Contact lenses

Mike Smith

Mike Smith

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I have read that mono-vision contact lenses are not approved by the FAA. My optometrist can prescribe glasses that, in effect, correct my vision back to standard vision and add bi-focals. My question is would this satisfy the FAR's? Or am I going to have to go back to standard contacts and wear readers when I fly? Thanks in advance!

Mike
 
I am flying now with "bifocal" contact lenses. They are designed for us oldsters.
I completed the required form for evaluation with the eye doc that I can read near, intermediate and far distances at the required 20/20 and presented it to the AME.

He issued the Class II on the spot and forwarded the paperwork to OKC.
The medical states that I have corrective lenses for near and far vision correction. It does not state that they be glasses or contacts. I have the freedom to fly with either.

I have found that my bifocal glasses are better at night or in low light conditions than the contacts and plan accordingly.
 
There are two kinds: correction in the center for distance, in the periphery for near.
Or.
Correct at the bottom for near, the rest for distance. There is a "weight" that keeps the lens right-side up.
 
So, bi-focal lenses are ok? I need to go see the good eye doc then.

Mike

ps. this getting a medical is getting tiresome...............................
 
Doc...its such a long story, I wont bore you. Suffice it to say that there are MANY obstacles...I am jumping hoops as fast as i can. I have contacted A CFI, made doc appts to get documents, talked to a friend about renting his 152....Had an over the phone with an AME......whewwww. Im working on it Doc.....I promise. On a side not, Its beautiful today.....I so wish I were flying.....In due time.

Mike
 
Bifocal contact lenses is good vision to people. Doctors also suggest to try this related
Monovision using single-vision lens to put near prescription on one eye and distance prescription on the other.
Modified monovision using single-vision lens on one eye and multifocal lens on the other.
 
robertjason896 said:
Bifocal contact lenses is good vision to people. Doctors also suggest to try this related
Click to expand...
If you're referring to "multifocal" contact lenses, that's what I use.
Monovision using single-vision lens to put near prescription on one eye and distance prescription on the other. Modified monovision using single-vision lens on one eye and multifocal lens on the other.
Click to expand...
The FAA prohibits the use of monovision contacts. If you need bifocal correction, your only contact lens choices are regular single vision distance-correcting contacts plus reading glasses for near vision, or multifocal lenses.
 
Can one fly LSA's with monovision contacts if one passes the DL test with them? If so, that's another alternative.

Come to think of it, if that's true I suppose one could be flying GA with bifocals in the morning and monovision in a LSA in the afternoon . :rolleyes:

Just askin

Cheers
 
bbchien said:
There are two kinds: correction in the center for distance, in the periphery for near.
Or.
Correct at the bottom for near, the rest for distance. There is a "weight" that keeps the lens right-side up.
Click to expand...
I've tried the periphery version, and was not impressed. At all.

I've never heard of the weighted version. I may give that a try the next time I get an exam. Thanks for the info!
 
X3 Skier said:
Can one fly LSA's with monovision contacts if one passes the DL test with them?
Click to expand...
I have no idea if it is legal, but considering the issues with monovision lenses, it sounds like a bad idea from a safety perspective. Read up on the problems with depth perception adaptation with monovision lenses (remember, you probably don't wear them 24/7) and the Delta 727 accident at LGA where the captain was illegally wearing them.
 
Rigged4Flight said:
I've tried the periphery version, and was not impressed. At all.

I've never heard of the weighted version. I may give that a try the next time I get an exam. Thanks for the info!
Click to expand...
The weighting is for lenses with astigmatic correction. Those without it don't have a right side to be up.
 
Ron Levy said:
The weighting is for lenses with astigmatic correction. Those without it don't have a right side to be up.
Click to expand...
That would definitely be me. :redface:

I wonder if that's why the other version didn't work out. But then again, I would think that my eye doctor would have factored that in... Perhaps I'll go to another eye doctor for my next exam. :yesnod:
 
Ron Levy said:
The weighting is for lenses with astigmatic correction. Those without it don't have a right side to be up.
Click to expand...
Bruce was talking about bifocal contacts I believe. I've never looked into bifocals and don't have any experience with them, but that would seem to be another good reason to have a top and bottom.
 
Bifocal contacts (each eye identically corrected) are okay but it's rare that pilots find them satisfactory.....

Multifocal contacts are okay. Down side is the 20/20 is more like 20/25 at best.

Monovision(one for near, one for far) are prohibited. LSA-ers beware. Monovision collisions will only add to the steam of those who way the LSA DL exemption was a bad idea. Those guys are out there.

And if you abuse the LSA-DL, that will happen.
 
The terms multifocal and bifocal for contact lenses are used somewhat interchangeably. There are three types of lenses in this category -- translating, concentric, and aspheric. See http://www.allaboutvision.com/contacts/bifocals.htm for a good explanation of the three types and their advantages/disadvantages Unless there is also an astigmatic correction involved, only the translating type needs the weighting to stay upright. I have concentric (also called "toric") which don't normally need vertical alignment, but with my astigmatic correction included, I need the weighting.
 
I have been wearing monovision gas permeable lenses almost "24/7" for years before starting to fly since the only time they are out is when I walk from the bathroom sink to the bed at night and back in the morning. Unless the time with my eyes shut counts, I think my brain has semi adapted pemanently since when I wear the bifocals required to fly, my vision deteriorates from 20/20 to just acceptable for the 3rd class medical.

OTOH, if I had the LASIK Surgery that resulted in permanent monovision, that would be fine with the FAA as I understand the rules since my brain would "rewire" just as it has with the contacts.

The bifocals are on the face and the contacts out while in the airplane but I think I am actually less safe since I could have better vision with the contacts just like those with LASIK. I have never noted any depth perception difficulties with the contacts in shooting or other sports like baseball (even as a Catcher) or football. The only time there was a problem was the first time I got them, the Doc set the right eye for reading and the left for distance which was contrary to my request. After a day or two missing some targets, I went back and changed to right distance and left reading and all was well.

Am I mistaken in believing that no corrective lenses are required after monovision LASIK Surgery? I understand the requirement for the "layoff" after LASIK but if one is required to wear corrective lenses to bring both eyes up to snuff for reading and distance (different bifocal perscriptions in the respective eyes like clear glass in the reading section for the left eye and clear distance in the right) even after the brain has "adapted", seems a lot simpler to just keep wearing the required bifocals. If not, I will look further into a LASIK operation.
 
Rigged4Flight said:
That would definitely be me. :redface:

I wonder if that's why the other version didn't work out. But then again, I would think that my eye doctor would have factored that in... Perhaps I'll go to another eye doctor for my next exam. :yesnod:
Click to expand...
AFaIK, until recently, multifocal lenses were limited to RGP types (i.e. "hard contacts") and those usually counteract astigmatism (aspherical correction) by forming a spherical surface over the cornea and that doesn't require any rotational orientation. There are weighted soft contacts that correct astigmatism by including aspherical refraction but I'm not sure that there are any that combine multifocal properties as well (sounds plausible though).
 
Unregistered said:
I have been wearing monovision gas permeable lenses almost "24/7" for years before starting to fly since the only time they are out is when I walk from the bathroom sink to the bed at night and back in the morning. Unless the time with my eyes shut counts, I think my brain has semi adapted pemanently since when I wear the bifocals required to fly, my vision deteriorates from 20/20 to just acceptable for the 3rd class medical.

OTOH, if I had the LASIK Surgery that resulted in permanent monovision, that would be fine with the FAA as I understand the rules since my brain would "rewire" just as it has with the contacts.

The bifocals are on the face and the contacts out while in the airplane but I think I am actually less safe since I could have better vision with the contacts just like those with LASIK. I have never noted any depth perception difficulties with the contacts in shooting or other sports like baseball (even as a Catcher) or football. The only time there was a problem was the first time I got them, the Doc set the right eye for reading and the left for distance which was contrary to my request. After a day or two missing some targets, I went back and changed to right distance and left reading and all was well.

Am I mistaken in believing that no corrective lenses are required after monovision LASIK Surgery? I understand the requirement for the "layoff" after LASIK but if one is required to wear corrective lenses to bring both eyes up to snuff for reading and distance (different bifocal perscriptions in the respective eyes like clear glass in the reading section for the left eye and clear distance in the right) even after the brain has "adapted", seems a lot simpler to just keep wearing the required bifocals. If not, I will look further into a LASIK operation.
Click to expand...

Same here. In real life I have used one contact for 20 years without a problem. In the early days I took them out to sleep but for the last 7-8 years they have progressed to the point that I wear them 24/7. There are some people who can't adapt and they are not good cantidates but they will figure it out quickly.

It gets down to the saftey vs compliance discussion.

Saftey first: I get my eye health guidance from my board certified Opthomologist and she is very comfortable with me and my prescription. It's the best for my situation.

Compliance second: I told her I was switching to glasses while flying to make the FAA happy. After she vented about how they should stick to aviation medicine and let Opthomologists figure out the eye issues and said that was a terrible idea, as a compromise she suggested she proscribe me a left eye prescription for a lens with very minimal correction. Now it's 2 contacts. Not the best but better than what the FAA wants and I play their game.

Clearly a case of bureaucratic compliance being more important to the agency than safety.

Perhaps this issue is one of the ones GAO will look at as they examine:

"(B) the alignment of medical qualification policies with present-day qualified medical judgment and practices, as applied to an individual’s medically relevant circumstances".

per the pilots bill of rights.
 
gismo said:
AFaIK, until recently, multifocal lenses were limited to RGP types (i.e. "hard contacts") and those usually counteract astigmatism (aspherical correction) by forming a spherical surface over the cornea and that doesn't require any rotational orientation. There are weighted soft contacts that correct astigmatism by including aspherical refraction but I'm not sure that there are any that combine multifocal properties as well (sounds plausible though).
Click to expand...
I wish I could remember what mine were. I'm stuck with glasses for the next long while, but if I could get some type of multifocal contacts that could also correct my astigmatism I'd probably jump at it when I return to the states. I despise wearing glasses, but if it's a choice between clear sight and personal preference, I'll take the clear sight.
 
Ron Levy said:
http://www.faa.gov/pilots/safety/pilotsafetybrochures/media/lasereye_ii.pdf
See page 8, the part in red italics.
Click to expand...

I read it and I'm confused. Does that mean the pilot now has no near vision since his close in eye is now corrected via a lens to be the second distance eye? Of is it a lens with a "bifocal" clear section for Near vision? Or is the pilot expected to take the glasses off to read the panel/chart?

No desire/need for LASIK or other stuff but that brochure has me scratching my head since there is a SODA process for LASIK but not for monovision via contacts when I assume the effect is the same in both cases as it appears from the two "unregistered" posts.

Cheers
 
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gismo said:
AFaIK, until recently, multifocal lenses were limited to RGP types (i.e. "hard contacts") and those usually counteract astigmatism (aspherical correction) by forming a spherical surface over the cornea and that doesn't require any rotational orientation. There are weighted soft contacts that correct astigmatism by including aspherical refraction but I'm not sure that there are any that combine multifocal properties as well (sounds plausible though).
Click to expand...
Soft, gas permeable, toric multifocal lenses with astigmatic correction have been available for several years -- I'm wearing them right now.
 
A lot of this has the flavor of, "damned bureaucracy" but none of the posters have accessed or shown understanding of why it is the way it is.

unregistered said:
but I think I am actually less safe since I could have better vision with the contacts just like those with LASIK
Click to expand...

I'm not saying that I'm agreeing with the subsequent NTSB pressure on FAA to do something about this report, but you should read it before you gripe, so that this stops having the "sour grapes" feel to it.

The real problem is that monovision reduces bifoveal fusion.
 

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The toric multifocals are not cheap. Some customers have a separate script of for one-day throwaway contacts that they use for things like swimming, water-skiing etc.
 
bbchien said:
A lot of this has the flavor of, "damned bureaucracy" but none of the posters have accessed or shown understanding of why it is the way it is.



I'm not saying that I'm agreeing with the subsequent NTSB pressure on FAA to do something about this report, but you should read it before you gripe, so that this stops having the "sour grapes" feel to it.

The real problem is that monovision reduces bifoveal fusion.
Click to expand...

No sour grapes here but after reading the Brochure Capt Ron posted on LASIK, I really am confused about the correction of the reading eye to distance and how that is reconciled to reading charts and instruments which is why the person has a near eye correction in the first place. If they need a clear section in the glass lens, that makes sense to me but the brochure seemed to be silent on this. :dunno:

If the FAA has a SODA process for LASIK and not for Contacts, so be it even if I don't understand the logic. :D

BTW, I really appreciate your comments on the board.

Cheers
 
They even have a SODA for one eye missing...... but not one contact.
 
jbarrass said:
They even have a SODA for one eye missing...... but not one contact.
Click to expand...
Read page 5 of Nakagarawa et al. I posted it in post #29, it's the first 1.1 meg PDF.

The problem is that the brain takes a while to adjust to the different cues of monovision. So, if you have the lenses in part of the time and not others, the brain gets confused. That is why, after Monovision lasik, there is a three month wait to fly. This is the three months of wearing the one contact in the one eye prior to the "burn in" of LASIK, then the 3 months after. From "Information for Pilots considering Laser Eye surgery":

Airmen who opt for monovision LASIK must initially wear correction (i.e., glasses or contact lens) for near vision eye while operating an aircraft. After a 6-month period of adaptation, they may apply for a Statement of demonstrated Ability (SODA) with a medical flight test. If the airman is successful, the lens requirement is removed from their medical certificate.​


One contact in- lessee, sometimes the contact is out, isn't it?

So if you read the postings you would see that the difference is, when one eye is missing, it doesn't sometimes come back and then go missing again, does it?

"...in the case of the
Delta 554 accident, the NTSB concluded that the
inability of the pilot to overcome his misperception
of the airplane’s position due to degraded stereopsis
and increased reliance on monocular cues, was a​
contributing factor."


Sigh.
 
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I really don't want to be a PITA about this but what does the airman do about near vision while wearing the required lens correcting the near vision eye to a distance eye for the six month adaptation period?

From the brochure:

"Airmen who opt for monovision LASIK must initially wear correction (i.e., glasses or contact lens) for near vision eye while operating an aircraft."

Sorry but while I understand that monovision contacts are unacceptable, it appears to me monovision via LASIK appears to be either a) acceptable via a SODA and no corrective lenses after six months or b) unacceptable unless one has good distance vision and poor near vision via a corrective distance lens on the near vision eye if one does not pass the MFT.

Is it that one has to have good enough near vision with the distance lens in place or is true monovision after the "six month period of adaptation" acceptable after passing the MFT with a resulting SODA?

Or is it since the airman is only wearing the distance lens while flying, it is good enough for the brain to be able to adapt during the rest of the time.

My basic questions are a) what is the solution for near vision in the cockpit while wearing distance lenses for the near vision eye and b) is monovision Via LASIK OK if one passes the MFT and is issued a SODA.

To quote Dr Chien "sigh":D

Cheers
 
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X3 Skier said:
I really don't want to be a PITA about this but what does the airman do about near vision while wearing the required lens correcting the near vision eye to a distance eye for the six month adaptation period?

From the brochure:

"Airmen who opt for monovision LASIK must initially wear correction (i.e., glasses or contact lens) for near vision eye while operating an aircraft."

Sorry but while I understand that monovision contacts are unacceptable, it appears to me monovision via LASIK appears to be either a) acceptable via a SODA and no corrective lenses after six months or b) unacceptable unless one has good distance vision and poor near vision via a corrective distance lens on the near vision eye if one does not pass the MFT.

Is it that one has to have good enough near vision with the distance lens in place or is true monovision after the "six month period of adaptation" acceptable after passing the MFT with a resulting SODA?

Or is it since the airman is only wearing the distance lens while flying, it is good enough for the brain to be able to adapt during the rest of the time.

My basic questions are a) what is the solution for near vision in the cockpit while wearing distance lenses for the near vision eye and b) is monovision Via LASIK OK if one passes the MFT and is issued a SODA.

To quote Dr Chien "sigh":D

Cheers
Click to expand...
(a) Contact in the one eye so that it sees distant, like the other eye, and then granny glasses out in front if needed. (b) yes.

and (c) conclude that the FAA would really rather you didn't have this solution. There are very few professional crews that will tolerate six months down.

In reality there is no opthalmologist who would burn in correction without a three month trial of monovision contacts, and you can't fly in that period, at all, if you want to figure out if your brain adapts- or you can fly with grannies or bifocals and much up your brain during that period like the pilot of the accident airplane; Afterward you can't fly until the SODA ride unless you have the "undo it" contact, and that messes up your chance of getting it right on the soda ride.
 
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bbchien said:
(a) Contact in the one eye so that it sees distant, like the other eye, and then granny glasses out in front if needed. (b) yes.

and (c) conclude that the FAA would really rather you didn't have this solution. There are very few professional crews that will tolerate six months down.

In reality there is no opthalmologist who would burn in correction without a three month trial of monovision contacts, and you can't fly in that period, at all, if you want to figure out if your brain adapts- or you can fly with grannies or bifocals and much up your brain during that period like the pilot of the accident airplane; Afterward you can't fly until the SODA ride unless you have the "undo it" contact, and that messes up your chance of getting it right on the soda ride.
Click to expand...

Thanks, appreciate the simple answer. Glad I don't want/ need LASIK. :wink2:

Cheers
 
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Rigged4Flight said:
I wish I could remember what mine were. I'm stuck with glasses for the next long while, but if I could get some type of multifocal contacts that could also correct my astigmatism I'd probably jump at it when I return to the states. I despise wearing glasses, but if it's a choice between clear sight and personal preference, I'll take the clear sight.
Click to expand...
My vision deficiency is more aspheric than spherical. IIRC one eye is about 20/200 and the other is around 20/40 but the aspheric correction (astigmatism) for each eye is bigger than the spherical correction. RGP multifocal lenses have given me 20/20 distance and around 20/30 near vision for several years. There are different sources of aspherical distortion. Mine is mostly due to misshapen corneas which is what the RGPs are good at correcting. If your problem is a non-spherical retina they probably won't work as well for you as for me.
 
My astigmatism is significantly greater than my nearsightedness. I tried weighted soft contacts once for a significant enough period of time that I could say I really gave them a shot, and hated them the whole time. About ten seconds with hard contacts was all that type took. No way.

I just wear glasses and learned the hard way not to cheap out on either the Doc nor the lab making the lenses.

About the only time I hate glasses is if I'm forced to use a cheap pair of binoculars with them that can't be properly adjusted. Anything else, I'll take the glasses.
 
I have had serious issues with vision in the military as I have grown older. In most military vehicles, radios are typically inches away from my face, and when wearing eye protection (always) I found it impossible to see the radios clearly enough to work them. I tried unsuccessfully several times to work with military eye doctors to get a prescription that would work for me. For reasons that no one was ever able to explain, military won't provide progressive lenses to deploying soldiers, and the bifocal distance/reading lenses were always too much of one and too little of the other to be useful for focusing just inches away from my face.

Now that I've typed all that out, I'm not sure it is even relevant to the thread... but I typed all them letters and I am by god gonna post 'em!
 
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