12+ years referring, co-managing and post-op following laser [both LASIK and PRK which is a similar treatment] patients.....also 42 years as an optometrist, 33years as a pilot, 25years as a CPL.


CASA Credentialed Optometrist/Aviation Eye Examiner.

PS I didn't put the @s in but I can't edit them out either!!!

aussie027 25th Jul 2014 05:36

Thanks Flopt, very informative post from someone very qualified to make well informed comments compared to many posters on these forums.:ok:

Captain Nomad 25th Jul 2014 06:09

Thanks Flopt. I'm blind as a bat without my soft contact lenses (or backup glasses) and have often thought about getting lasered but just haven't had the guts to risk putting my career on the line for the sake of it. I have also put it off hoping medical procedures might advance and offer the possibility of an even better long term result. I have toyed with putting it on the agenda for long service leave. After reading your post it only encourages me to stick to the traditional, non-invasive corrective methods for the foreseeable future and do something more enjoyable on long service leave...!

For those out there who are younger, want to wear the normal sunnies etc. I highly recommend trying out disposable soft contact lenses for short-sightedness. I find I have better peripheral vision compared with glasses also. People used to say that contacts would not be a good idea for the dry pressurised environment, back of the clock night operations etc. It may encourage some that I do all of the above quite successfully with soft contact lenses which I have found to be great. Still wish I had perfect non-corrected vision but I guess the contacts are the next best thing for now...

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