Keratoconus + Scleral Lenses

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I'm looking to get an FAA medical for the first time and am contemplating trying for a first class to see if it is achievable. I'm in my mid 30's and signs of keratoconus first appeared about 20 years ago. My vision can now be corrected to 20/20 in each eye with scleral lenses. My corneal topographies from the past several years haven't indicated any significant changes, and my vision suggests that there hasn't been any major progression in many years. We are holding off on corneal cross-linking unless some evidence of progression appears, but hopefully that is becoming less likely as I age.

I've searched for other keratoconus posts but couldn't find any definitive answers on scleral lenses. Are there any special requirements when scleral lenses are necessary? (I can't achieve the same acuity with spectacles.) It took some fine-tuning to get the last couple of letters on the 20.20 line of the chart sharp enough to read. If at some point in the future we are no longer able to get all of the 20/20 letters legible for an eye, how difficult would it be to still obtain a first/second class medical?

I had a first consultation with an AME who wasn't certain of the FAA's keratoconus requirements. He said I would need an 8500-7 form filled out by my optometrist. He suspected that I might need Humphrey visual field tests but said he would look into it further. I'd also imagine that notes/status reports from my corneal specialist and optometrist who prescribed the lenses would be needed. If anyone has worked through keratoconus cases and can state what other information I'd need to provide the FAA, that would be most helpful.

On another issue, I've had a history of psoriasis (mainly on my knees) in my teen years but all symptoms seem to have disappeared for the last few years. I don't know if I could obtain any records of the diagnosis since it was so many years ago and the doctors involved have likely retired. However, I've reported the condition on more recent medical history question sheets at various doctors' offices, so it likely would show up on the medical records I'll need to pass along for the FAA medical. I've never used anything other than topical treatments in the past. Since there is the history, I assume I'll need to report it as an "other illness, disability, or surgery." I understand that an active psoriasis case would require an SI, but would this that is now presenting no symptoms require anything? Will the lack of records on my psoriasis history present a problem?

Thanks in advance.
 
It's entirely an agency decision, case by case.
 

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There is someone who used to be quite active here who got approved with keratoconus. Maybe he will chime in or PM you.
 
It's entirely an agency decision, case by case.

Dr. Chien - Thank you for the reply. I've been learning about the general process of dealing with SI/disqualifying conditions by reading many of your replies for a variety of conditions, and to the best of my understanding, your general approach is to get everything squared away until you're confident the airman will pass before conducting the exam. For keratoconus, the FAA's guidance (as you attached) seems rather open-ended and not conducive to reaching a high level of confidence prior to the deferral going to them. It's appearing that all I can do is try to achieve the best correction that I can and then take the exam.

Azure - Thanks for the comment. Searching through threads here and elsewhere, it is encouraging to see that others are ultimately successful.
 
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