Ophthalmology: Standards and Random Flashcards
Service Group 1
Aviators qualified for unlimited or unrestricted flight duties
Service Group 2
Aviators restricted from shipboard aircrew duties (include V/ STOL) except helicopter
i.e., fixed wing carrier landings
Service Group 3
Aviators restricted to operating aircraft equipped with dual controls and accompanied on all flights by a pilot or copilot of Medical Service Group 1 or 2, qualified in the model of aircraft operated.
Light passes through the 1 , 2 , 3 , 4 , and 5 before hitting the retina
- Tear film
- Cornea
- Anterior Chamber
- Lens
- Vitreous humor
Total refractive power of the eye
Approx 60 D
Note: roughly 44 D come from cornea and 16 D come from lens
Standard eye length
24 mm
standard focal length = 16.7 mm (see below)
- Remember: lens power = 1/f*
- f = 1 / lens power (1/60D*) = 0.01666 m*
- *Standard refractive power*
How thick is the cornea compared to the lens?
Cornea = 0.55mm
Lens = 4.5 - 5.5mm
BUT, the cornea still contributes more to refractive power
Why does the Navy use minus cyl
…because Optometry “won”
Ophthalmologists will use (+) when documenting cyl (why some of the waiver guidelines fluctuate between -1 and +1)
3 components of spectacle prescriptions
Sphere, Cyl, Axis*
*Axis from 001 - 180 (never negative or greater than 180)
Steepest meridian
aka the “most minus” meridian
Transposition
Converting (+) cyl to (-) cyl Rx
- Add Sph and Cyl powers = new Sph value*
- Flip the sign of the cyl value*
- Change the axis by 90 deg*
Calculate Spherical Equivalence
Sph + 1/2 Cyl
Used on the refractive surgery AMS, and to “spot check” VA (-0.25 D of SE is approx 1 line of VA)
Prism ____ to the deviation
points to the deviation
- Note: light bends towards the BASE*
- Ex. BI (Base In) = exo (aka prism pointing out)*
- BO (Base Out) = eso*
- BD (Base Down) = hyper*
- BU (Base Up) = hypo*
DVA for SNA
Better than 20/40-0 and correctable to 20/20-0 on GoodLite
DVA for all applicants except SNA
NO LIMIT for Uncorrected*
20/20-0 on Snellen OR 20/20-3 on AFVT or GoodLite
*Exception = Aircrew Applicant for rotary wing (must be better than 20<100, aka SG1 standards) and correct to 20/20-0 on Snellen or 20/20-3
Ref error for SNA vs SNFO
SNA: - 1.50 to + 3.00 (in any Meridian)
SNFO: < +/- 8.00 (all Meridians)
Max Cylinder for SNA vs SNFO vs everyone else
SNA < 1.00 (or > -1.00)
SNFO < 3.00
Everyone else = no limit (to include rotary wing aircrew applicants)
SNA and SNFO Anisometropia Limits
< 3.50 in any Meridian
No limit for any other applicant
NVA for applicants
SNA must be better than 20/40 and correct to 20/20
Everyone else just needs to correct to 20/20*
Exception = rotary wing aircrew applicants (must be better than 20/100 and correct to 20/20)
Other than SNAs, which other applicants have measured phoria limits?
UAV/UAS
Limits are:
< 6 eso/exo
< 1.5 hyper
Color Vision Passing Score
PIP
CCVT (Waggoner)
CCT
PIP = 12/14
CCVT (Waggoner) = normal or mild
CCT (Rabin) = > 55 on all 3 cones in each eye
Stereo is required for which applicants?
- SNA
- Rotary Wing Aircrew
- UAV/UAS
Normal IOP
< 22 mmHg in each eye
Difference between eyes < 4 mmHg
If out of standards by NCT, retest with TAP
Which stereo tests should be performed first (per NAMI)?
AFVT (A-D to pass)
and
Verhoeff (8/8 to pass)
If failed, Optometrist should test for Titmus or Randot (40 sec to pass) to ensure validity
MWCLWF
Must Wear Corrective Lenses When Flying
MWCLWF + CEP
Must Wear Corrective Lenses When Flying
+
Carry Extra Pair
DDVA
Defective Distant Visual Acuity
Pre-op refractive limits for applicants
Class I: +3.00 to -8.00 SE (spherical equivalents)
Class II-IV: +6.00 to -8.00 SE
3.00 D cylinder
3.50 D anisometropia
BOTH LASIK and PRK
Pre-op refractive limits for designated personnel
Myopia: -11.50 SE with no more than 6D total cylinder
Hyperopia: +6.00 SE with no more than 6D total cylinder
ONLY FOR LASIK (no limits for PRK)
For civilian applicants, the minimum time between surgery and flight physical eye exam is _____.
6 months
Minimum time to flight following LASIK
Hyperopia < +4.00 SE = 4 weeks
Hyperopia > +4.00 SE = 8 weeks
Myopia = 2 weeks
Minimum time to flight following PRK
Hyperopia = 6 months
Myopia < - 6.00 SE = 3 months
Myopia > - 6.00 SE = 6 months