The eye is elegant, delicate, and complex—but, like sophisticated airplanes, stuff fails and preventative maintenance is key.
Light is primarily focused by the eye’s cornea. It penetrates the pupil, an opening in the iris controlling how much light penetrates into the front chamber, which is filled with aqueous humor, a transparent gel. Next, light is focused further by a lens and then into the vitreous humor, which also nourishes and shapes the eye. Finally, the retina translates images into nerve impulses and to your brain.
Myopia, or nearsightedness, occurs because of mismatched focusing power and eye length. Usually corrected with eyeglasses or contact lenses, some people opt for laser refractive surgery in which corneal focusing is altered. Presbyopia (“see like an old man”) is a function of aging that impairs close vision. Again, contact lenses do the trick and bifocals work for people with myopia and presbyopia. As long as you can meet the standards for the class of medical sought, you can obtain your certificate. Aging also leads to lens clouding or cataracts (see “Fly Well: A Clear Picture,” May 2013 AOPA Pilot).
Boxer Muhammad Ali claimed he could “float like a butterfly, sting like a bee,” but if you get a floater you will be buzzing with irritation until it goes away. As we age, vitreous humor changes and debris floats around—casting annoying retinal shadows. Sometimes lasting for weeks or months, most eventually recede. If accompanied by light flashes or visual impairment such as a descending curtain, see an eye specialist lest you see nothing further; this can be a harbinger of retinal detachment. Really problematic floaters can be zapped by laser, although that might induce cataracts; in dire circumstances, unfunny surgical removal of your humor is performed. Self-grounding may be appropriate, but if you see a doctor, report to your AME and submit a completed FAA Form 8500-7, Report of Eye Evaluation.
Eyelid hair follicle infection or stye is uncomfortable, merits treatment with antibiotic ointment, and usually resolves rapidly. If you see a white pimple on your lid, apply warm compresses followed by a soothing cool flannel, which should help “draw” pus out. Chalazion is a swelling caused by a blocked oil gland but can develop from a stye. If unresolved and painful, surgery may be required. As before, grounding is up to you—unless surgery is required, then you cannot fly until fully recovered.
Conjunctivitis or pink eye is caused by infection with bacteria or viruses, allergies, or chemical irritation. If the former, it can be quite contagious to family members, so avoid touching your eyes and seek therapy quickly. Avoid flying during the acute phase, as vision and concentration may be impaired.
Working with power tools? Wear protective glasses, because foreign-body eye damage is common and dangerous. If something other than tears are in your eyes, visit your doctor’s office or emergency room, where they will insert fluorescent drops to expose corneal abrasions. This might merit an eye patch and healing ointments—and prevent you from flying.
Glaucoma occurs when optic nerve damage leads to loss of vision. Poor humor drainage from the front chamber raises pressure, and increased blood pressure is also a culprit. Checking for increased eye pressure is done by puffing air on your cornea; if detected early, treatment helps limit sight loss. Eye drops to lower eye pressure, various surgical procedures, and implantable devices may help. Some medicines are allowable by the FAA with the exception of Diamox (acetazolamide). Glaucoma is a CACI (conditions AMEs can issue), providing airmen are over age 40 and using acceptable medication; they must complete 8500-14, provide visual fields documentation, and visual acuity must be compatible with medical standards for class of medical.
Of growing concern in our aging population, age-related macular degeneration (AMD) causes blindness and is sometimes treated with drugs injected into the eye to limit blood vessel growth. The FAA has to get involved in certification for patients with AMD. Flight for those prescribed Avastin and Eylea is allowable 72 hours after administration. Lucentis requires submitting the eye evaluation form.
Weight is an issue in aviation, as well as eye medicine. Obesity causes high blood pressure and diabetes, both of which can damage your eyes. So burning pounds will burn less 100LL—and protect your peepers, heart, liver, and joints. To see well and fly well, wear sunglasses—you will look cool and protect your baby blues. Have an annual eye exam, not just for visual acuity, but to screen for other problems.
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Dr. Jonathan Sackier is an active GA pilot and consultant for the AOPA Pilot Protection Services Plan.
Jonathan Sackier
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