Laser Vision Correction and Military Service by David A. Wallace MD IntroductionSurgical methods of vision correction have made it possible for many people to function at a consistently high level in a wide variety of duties and occupations. Particularly in the context of active duty service in hostile situations, often including adverse climate conditions, contact lens wear is not always a reliable form of vision correction. Neither, for that matter, is the use of prescription eyeglasses. This has been recognized by all branches of the US military, and now each branch of the Armed Forces has its own policy regarding vision correction treatment. We present here a brief overview of the prevailing policies for each branch of the US Armed Forces as we understand them. We also provide links to relevant sites where more detailed information can be obtained directly from the appropriate service website. It is imperative that every individual contemplating military service, or already engaged in same, become familiar with the specific regulations pertaining to surgical vision correction for their chosen or assigned branch of service. For instance, while PRK (aka "surface treatment") is permitted by the US Navy for all Special Warfare personnel and pilots, LASIK is at this time not permitted for these duty classifications; and would disqualify from active duty. While we can offer information and guidance on a web page like this, and while we endeavor to maintain up-to-date information on vision correction policies of the US Armed Forces (and other branches of Government service including FBI, US Treasury, Dept. of Homeland Security, and the numerous Federal, State and local law enforcement agencies), you should not rely solely or exclusively on the information contained herein before making a decision about surgical vision correction. Service branches are listed below in alphabetical order.  US Air Force
The US Air Force has since about 1997 permitted PRK (or equivalent forms of surface treatment) for pilots and aviation-related duty positions, but had considered LASIK disqualifying for duty. In May 2007, this position was substantially revised. USAF now allows LASIK for all classes of aviators. The change in policy became effective after studies showed there was little or no difference between LASIK-treated eyes and untreated eyes when subjected to wind blast experienced during aircraft ejection or exposure to high altitude, and to high G-forces. This approval followed closely after the NASA medical advisory board recommended LASIK approval in astronauts. All applicants to aviation-related career fields — regardless of whether they have had corrective eye surgery — must still meet the vision requirements articulated in AFI 48-123. The change also removes the altitude and high-performance aircraft restrictions for people who have had LASIK. The Air Force is recommending two particular types of LASIK surgery for aviation candidates: Wave Front Guided Photorefractive Keratectomy, or WFG-PRK, and Wave Front Guided Laser In-Situ Keratomileusis, or WFG-LASIK. LA Sight offers both forms of treatment. For detailed information, you can download the May, 2007 USAF Refractive Surgery Program memo detailing relevant updates and changes. This is a 17-page memo so don't be surprised that it's a 4.4MB file size at download. For further information about the USAF Warfighter Refractive Surgery Program see US Air Force Aviator/Special Duty Refractive Surgery Program and USAF Corneal Refractive Surgery Registry, sponsored by the USAF School of Aerospace Medicine and the Aeromedical Consultation Service Ophthalmology Branch.  US Army US Army Information about Refractive Surgery This site offers links to the following:
Army Warfighter Refractive Eye Surgery Program ("AWRESP") USASOC allows PRK only. Ranger school usually provides waivers for PRK and LASIK. All other commands allow LASIK or PRK. PRK waivers are available three months after surgery.
Expanded Medical Waivers for Refractive Eye Surgery
Refractive Surgery in the Military
Evaluation of Refractive Surgery for Army Aviation Study
Policy on Medical Waivers for US Army Personnel with a History of Refractive Surgery The Army reviewed what was known about the safety of laser refractive surgery in the civilian population to include safety in active sports figures such as boxers, NFL football players and others and determined there was good reason to expect safe results in the Army's most valuable asset….the soldier. Additional studies within the military were begun and examined military specific issues such as parachute jumping and prolonged field duty after laser refractive surgery. Restrictions and/or special waivers exist for soldiers who have had refractive surgery prior to entry into training programs for aviation, airborne, Ranger, Special Forces, HALO (high altitude, low opening), marine diving or combat diving. Army Aviators: Only pilots who are enrolled in the USAARL approved protocol to follow PRK and LASIK throughout flight school would be allowed to have surgery. All other pilots are not eligible to have surgery. LASIK is currently disqualifying/non-waiverable for SOC schools (HALO, SCUBA, SFQC, SERE).
 US Coast Guard
Coast Guard personnel may choose to have PRK or LASIK. All methods of laser vision correction (PRK, LASIK and LASEK) can be waivered for accessions, if they meet all other vision and eye policies. Read the relevant Coast Guard Bulletin for further clarification. PRK or other methods of surface treatment have been acceptable (within guidelines as specified) since at least the year 2000. Coast Guard policy was apparently revised in mid-2005 to permit LASIK as a treatment option, where previously it had been disqualoifying for most active duty positions. Refer to updated Refractive Surgery Policy in Chapter 3D Vision correction for active duty members can be obtained through DoD or civilian providers. Like any other elective procedure, care would be obtained at the cost, time and risk of the individual.  US Navy & Marine Corps 
The Navy does recognize and support both LASIK and PRK for active duty personnel, with specific restrictions, as long as strict guidelines are respected and follow-up care is maintained. In general, PRK is acceptable but LASIK is considered disqualifying for active duty in any Special Forces (air, sea or land) capacity, and for naval aviators. LASIK is not disqualifying for general duty positions. See the US Navy Bureau of Medicine and Surgery Policy on Refractive Surgery . The permissions and restrictions representing official Spreadsheet indicating Specific Navy & USMC Policy by Procedure and Duty Classification as published in April '04 is shown. Review also their monograph on Corrective Eye Surgery Information. Beginning in approximately 2005, the Navy began an internal study of LASIK for pilots and aviators. Currently (as of April, 2008) it is only possible to obtain LASIK and maintain aviator active duty status with waivers if the surgical procedure is provided by a select few Navy refractive surgery centers operating under an Investigational Review Board. The data from this experience is apparently favorable, and it is likely that the Navy will change to a more permissive position regarding LASIK for Naval aviators (or perhaps first trainees for such positions) in the near future. |