Laser Retina Repair & FAA Third Class

[Unregistered]

I'm about 60 years old.

Later today, I'm having laser repair of a "tiny tuft" (opthamologist's term) of the retina which tore loose in my right eye. It's been described to me as welding a containment circle around the tear to prevent the spread of damage.

I went to get it checked out after the sudden onset of some new floaters, cloudiness in that eye's vision (still 20/20 corrected but foggy-looking), and little streaks of light visible in the periphery if I move my head suddenly in a dark room. Doc says I experienced an event called a PVD, and there's blood in the ocular fluid which will dissipate over several weeks, resolving the cloudiness.

I can pretty much trace the start of symptoms to a night when, in frustration over flu-plugged sinuses, I blew my nose too hard. But a video at the doc's says shrinking of the gel in the eyeball, which can tear loose small sections of the retina, is a normal part of aging.

So...could this recur as I continue to age?

Of lesser importance, have I passed my last third-class FAA medical? Should I be shopping for an LSA?

I've always had good vision in low light, and love flying at night. Obviously, I've grounded myself since this issue developed, but if I recover with the help of the laser repair, and am able to maintain my medical, should I worry about flying at night in the future?

I had hoped up till now to prepare for CFI and offer flight instruction as a part-time income in retirement a few years from now. Is it time to find a new goal?

Dr. Bruce, I appreciate your comments, especially if there's any guidance I can give the medical team that's about to work on my right eye. Thanks!

 

[poadeleted20]

Regarding Third Class issuance, I think your answer is here:
http://www.faa.gov/about/office_org...m/ame/guide/app_process/exam_tech/item31/amd/
It appears your first exam after the surgery will be deferred to HQ for approval, but depending on the situation, after that, you may be issued by the AME without future deferrals.

 

[bbchien]

Unreg, there is actually nothing hold your retina onto the back wall of the eye. It's just a five to ten layer thick cell membrane that is plastered between the back wall of the eye and the jelly that fills it.

So the Opthalmologist makes a "judgement-as to how likely the thing is to roll up like a windowshade. That's the event we worry about- as it appears to the person with the problem like a windowshade just came down oer the eye, which is the retina curling up like a windowshade. We have NO tools to unroll it.

So he inspects around the edge of the retina, vey carefully, for any sign that the eges are starting to curl, and creates a small laser burn at the edge, to "tack weld" it down. You can actualy go all the way around the edge, 30 degrees apart and tack the thing down.

But the membrane, if it's very thin in spots, can buckle just about anyplace in the "mat". The problem arises when this occurs in an area of critical high resolution vision. We really don't want to create even a pinpoint laser burn there.

And so it goes. This is one of the situations where the expertise and experience of the opthalmologist is the most critical variable....

For all classes of certification after one of these you need the opthalmologist's sign off (you're stable, no complications) on the 8500-7, and a formal set of humphrey visual fields. Every year for three successive years (4 such evaluations) if there is no change, they will "cut you loose" back into the regular issuance pool.

 

[tlglenn]

Incidentally, I took a frisbee to the eye a while back resulting in retinal tears and laser surgery. I've been regularly issued a second class medical twice since that time. I present an 8500-7 from my ophthalmologist to my AME each year dated the prior month. I think I get less scrutiny since my retinal tears were due to an acute event rather than chronic wear and tear.

 

[Unregistered]

(Update from OP)

Laser repair went well. I have a follow-up appointment in a few days. No more "flashes," but they tell me it will take "at least a few weeks" for the blood in the gel to dissipate. For now, the affected eye is close to 20/20, but it always looks like the right lens of my glasses is smudged.

They also tell me there are several Humphries tests with varying field-widths, and I just need to tell them which one I need.

I don't fly for a living, so it's not worth the cost nor risks to me to seek a special issuance. When the docs tell me I'm back to normal, I'll stick with Sport Pilot privileges for three years, get the tests and documentation, then see if my overall health warrants rolling the dice on another renewal of my medical.

Thanks to Dr. Bruce et al all for the responses!

 

[bbchien]

(Update from OP)

Laser repair went well. I have a follow-up appointment in a few days. No more "flashes," but they tell me it will take "at least a few weeks" for the blood in the gel to dissipate. For now, the affected eye is close to 20/20, but it always looks like the right lens of my glasses is smudged.

They also tell me there are several Humphries tests with varying field-widths, and I just need to tell them which one I need.

I don't fly for a living, so it's not worth the cost nor risks to me to seek a special issuance. When the docs tell me I'm back to normal, I'll stick with Sport Pilot privileges for three years, get the tests and documentation, then see if my overall health warrants rolling the dice on another renewal of my medical.

Thanks to Dr. Bruce et al all for the responses!

You know, you're going to see the opthalmologist annually anyway for 3 years....so all you have to do is take along an 8500-7 with you.....

 

[Unregistered]

You know, you're going to see the opthalmologist annually anyway for 3 years....so all you have to do is take along an 8500-7 with you.....

Bruce, understood, and I will, but what should I do with that form? Put it in a file till sometime in 2016 when I try to renew, show it to my AME and start working now on a strategy, or try to renew at my next expiration and see what happens?

Is there benefit to renewing and getting a special issuance when my current 3rd expires in 2014? Or, if I just wait three years and show up with my documentation in order, am I likely to be issued a normal medical?

Is there any amount of time that could pass with clear/stable exam outcomes after which my AME would no longer need to refer the application to Oklahoma City?

I could probably live out my days flying LSAs happily (and safely) and don't want to do anything which risks preserving even THAT option.

 

[bbchien]

Bruce, understood, and I will, but what should I do with that form? Put it in a file till sometime in 2016 when I try to renew, show it to my AME and start working now on a strategy, or try to renew at my next expiration and see what happens?

Is there benefit to renewing and getting a special issuance when my current 3rd expires in 2014? Or, if I just wait three years and show up with my documentation in order, am I likely to be issued a normal medical?

Is there any amount of time that could pass with clear/stable exam outcomes after which my AME would no longer need to refer the application to Oklahoma City?

I could probably live out my days flying LSAs happily (and safely) and don't want to do anything which risks preserving even THAT option.

I don't want to "hold out".

But there is zero risk if your stuff is reviewed by someone who really knows what will pass and what will not. If it won't, then nothing gets sent.

In 2016, if you only want to go to the opthalmologist once, do it in early 2016 and get the 8500-7 filled out and formal Humphrey Visual fields. That's about it. Get it reviewed then.

But my point was that you can get the SI with no risk if you do it right.
And you are going to see the doc anyway so there really is no additional healthcare cost(s). But if you are OK with LSA, that's fine too.

 

[Unregistered]

OP here...

I had the procedure 1/17, had my post-op appointment today and walked in with 8500-7. Doc says everything looks good, return to all normal activities including the gym, and visual field should be unaffected.

I was not prepared when they asked me which Humphrey Field was needed. 24º or 30º? Fast or slow?

Is this published somewhere?

 

[bbchien]

OP here...

I had the procedure 1/17, had my post-op appointment today and walked in with 8500-7. Doc says everything looks good, return to all normal activities including the gym, and visual field should be unaffected.

I was not prepared when they asked me which Humphrey Field was needed. 24º or 30º? Fast or slow?

Is this published somewhere?

Either the 24-2 or 30-2 Humphreys are okay. They self validate becuase the randomly over time show you teh same dots at all 4 levels of intensity. If you get the weak ones and miss a strong one, they know your eye is wandering and not straight ahead, or you are random pushing the button. I don't know what you're getting about fast vs slow. There is no time constraint on either study. Go with whatever the opthalmologist has got. The machinery is very pricey so they only have one. Go back and get 'em, or don't try to recertify and do LSA. the 8550-7 without them will be denied.

Humphrey visual fields can be your BEST FRIENDs.

 

[Unregistered]

OP here with long overdue update.

The repair on my retina went well, as described above, but shortly after my last post I had another horseshoe tear, same eye but different spot, and this one caused much more bleeding.

It was repaired like the first, and I'm told the few new floaters will again dissipate over the next few months.

I was told by the surgery team that there's an elevated risk of additional tears for 90 days after a first one occurs, and I'm now nearing the end of that window. They also say those who have had a PVD in one eye have a 15% risk of recurrence in the other eye.

The good news is that on my last follow-up I was back to 20-15 corrected in the affected eye, and my Humphrey 24-2 shows a normal field.

I appreciate the advice here. I'm still not sure exactly what I'll do going forward regarding medical, but will not risk a denial. I had considered signing up for AOPA's medical assistance plan when I renewed my membership, as it came highly recommended by pilots who've used it. But I can't bring myself to renew my membership after watching that organization's recent direction.

Dr. Bruce, I'll be calling.

 

[Old Geek]

Humphrey visual fields can be your BEST FRIENDs.

Totally off-topic.

My best friend used to work for Humphery Instruments and built their Field Analyzers back before Humphery was sold to Carl Zeiss. He loved airplanes and flying, but couldn't become a pilot because of poor vision. One of life's ironies.

 

[txcfi]

Don't let this keep you out of flying. The process for getting a SI is really not that big a deal. Even getting a SODA and a waiver is fairly painless. You will not not lose your medical over this. Even people who lose their vision in one eye can keep a medical with a waiver. I know for a fact the are guys flying pt121 on a monocular vision waiver 1stclass medicals.