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.