Pre-surgery: with trifocals and Dr. Lahners
When Proust wrote, "The only real voyage of discovery consists not in seeking new landscapes, but in having new eyes," I don't believe he was referring to LASIK surgery. But if he were alive today, he might well have to clarify it.
Over the past few years, I had become increasingly dependent on my annoying prescription glasses. A repeat of what my parents had experienced, it shouldn't have been a surprise when my AME put, "Must wear corrective lenses," on my medical certificate. Sure, I got compliments on the cute round lenses I wore, but I hated them. They were the first things I reached for in the morning, and they were the last things I put down at night. I kept thinking of Henry Bemis, the character played by Burgess Meredith in the famous Twilight Zone episode, "Time Enough at Last."
Bemis, a bookish bank teller who loved to read, was hounded by his employer and wife not to waste his time with books. In the story, he sneaks away to read in a bank vault, when an explosion occurs. After grabbing his thick glasses, he emerges to find a nuclear war has destroyed everything and everyone around him. He wanders in despair until he finally sees a public library and finds himself surrounded by books, where he can read to his heart's content. As he bends down to pick up his first book, his glasses fall off his face and smash on the floor. Surrounded by books he can never read, he bursts into tears. He has lost everything: his eyesight, freedom and his independence.
Maybe it was time to do something. I had heard of LASIK, but I didn't want anyone messing with my eyes. Then, I started hearing of more and more pilots, even a couple of AMEs I knew, who admitted to having LASIK, so I became more curious.
I met Dr. Bill Lahners, a pilot and a highly regarded specialist in laser and cataract surgery with the Center for Sight in Sarasota, and asked him what he thought. He understood my concerns and invited me to have a consultation. After my exam, he told me that not only was I a good candidate for LASIK, but since everyone over the age of 50 develops cataracts at some point, I was a candidate for Intraocular Lens replacement (IOL) as well. Cataracts! Cataracts are a clouding of the natural lens in the eye and a normal part of the aging process, but the idea of me having cataract surgery was shocking. Doesn't this happen to really old people? I was told that if I did IOL instead of just LASIK, I'd never develop cataracts in the future and would have good eyes for the rest of my life. By the way, it didn't hurt that Dr. Lahners had treated Nik Wallenda's eyes. Remember Nik Wallenda, from the famous circus family, who recently walked a tightrope across the Grand Canyon?
I went home and thought about it for more than a year. In the meantime, my eyesight didn't miraculously improve. I was even unhappier with my trifocals and having to move my head around to read my GPS and then to adjust to see into the distance. It was depressing, I was sick of it, and I decided it was time to do something about it.
I considered several things. One: What was the FAA's position, and would I be able to maintain a Second Class Medical? Two: what about pulling positive Gs and pushing negative Gs? Three: What type of lens should I get?
Post-surgery: 20/20, wearing Ray-Bans!
Using the FAA and the AOPA websites, my research found that until recent advancements in IOL manufacturing technology, the FAA didn't allow pilots to fly with lens implants, but they do now. FAA regs require the pilot wait 90 days after surgery to apply for a medical and to submit Form 8500-7 with a report from their operating surgeon or treating specialist stating their vision is up to FAA standards. So, before my surgery, I renewed my Second Class Medical, and will submit my 8500-7 form before I renew it next year. There are no regulations against flying in the meantime, and my medical is still valid. Block checked.
As far as flying aerobatics, I asked a prominent physician and former Navy Flight Surgeon who's a known expert on Gs. He said, "No pulling Gs for at least 30 days…when you pull G, you naturally strain to stay awake. This works by raising the BP (sometimes known as aortic valve pressure) to incredibly high levels. This pressure increase is transferred to the eye, brain and spinal fluid. When the new lenses are placed, there's a small defect created in the cornea. The incredible pressure can disrupt this defect in the form of a fluid leak from the eye or a bleed, both of which are bad and can threaten your vision." No Gs for 30 days is a small price to pay for better eyesight.
I then had to choose from three available lenses: Premium, which corrects near and distant vision; the Multifocal lens, which corrects each eye differently; and the Crystalens, which corrects far and medium distance, but still might require reading glasses. Dr. Lahners and I agreed that Crystalens would be the best alternative for me and the type of work I do, flying upside-down at 20 feet cutting ribbons and such. It wouldn't affect my depth perception in any way, they're "FAA friendly," and after surgery, I should only need glasses for very close-up reading.
We scheduled surgery for my right eye on Wednesday, and left eye on Thursday, with a follow-up exam Friday morning. Dr. Lahners had said I could fly myself to and from Sarasota (amazing!), but I took the conservative approach and had a friend fly me there and back. On Wednesday morning, a Center for Sight shuttle picked me up at my hotel for surgery, where I was given a lot of eye drops and an IV sedative. Scary as it might seem, I was awake during the procedure, and it was quick, painless and even interesting. No doubt the sedative helped. The room was dark, and all I really saw was a machine hovering over me with some party lights dancing around it.
Center for Sight fixes a lot of eyes and has it all figured out. My experience from beginning to end was easy, painless and fairly anxiety-free. The staff is pleasant and friendly, which made the experience even better. After surgery, I was given some apple juice and those great peanut butter crackers that pilots like so much. Even my shuttle driver, Jack, was right there waiting to take me back to my hotel. I took a nap and woke up to the miracle of much improved vision, in one eye at least.
On Thursday, Jack picked me up again. After surgery, I went back to my hotel, took another nap and woke up to even more miraculously amazing vision. I had brought a pair of Ray-Bans that I hadn't worn in a couple of years. My prescription glasses had the photochromic or transition lenses that automatically darken when exposed to sunlight, so I had been wearing them as shades. I put on my Ray-Bans and walked to the Ringling Circus Museum, where I discovered a new, more colorful and sharper world. Inside, I could read the exhibits; outside, I walked the grounds marveling at the detail of the leaves in the trees. The sky was bluer, and the trees were greener. Everything seemed crystalline, and the phrase, "I couldn't believe my eyes," had a whole new meaning for me.
A week or so later, I'm still trying to figure out the glasses thing and tend to automatically grab for them. Yesterday, while at an airport coaching aerobatic pilots, I realized that I hadn't used my prescription glasses all day. Today, I went to a grocery store and forgot to bring them in with me, but I didn't need them. What a delightful confusion—to walk from room to room without glasses or to put them on and find I don't need them. I still need my reading glasses to read a text message and do close-up computer work, but that's the only time I need to put them on. I'm happy, and my parrot, Buddha, is as happy as I am, because he hated my glasses, too.
Since a pilot's ability to fly depends on their good health, it isn't easy for us to share our medical issues and experiences, even with each other. We're often out there on our own, and this makes it hard to find out what might medically be in our best interest. Pity any pilot who has to report something on their application for an FAA medical, even something innocuous like taking a short-term medication. It can take years to get a medical back for even minor things, as paperwork gets backlogged in the FAA Aeromedical Division in Oklahoma City. I've seen inaccurate EKGs and BP monitors, too. I say never trust your AME with anything other than what's routine and what they legally need to know.
I recently ran into an old friend, a top competition and air show pilot, who told me he had cataract surgery eight years ago. I had no idea! He also said he didn't do aerobatics for 30 days, but he has flown pretty hardcore since then, and has had absolutely no problems. I was so grateful to hear this, and this is why I want to share my experience with IOL and the fantastic results I'm experiencing.
We're so lucky to live in this era of emerging medicine. Even for a healthy person like me, this kind of technology has made a huge difference in my life. I hope I'm reborn in 100 years to see how far we've come then because it's only getting better. I want to share my experience with pilots to encourage those who are candidates for LASIK or IOL surgery to consider it and perhaps enjoy the best eyesight of their lives. It may not be for everyone, but as a pilot, it's worth considering.
We'd love to hear your comments about LASIK and IOL from a pilot standpoint. Drop us a note at [email protected]