FAA Aeromedical Approves Multifocal Implants, Lenses

One of the ocular illnesses that comes with age is cataracts -- a buildup of protein in the eye which interferes with vision. The FAA has just made a lot of aging pilots safer by approving the latest surgical therapy for the disease. While they were at it, the crew at FAA Aeromedical in Oklahoma City also approved the popular multi-focal contact lenses, which is good news for a lot of pilots on the dark side of 40.

Cataracts are very common, and only a decade ago they diminished the vision of millions, causing first night blindness and even full blindness in many people. Half of Americans over 65 have age-related cataracts, and cataracts are often the reason when an older person gives up driving -- or flying -- or gives up doing those activities at night. Some symptoms of cataracts are a sensitivity to glare, and "halos," or double vision, around objects.

A smaller number of people suffer from secondary cataracts, most commonly a result of UV exposure -- a problem I was diagnosed with on return from Afghanistan. While my exposure came from an outdoor life at high altitudes on the ground, in an Army that for most of my career disdained and even banned sunglasses, pilots are at terrible risk of contracting this disease.

Secondary cataracts are preventable by wearing good UV-blocking sunglasses. This is especially important for pilots who spend time at high altitudes -- above the protective layers of the lower atmosphere.

The treatment is to remove the protein-encrusted lens from the eye and replace it with an implanted intraocular lens, essentially an artificial replacement. Lens replacement for cataract therapy is actually the most common surgical procedure conducted in the United States, according to WebMD. While the first lenses were rigid, a flexible alternative under the brand name Crystalens was FDA-approved three years ago and it allows the patient, in most cases, to recover youthful near and far vision alike. (Not perfect vision, necessarily; many who needed eyeglasses before still will, but of a much milder prescription in most cases).

Normally the FAA approves new therapies after a year or so's experience with them, subsequent to FDA approval. In this case, the FAA did have some concerns about possible side effects of the treatment, so it's taken longer. Considering the importance of vision to flight, the FAA's caution is understandable.

But by approving the latest cataract therapy (FAA previously had approved single-focal intraocular implanted lenses), the FAA helps increase the quality of vision across the breadth of the pilot community. (It's perfectly legal to fly with cataracts, so long as you can still pass the vision tests, but it's clearly -- no pun intended -- not optimal). While this lens may not be in your own future, chances are it is in the future of a pilot who will be trying to see and avoid your aircraft.

Cataract surgery is covered by most health insurance, but health insurers often are sticky about paying for the treatment until vision is seriously impaired.

While they were approving the multifocal intraocular lens, FAA medical experts also conveyed their blessing upon multifocal contact lenses.

These lenses have been popular for many years; they're basically just an update of Ben Franklin's bifocal specs for the person who has both presbyopia (farsightedness), which is a normal effect of aging, and myopia (nearsightedness). The contacts ingeniously have a heavier sector that orients itself with the help of gravity. Not only are bifocal contacts approved, but progressive multifocal contacts are now also blessed by the FAA.

Progressive multifocal and bifocal contact lenses have long been on pilots' medical certification wish-list. Indeed, many pilots have been violating the regs and flying with them already. In this day and age, with the Federal government mounting multimillion dollar investigations to find and prosecute pilots who lie on their medical certification forms, those pilots now have a golden opportunity to get legal -- and stay out of prison.

(By the way, once the FAA starts to investigate your medical it's too late, but if you cheated in the past and want to get right with them, they do offer amnesty. It's helpful to have a middleman like AOPA or one of the many services that assist professional pilots with medical issues in your corner before you go to FAA to talk about this. And of course, whatever the problem was "then," you have to be medically certifiable "now". For those who have never put misleading information on your medical forms, keep it up... now that it's getting the felony treatment, it's best to err on the side of disclosure).

But straight shooters or scofflaws, to see the FAA embracing this new technology is welcome news.

Aero-News learned of these new approvals from AOPA, and AOPA's Director of Medical Certification, Gary Crump, explained the procedure. "You can fly with these lenses now, as long as your vision is normal," he said. "You just need an FAA eye evaluation form completed by your eye-care specialist. Give that to your AME at the time of your next medical certification exam."

AOPA will make the form available in its members-only area.

FMI: www.aopa.org, www.faa.gov