Vision correction and BUD/S: Here's the answer

[Navy5337]

I posted this on another discussion board, but Hopefully it will answer some questions here too:

I think I've received 40 calls in the last 3 days about this, so here's the scoop, this information comes from the Navy's recruiting manual and from the director of the Navy's refractive surgery center:


If your eyesight does not meet the requirments for BUD/S, and you wish to have surgery, have PRK. At this time, it is the only waiverable procedure for diving programs in the Navy at an entry level. HOWEVER, there are limits, read on.........

I know, I know, you've all read about the LASIK study being done for BUD/S candidates on the SEAL challenge web-site. Be advised: this program is for individuals that are already in the Navy requesting BUD/S or for active duty team guys who sign a statment of understanding that they know LASIK is an elective procedure and that they may potentially be disqualified as a result. And, since it is an elective surgery, it has to be approved by the individual's chain of command AFTER he has been evaluated and found to be a good candidate for the procedure. LASIK surgery makes some kind of flap on the surface of the eye, (I'm not a doctor, so I don't know the technical terms) and there is a potential for this flap to be dislodged. It happened to a guy in Delta on a training op, and he is screwed! There is not enough long term data on LASIK and the effects of changes in pressure associated with diving, jump ops, etc. If you're on a real op, and your eyes get screwed up for some reason, you're not only hurting yourself, you're screwing your teammates as well, they've got to carry your load.

If you are a new accession (new recruit) you fall under completely different guidelines. If your eyesight is not within standards, the job classifiers at the Military Entrance Processing stations cannot book you a seat under the SEAL challenge program; the reservation program they use will not allow them to do this because eyesight data has to be entered, there is an algorithm that prevents the SEAL challenge from being offered (at least that's what the computer geeks tell me). There's just no way to get around that, unless the classifiers lie, or type incorrect data in, and believe me, that ain't gonna happen! I know this may be hard to believe, but your desire to be a SEAL is not worth anyone's career!!!

Now we come to PRK: If you have a slight refractive error, have PRK, wait the required post-surgery waiting period (two months), have two follow-up evaluations, AND the surgery was successful, then you can request a waiver. No one can guarantee that it will be approved, but chances are it will. Qualifier here: if your eyes are really bad, chances are that your waiver will not be approved. Like I said before, a SLIGHT refractive error.

Many individuals contact me and say they've heard the Navy will perform PRK for you if you're on a challenge contract. Like I said, if your eyesight is not within standards, you can't even get the contract. PRK is being done by the Navy, but the priorities are for active duty SEALs, EOD technicians, and aviators. As a new recruit, you ain't a priority!! Now, let me qualify that: If you have a slight vision problem, no more than 20/100 in one eye and 20/70 in the other, and your vision is correctable, AND you have normal color perception you can request a waiver to go to BUD/S. If you SUCCESSFULLY complete BUD/S, you too will have priority to have PRK. One caveat here: the Navy WILL NOT PERFORM PRK ON YOU IF YOU ARE UNDER 21 YEARS OF AGE, OR DO NOT SHOW REFRACTIVE STABILITY.

Now I know someone is gonna say: "But I talked to this guy, or I know this guy, or I've heard about this guy........." It's CRAP! Guidlines for new accessions into the Navy are set by Commander, Navy Recruiting Command. It doesn't matter what anyone else says!

Someone else is going to say: "What if I enlist, have LASIK, then apply to BUD/S? Will I be accepted?" My answer: Yes, Maybe, Probably not........does that answer your question? Once you are in the Navy, you fall under the guidelines of the Military Personnel Manual, that's a whole different ballgame.

Someone else is going to say: "How much is a slight refractivew error?" Like I mentioned before, I'm told 20/100 in one, 20/70 in the other.

If your eyesight is not within standards for the SEAL challenge program, consider one of the Navy's other challenge programs; EOD, Fleet diver or SWCC. All of these programs are very challengeing, and offer many of the same things: diving, demolition, parachuting, special pays, enlistment bonuses, etc.

I will keep up on any changes to Navy policy regarding refractive surgery, and will post any that apply.

Good luck to all

[Crashola]

I would add that for those who are close to the vision requirements should seriously consider getting retested before applying. Aviators have known for years that they can better their chances on an eye exam by drinking tons of water during the 24 hour period before the exam. The difference in vision acuity between being dehydrated and being well-hydrated can be pretty dramatic.

[Chris Mac]

http://www.washingtonpost.com/wp-dyn/articles/A44398-2002Mar31.html

I don't usually post much here but saw the thread and thought this would encourage those of us that wear glasses now.

[DocHabu]

Down here at Pensacola there is an ongoing study being conducting by NOMI on the effects of PRK and LASIK on flight canidates. 100 OCS/API students are participating. The study is expected too be completed in 2 years, afterward a recommendation will be made to BUMED.
V/r
Doc

[Max Power]

Doc-
Not to get in a pissing contest, but I thought PRK was already "approved" for pilots and NFOs as long as pre-op vision was no worse than +/- 5.50 diopters combined refractive error (i.e. farsightedness/nearsightedness + astigmatism)? Think I saw that on the http://navymedicine.med.navy.mil/PRK/refractive_surgery_information.htm website. Has policy changed?

Matt

[DocHabu]

Kinda sorta. Yes for Naval Aviators and NFO's PRK is approved, with a waiver. So you are NPQ on your Physical with a waiver recommendation. Also you cannot do a applicant P.E. and have PRK already done (for Aircrew I know this is a fact). Only after API, NACCS. If that doesn't really make sense I try again later in english.
V/r
Doc

[Max Power]

Yes, I have absoluetly NO CLUE what all those abreviations are for, well, except for PRK or NFO, those I know. In fact, you might say I have no idea what you just said, lol.

Matt

[vrptor]

Originally posted by Crashola
Aviators have known for years that they can better their chances on an eye exam by drinking tons of water during the 24 hour period before the exam. The difference in vision acuity between being dehydrated and being well-hydrated can be pretty dramatic.

I'm not trying to get a challenge contract and my eyesights fine, but i've never heard about hydration affecting your vision. Do you know of any sources where I could read up on this some? Thanks.

[fish78]

Andrew,
Now hear this!

[Crashola]

Originally posted by vrptor


I'm not trying to get a challenge contract and my eyesights fine, but i've never heard about hydration affecting your vision. Do you know of any sources where I could read up on this some? Thanks.

Sorry, I've never really researched the subject. It was just the "gouge" in Naval Aviation that you gave yourself a leg up on an eye exam if you were well hydrated. Also, I was personally dehydrated during my first flight physical and failed on my first attempt. The flight surgeon told me to start drinking water and he would retest me later that day. I heeded his advice and passed with no problems. I never went to another flight physical dehydrated again.

[DocHabu]

Originally posted by DocHabu
Kinda sorta. Yes for Naval Aviators and NFO's PRK is approved, with a waiver. So you are NPQ on your Physical with a waiver recommendation. Also you cannot do a applicant P.E. and have PRK already done (for Aircrew I know this is a fact). Only after API, NACCS. If that doesn't really make sense I try again later in english.
V/r
Doc

OK, an Aviator is a pilot, and an NFO isn't. When a Flight Physical (ie: PE) is done several conditions are immediatley disqualying (NPQ = Not Physically Qualified). If the condition such a vision, long term medications, or even some hereditary diseases is one that the Navy allows to fly (or dive/jump) a waiver can be requested through BUMED/NOMI/NAMI (BUMED=Burea of Medicine and Surgery, NOMI=Naval Occupational Medical Institute, NAMI=Naval Areospace Medical Institute)(for those in the know yes they have changed their name again and split apart). If the condition is one that is approved for Flight then a waiver is granted.

Now if you applying for a Flight status the rules are different. For enlisted PRK is considered disqualifying on an applicant PE(I'm pretty confident the same can be said for Officers) as the Navy will not have a prior NAVY record of your vision before the surgery. So yes you can fly with PRK, as long as you are already qualified for flight duty before the surgery. This is one of those things that if the Navy didn't do it, they don't want too even touch it. As for Dive, Jump, or Explosive's PE's I have no idea because we do not do them at my clinic.

Hope that helps bert. Don't read too much into the MANMED P-117, (the link you gave is based off that Pub) as it is the general rule for how we do everything, not the exact finding.

V/r
Doc

[DocHabu]

Here's the message about that PRK study I was talking about going on down here.

RATUZYUW RUENMED1235 2841852-UUUU--RUENMED.
ZNR UUUUU
RULYSCC T FOURTH MAW
R 101244Z OCT 00 ZYB
FM BUMED WASHINGTON DC//23//
TO AIG SEVEN SEVEN EIGHT THREE
RUCTPOA/CNET PENSACOLA FL//253//
RUENAAA/CNO WASHINGTON DC//N88/N851//
RHMFIUU/CNO WASHINGTON DC//N88/N851//
RUWHTXF/CNATRA CORPUS CHRISTI TX//N00/N74/N811//
RUEACMC/CMC WASHINGTON DC//ASD//
RHMFIUU/CMC WASHINGTON DC//ASD//
RUCOSSA/COMNAVAIRLANT NORFOLK VA//N00/N01/N3/N45/N453/N8/N02M//
RUWFEAA/COMNAVAIRPAC SAN DIEGO CA//N00/N01/N01M/N3/N45/N453//
RULSFAN/COMNAVAIRSYSCOM PATUXENT RIVER MD//00/50D//
RUCCNOM/COMNAVRESFOR NEW ORLEANS LA//N45/N73//
RUCOPAW/COMNAVSAFECEN NORFOLK VA//00/10/11/054//
RUCCBWI/COMNAVCRUITCOM MILLINGTON TN//JJJ//
RUCTPOH/NAVOPMEDINST PENSACOLA FL//00/23/42//
RULYSCC/FOURTH MAW
RULSABC/USNA ANNAPOLIS MD//JJJ//
RHMIUUU/USNA ANNAPOLIS MD//JJJ//
BT
***THIS IS A 2 SECTIONED MSG COLLATED BY MDS***
UNCLAS //N06470//
CO, MEDICAL DIRECTORS, INTERN DIRECTORS, GME COODINATOR AND CLINICAL
DEPARTMENT HEADS
MSGID/GENADMIN/MED-23//
SUBJ/LASER EYE SURGERY PRK IN NEW ACCESSIONS TO NAVY AND MARINE CORPS
/AVIATION CLINICAL STUDY ANNOUCEMENT CLARIFICATION//
REF/A/GENADMIN/BUMED WASHINGTON DC/121600ZAPR2000//
REF/B/DOC/BUMEDNOTE 6410/YMD:19991014//
REF/C/GENADMIN/BUMED WASHINGTON DC/222038ZSEP2000//
NARR/REF A IS THE REFRACTIVE SURGERY POLICY FOR THE NEW AND MARINE
CORPS. REF B IS THE MANUAL OF THE MEDICAL DEPARTMENT ARTICLE 15-65.
REF C IS LASER EYE SURGERY PRK IN NEW ACCESSIONS TO NAVY AND MARINE
CORPS ANNOUNCEMENT OF AVIATION CLINICAL STUDY.//
POC/ANNA STALCUP/LCDR/MED-23/LOC:PENSACOLA FL/TEL:850-452-2257
/TEL:EXT 1052//
POC/KEN UYESUGI/LCDR/MED-23/LOC:PENSACOLA FL/TEL:850-452-2257
/TEL:EXT 1018//
RMKS/1. REF C IS HEREBY CANCELLED. THIS MESSAGE CLARIFIES AND
CORRECTS ERRORS IN REF C. BUMED ANNOUNCES THE START OF A STUDY TO
EVALUATE FLIGHT PERFORMANCE OF STUDENT NAVAL AVIATORS (SNA) AND
STUDENT NAVAL FLIGHT OFFICERS (SNFO) WHO HAVE UNDERGONE A TYPE OF
LASER VISION CORRECTION CALLED PHOTOREFRACTIVE KERATECTOMY (PRK).
EFFECTIVE IMMEDIATELY, BUMED WILL CONSIDER RECOMMENDING WAIVERS FOR
AVIATION CANDIDATES WHO HAVE PREVIOUSLY UNDERGONE PRK. PRK SURGERY
WILL NOT BE OFFERED AS PART OF THE STUDY. WAIVERS WILL NOT BE
CONSIDERED FOR CANDIDATES WHO HAVE HAD ANY TYPE OF EYE SURGERY OTHER
THAN PRK.
2. STUDY ENROLLMENT CRITERIA FOR SNA AND SNFO CANDIDATES ARE:
INCLUSION CRITERIA: (APPLIES TO BOTH SNA AND SNFO CANDIDATES UNLESS
OTHERWISE SPECIFIED)
A. MALE OR FEMALE, OF ANY RACE, AND AT LEAST 18 YEARS OLD
AT THE TIME OF THE EXAMINATION.
B. APPLYING FOR AVIATION TRAINING, EITHER AS A STUDENT
NAVAL AVIATOR SNA OR STUDENT NAVAL FLIGHT OFFICER SNFO.
C. UNDERWENT PHOTOREFRACTIVE KERATECTOMY PRK AT LEAST 3
MONTHS PRIOR TO ENROLLMENT.
D. PREOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS OR MINUS 5.50 TOTAL DIOPTERS IN ANY MERIDIAN
WITH LESS THAN OR EQUAL TO PLUS OR MINUS 3.00 DIOPTERS OF
CYLINDER AND ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS.
E. DEMONSTRATED REFRACTIVE STABILITY, CONFIRMED BY
CLINICAL RECORDS. NEITHER THE SPHERICAL NOR THE CYLINDRICAL
PORTION OF THE REFRACTION MAY HAVE CHANGED MORE THAN 0.50D
DURING TWO OF THE MOST RECENT POSTOPERATIVE EXAMINATIONS
SEPARATED BY AT LEAST ONE MONTH.
F. BEST SPECTACLE CORRECTED DISTANCE AND NEAR VISUAL ACUITY OF
AT LEAST 20/20 IN EACH EYE.
G. NORMAL COLOR VISION. FOR FALANT, 9/9 CORRECT TO PASS. IF
FAILED ONE OR MORE, MUST REPEAT 2 SERIES OF 9 AND MEMBER MUST
HAVE 16/18 CORRECT TO PASS. FOR PIP, 12/14 CORRECT TO PASS.
H. ABLE TO PROVIDE DETAILED CLINICAL RECORDS OF THE PREOPERATIVE
REFRACTIVE ERROR, OPERATIVE REPORT INCLUDING TYPE OF PROCEDURE,
AND AT LEAST TWO POSTOPERATIVE EYE EXAMINATIONS SEPARATED BY AT
LEAST ONE MONTH INCLUDING VISUAL ACUITY AND REFRACTION THAT
DEMONSTRATE REQUIRED REFRACTIVE STABILITY.
I. MEET ALL OTHER AVIATION APPLICANT ENTRANCE CRITERIA AS
DELINEATED IN REF B.
J. (SNA ONLY) CURRENT REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS 3.00 OR MINUS 1.00 DIOPTERS SPHERE IN ANY MERIDIAN,
LESS THAN OR EQUAL TO 0.75 DIOPTER TOTAL CYLINDER, AND
ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS.
K. (SNA ONLY) VISUAL ACUITY AT LEAST 20/30 EACH EYE.
L. (SNA ONLY) HETEROPHORIA OF LESS THAN OR EQUAL TO 10 PRISM
DIOPTERS ESOPHORIA, 6 PRISM DIOPTERS OF EXOPHORIA OR 1.5 PRISM
DIOPTERS OF HYPERPHORIA.
M. (SNA ONLY) NORMAL STEREOPSIS. FOR VERHOEFF, 8/8 CORRECT TO PASS.
IF FAILED ONE OR MORE, MUST REPEAT 2 SERIES OF 8 AND MEMBER MUST
THAT 16/16 CORRECT TO PASS. FOR AFVT, A-D CORRECT TO PASS.
N. (SNA ONLY) NEAR POINT OF CONVERGENCE NPC OR PC OF 100 MM OR
LESS.
O. (SNFO ONLY) CURRENT REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS OR MINUS 5.50 TOTAL DIOPTERS IN ANY MERIDIAN WITH LESS
THAN OR EQUAL TO PLUS OR MINUS 3.00 DIOPTERS OF CYLINDER AND
ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS.
P. (SNFO ONLY) NO OBVIOUS HETEROTROPIA OR SYMPTOMATIC HETEROPHORIA
(NOHOSH).
EXCLUSION CRITERIA: (APPLIES TO BOTH SNA AND SNFO CANDIDATES)
A. ANY TYPE OF REFRACTIVE SURGERY OTHER THAN PRK. THIS
INCLUDES LASER IN-SITU KERATOMILEUSIS LASIK.
B. CURRENT USE OF TOPICAL OPHTHALMIC STEROID DROPS.
C. VISUAL SYMPTOMS RELATED TO THE PROCEDURE.
3. AN INDIVIDUAL INTERESTED MUST SUBMIT AN APPLICATION FOR AVIATION
TRAINING THROUGH THE USUAL ESTABLISHED APPLICATION PROCESS FOR THE
CANDIDATES ACCESSION SOURCE, AND INCLUDE A WAIVER REQUEST FOR
"HISTORY OF PHOTOREFRACTIVE KERATECTOMY PRK." WAIVER REQUEST MUST
INCLUDE CLEAR AND COMPLETE DOCUMENTATION OF THE ABOVE ENROLLMENT
CRITERIA.
A. CIVILIAN ACCESSION:
POTENTIAL SNA SNFO CANDIDATE CIVILIAN APPLICANTS WHO HAVE PREVIOUSLY
UNDERGONE PRK WILL WORK WITH THEIR RECRUITER IN THE USUAL FASHION
TO DETERMINE AERONAUTICAL ACCEPTABILITY AND TO ASCERTAIN
ELIGIBILITY STATUS FOR THE STUDY. ALL OF THE NECESSARY PAPERWORK
REGARDING PRK PREOPERATIVE REFRACTION, OPERATIVE REPORT,
POSTOPERATIVE FOLLOW-UP WILL BE ASSEMBLED. IF SELECTED FOR
FURTHER PROCESSING, THEY WILL BRING THIS PACKAGE WITH THEM TO NAVAL
AEROSPACE MEDICAL INSTITUTE (NAMI) FOR THEIR SCREENING MEDICAL
EXAMINATION. INVESTIGATORS AT THE DEPARTMENT OF
OPHTHALMOLOGY/OPTOMETRY, NAMI WILL DETERMINE IF THEY MEET
ACCESSION STUDY PARAMETERS, ASCERTAIN THAT THEY ARE OTHERWISE
MEDICALLY QUALIFIED FOR THEIR APPLICATION PROGRAM, AND OFFER
ENROLLMENT INTO THE STUDY.
B. NROTC ACCESSIONS:
SNA/SNFO CANDIDATE NROTC APPLICANTS WILL OBTAIN APPROVAL FROM THEIR
COMMANDING OFFICER TO UNDERGO PRK AT THEIR OWN EXPENSE AT A
CIVILIAN INSTITUTION. THE NROTC UNIT WILL DETERMINE AERONAUTICAL
ACCEPTABILITY AND ASCERTAIN ELIGIBILITY STATUS FOR THE STUDY. ALL
OF THE NECESSARY PAPERWORK REGARDING PRK PREOPERATIVE REFRACTION,
OPERATIVE REPORT, POSTOPERATIVE FOLLOW-UP WILL BE ASSEMBLED. IF
SELECTED FOR FURTHER PROCESSING, THEY WILL BRING THIS PACKAGE WITH
THEM TO NAMI FOR THEIR SCREENING MEDICAL EXAMINATION.
INVESTIGATORS AT THE DEPARTMENT OF OPHTHALMOLOGY/OPTOMETRY, NAMI.
WILL DETERMINE IF THEY MEET ACCESSION STUDY PARAMETERS,
ASCERTAIN THAT THEY ARE OTHERWISE MEDICALLY QUALIFIED FOR THEIR
APPLICATION PROGRAM, AND OFFER ENROLLMENT INTO THE STUDY.
C. USNA ACCESSIONS:
SNA/SNFO CANDIDATE MIDSHIPMEN WILL OBTAIN APPROVAL FROM THE
COMMANDANT TO UNDERGO PRK EITHER I, AT A NAVY MEDICAL CENTER OR 2,
AT THEIR OWN EXPENSE AT A CIVILIAN INSTITUTION. THE ACADEMY WILL
DETERMINE AERONAUTICAL ACCEPTABILITY AND ASCERTAIN ELIGIBILITY
STATUS FOR THE PRK ACCESSION STUDY DURING THE PRE-AVIATION
SCREENING PROCESS. ALL OF THE NECESSARY PAPERWORK REGARDING PRK
PREOPERATIVE REFRACTION, OPERATIVE REPORT, POSTOPERATIVE FOLLOW-UP
WILL BE ASSEMBLED. STUDY INVESTIGATORS, WILL DETERMINE IF THEY
MEET ACCESSION STUDY PARAMETERS, ASCERTAIN THAT THEY ARE
OTHERWISE MEDICALLY QUALIFIED FOR THEIR APPLICATION PROGRAM, AND
OFFER ENROLLMENT INTO THE STUDY.
D. ACTIVE DUTY ACCESSIONS:
SNA/SNFO CANDIDATE ACTIVE DUTY PERSONNEL WILL OBTAIN APPROVAL FROM
THEIR COMMANDING OFFICER TO UNDERGO PRK VIA ESTABLISHED GUIDELINES.
THEY WILL APPLY FOR AVIATION TRAINING AND OR REDESIGNATION IN
ACCORDANCE WITH NAVY REGULATIONS. ALL OF THE NECESSARY PAPERWORK
REGARDING PRK PREOPERATIVE REFRACTION, OPERATIVE REPORT,
POSTOPERATIVE FOLLOW-UP WILL BE ASSEMBLED. STUDY INVESTIGATORS
WILL DETERMINE IF THEY MEET ACCESSION STUDY PARAMETERS,
ASCERTAIN THAT THEY ARE OTHERWISE MEDICALLY QUALIFIED FOR THEIR
APPLICATION PROGRAM, AND OFFER ENROLLMENT INTO THE STUDY.
4. MEETING ALL ENROLLMENT CRITERIA DOES NOT GUARANTEE
ENROLLMENT INTO THE STUDY, NOR ACCEPTANCE INTO NAVAL AVIATION
TRAINING. ENROLLMENT INTO THE STUDY AND ACCEPTANCE INTO AVIATION
TRAINING DOES NOT GUARANTEE COMPLETION OF TRAINING NOR
DESIGNATION AS A NAVAL AVIATOR OR NAVAL FLIGHT OFFICER.//
BT
#1235
NNNN

[Max Power]

Thanks Doc, appreciate it.

PS - I found that note upon visiting the link I posted, lol.

[Doctor_Doom]

Hey vrptor

I am a general/ trauma surgeon, and even though I am not an expert, or an opthamologist, my friend from surgery residency (who is an experienced opthamologist) and I discussed the subject of hydration and vision. The vitreous body, a gelatinous substance which gives the eyeball its shape, has a very high water content. With proper hydration it expands to its appropriate size, and changes the focal length of the lens in the eye. For nearsighted individuals, this partial diopter change may be enough to improve eyesight rather significantly to meet military requirements. This is a common sense and simple explanation of why well hydrated individuals tend to have better vision.

Doc Doom