macular degeneration

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I've just been told today that I do have this disease. It has not yet affected my vision. But how is having this on my medical record now going to affect me getting past my next medical, which I need to be able to start back flying lessons and re-soloing and getting the ticket? Should I just give it up now?

Im just a little anxious about this, although I know it can possibly never affect my vision for a very long time, if ever, it's still like having a sort of sword hanging over my head.

Thanks.
 
Well, Dr. Bruce can probably give you a more complete answer, but if this will keep you from passing a medical, so long as you don't fail a medical, you can go for your sport pilot's license. That is entirely self-certifying so long as you are medically fit for a driver's license. Good luck!
 
t0r0nad0 said:
Well, Dr. Bruce can probably give you a more complete answer, but if this will keep you from passing a medical, so long as you don't fail a medical, you can go for your sport pilot's license. That is entirely self-certifying so long as you are medically fit for a driver's license. Good luck!
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That's not entirely true. What the relevent reg (14 CFR 61.53(b)) says is, "a person shall not act as pilot in command, or in any other capacity as a required pilot flight crewmember, while that person knows or has reason to know of any medical condition that would make the person unable to operate the aircraft in a safe manner." [emphasis added]

What is not clearly spelled out in that reg or in any other FAA pub is what constitutes a "medical condition that would make the person unable to operate the aircraft in a safe manner." Is macular degeneration such a condition? Consider this from Wikipedia: "Macular degeneration is a medical condition predominantly found in elderly adults in which the center of the inner lining of the eye, known as the macula area of the retina, suffers thinning, atrophy, and in some cases bleeding. This can result in loss of central vision, which entails inability to see fine details, to read, or to recognize faces." [emphasis added]

I would suggest that as long as you can still pass an FAA visual acuity test at the Third Class level (i.e., 20/40 vision on the "Big E" eye chart, which is the same as most states require for a driver's license), your condition does not "make [you] unable to operate the aircraft in a safe manner." If you can't pass that test, I don't think you can see well enough to see and avoid other aircraft, and I'd say you would be "unable to operate the aircraft in a safe manner" even if your driver's license hasn't come up for renewal with an eye test yet. Note that since "see and be seen" is an inherent part of VFR flying, I would be very hesitant to substitute my own judgement for the FAA's about what constitutes the minimum visual acuity to fly safely under VFR even in a Light Sport plane.
 
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You will continue to be able to pass the FAA minimum standards for some time.....but after that, everything that Cap'n Levy wrote is TRUE.

I personally could not stand to fly if my VA were 20/40. I have had a student who was 20/40, passed his third, but when he got corrected to 20/20 started making all kinds of progress.....
 
Bruce, regarding Macular Degeneration: Both my father (91 now) and my uncle (by marriage) have or had Macular Degeneration. (My uncle has since passed away). As both were smokers (Dad quit about 1965, my Uncle never did) I am wondering if there is any correlation between smoking and MD...

I have never smoked (not counting the 3 or 4 I tried in the basement when I was 12). I'm just looking for whatever causation might be out there...

-Skip
 
Skip Miller said:
Bruce, regarding Macular Degeneration: Both my father (91 now) and my uncle (by marriage) have or had Macular Degeneration. (My uncle has since passed away). As both were smokers (Dad quit about 1965, my Uncle never did) I am wondering if there is any correlation between smoking and MD...

I have never smoked (not counting the 3 or 4 I tried in the basement when I was 12). I'm just looking for whatever causation might be out there...

-Skip
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yes, there is, and also between MD and vitamin B12 deficiency.
 
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Your situation sounds genetic in nature. Most cases of adult onset vitelliform macular dystrophy are caused by sporadic genetic lesions, although a sizable minority are due to mutations at the Best disease VDM2 gene on chromosome 11. This disorder is autosomal dominant, which may explain the number of your relatives affected.

Sorry for the bad roll of the dice. If it makes you feel any better, lots of people have genetic predicpositions for things that reak havoc on medicals; heart disease, epiliepsy, and diabetes all have genetic components to their etiologies. So do many disorders of the central nervous system, like bipolar disorder and schizophrenia. Heck, my father suffered from early onset Alzheimers, which is linked to a particular allele at the Apo E54 locus. I'm too chicken to genotype myself or my siblings; I really don't want to know. After what happened to my old man, to be honest I'd rather go blind.

Smoking still sucks big time, though.
 
steingar said:
Your situation sounds genetic in nature. Most cases of adult onset vitelliform macular dystrophy are caused by sporadic genetic lesions, although a sizable minority are due to mutations at the Best disease VDM2 gene on chromosome 11. This disorder is autosomal dominant, which may explain the number of your relatives affected.

Sorry for the bad roll of the dice. If it makes you feel any better, lots of people have genetic predicpositions for things that reak havoc on medicals; heart disease, epiliepsy, and diabetes all have genetic components to their etiologies. So do many disorders of the central nervous system, like bipolar disorder and schizophrenia. Heck, my father suffered from early onset Alzheimers, which is linked to a particular allele at the Apo E54 locus. I'm too chicken to genotype myself or my siblings; I really don't want to know. After what happened to my old man, to be honest I'd rather go blind.

Smoking still sucks big time, though.
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Um, what he, uh, said. :dunno:
 
Dah, my bad. Doesn't preclude a genetic predisposition, but does make is less likely. Twin studies suggest 70% of all macular is genetic in nature, leaving 30% to environmental causes. Of course, environment and genetic factors can interact to cause macular.

Do you know if there is an increased incidence of macular in your community?
 
How are you defining community? Hmmm... I guess that question is irrelevant, because the answer is no.

-Skip
 
bbchien said:
I have had a student who was 20/40, passed his third, but when he got corrected to 20/20 started making all kinds of progress.....
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Correct me if I'm wrong (and I'm not saying you were saying this -- I think you were just noting that 20/40 vision may be legal but not safe), but I don't think I've ever heard of any way to correct deficient DVA due to macular degeneration by use of prescription lenses, so that would not be an option once DVA deteriorates below that level due to macular degeneration.
 
Ron Levy said:
Correct me if I'm wrong (and I'm not saying you were saying this -- I think you were just noting that 20/40 vision may be legal but not safe), but I don't think I've ever heard of any way to correct deficient DVA due to macular degeneration by use of prescription lenses, so that would not be an option once DVA deteriorates below that level due to macular degeneration.
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You are correct, Ron. The fine vision portion of the macula is REQUIRED for the eye to produce anything better than ~20/100.

We don't know much about macular degeneration. It's the "endstage" of the retina. Why don't we know much? We've never lived this long before.
 
Thanks Cap'n Ron and Dr. Bruce for giving me some hope that I don't have to feel like I am throwing away everything I've worked for thus far. The retinal specialist did say it would be some years down the road--even IF the conditions started to deteriorate--but I had someone tell me before I posted here that this was it and hell--that would've been pretty damn depressing.

Currently my eyesight is fine (corrected, anyway) and I am on an increased intake of certain vitamins and minerals per optometrist, retinal specialist, and regular MD.

The optometrist who originally discovered the "drusen" in my eyes was very surprised to see them there, she said she didn't normally see them in people "my age" (48). However, in my own research I see this condition is becoming markedly increased for the over 50 crowd and studies have, indeed, linked it to tobacco use and B12 anemia. Most predisposition to diseases is genetically linked, yes, but conditions can be speeded up/acerbated by mistreatment of the bodily machine. I used to be a smoker (quit nine years ago). I can't rule out that those dozen or so years of rather heavy smoking had some sort of effect on me, even though I might think I am reasonably healthy now.

In any case, all we can do is take care of ourselves best we can with the knowledge we have today and what is being learned every day.

Thanks again for giving me hope for what is left of my flying future and more interesting information on this disease.
 
At the end of the day, the real test is whether you can see other airplanes at distances great enough to give you enough time to evaluate their movement and get your plane out of the way if necessary. I suspect you'll eventually find that ATC is calling traffic you just can't see until it's so close you get an uncomfortable feeling when you do see it. You may also find you have trouble reading PAPI's, getting a read on the wind sock from overhead, etc. Those sorts of clues would suggest you're at the point at which you have to make the "knock it off" call for safety reasons, even if you still test better than 20/40 on the eye chart.
 
Speaking of eye stuff officially on the record, I discovered that I've got code 377.41 in my record: Optic Neuropathy, Ischemic. I'm not even gonna try to get the doc to explain to the FAA that it was a freak, isolated incident that isn't going to happen again. Riiiight.....
 
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