Posted on Oct 30, 2015
Calling all Flight Surgeons (and other Medical Personnel) and/or Rated Aviators – Flight Physical Question!
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I have been selected for a UPT slot and this past Tuesday I took my flight physical at Scott, AFB. I thought the physical went well…until the very last station – Optometry. The doc told me that I have “enlarged optical nerves” – which is one potential sign of Glaucoma. He repeatedly told me that he is not diagnosing me with, nor does he think I have Glaucoma because I show no other signs of the condition. He stated he believes my optical nerves are enlarged because it’s just my anatomy, and not due to tissue degradation – which would typically be a sign of the disease otherwise. His exact words were “You have fantastic vision and your eyes look healthy”. I even passed the stereo-vision profile using that stupid "Dot Test" -- they didn't have to confirm my depth perception with the ancillary tests. Anyway, the Optometrist simply said “I just have to make a note of this in your file” and “not to be overly concerned”. Of course, after he brought it up, it’s kind of hard to dismiss as unimportant. I have had many, many eyes exams by both the military and the private sector – this is the first time it’s ever been mentioned. That said, this news is a little unsettling. Anyway, I asked him if this would require additional testing and/or a waiver. He said “possibly” but wasn’t sure. He said HQ AETC may require additional testing before certifying my physical and they may not.
Has anyone dealt with this issue or something similar during the flight physical certification process? Do I have a fighting chance or does it sound like I am boned?
Has anyone dealt with this issue or something similar during the flight physical certification process? Do I have a fighting chance or does it sound like I am boned?
Posted in these groups: 
Medical
Flight Medic
Medical Flight Medic
Posted >1 y ago
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For something like this, IF it is deemed a need to evaluate it further, HQ AETC will tell the base what tests it needs. Often times, the extra testing is done and all gets finished up. In a limited few instances, it is a deny to fly, and the middle ground is that if anyone sees it as a non-issue, but something to cover for, they may require a waiver (takes some time, but isn't difficult). Good luck!
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2d Lt (Join to see)
Thank you, sir. I appreciate the insight. In your experience, what is the 'average' turnaround time for certification of flight physicals? (Provided I don't require an additional testing/waiver, etc.) A month? Six weeks?
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Maj Chris Nelson
2d Lt (Join to see), Just talked to my Flight Surgeon. In a completely normal physical, expect 30 days (most common) up to 60 days to process. I mentioned to her about the "larger than average optic nerve". She indicated that that will most likely require a waiver. It will probably require additional exam/tests to verify there are no issues. She also stated that this condition is not an uncommon waiver...but they do have to chase it to ground before they approve you for flight. Without seeing your medical record, I can't give you any firm answers....but I suspect you will have more eye testing/exam, then if all is well, you will be granted a waiver. If they find something, you will not be approved....this is for both your safety and the safety of the airframe. Eyes are one of the systems that they take VERY seriously for flight physical.
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2d Lt (Join to see), I have the same thing. They watched me for 5ish years with NO change. So it isn't a big deal, IF you have the same prognosis as I have.
Here's how a surprisingly concerned (and the first guy to even noticed it) eye dude (Major) at the base clinic explained it. There is a passage for light to come in to the back of the eye. Correlate that with a donut. We have a larger donut hole than most folks have. As long as the donut hole doesn't change we are good to go. Mine hasn't changed for 6-7 years now, so, no worries.
The only thing I have ever noticed is that I have always been overly light sensitive. So I always have had to wear sun glasses outside. Is it related? Don't know, or they couldn't say either way, but it makes sense to me now.
I hope this helps. Ask your eye dude if this jives with what I have told you.
Good luck,
Dave
Here's how a surprisingly concerned (and the first guy to even noticed it) eye dude (Major) at the base clinic explained it. There is a passage for light to come in to the back of the eye. Correlate that with a donut. We have a larger donut hole than most folks have. As long as the donut hole doesn't change we are good to go. Mine hasn't changed for 6-7 years now, so, no worries.
The only thing I have ever noticed is that I have always been overly light sensitive. So I always have had to wear sun glasses outside. Is it related? Don't know, or they couldn't say either way, but it makes sense to me now.
I hope this helps. Ask your eye dude if this jives with what I have told you.
Good luck,
Dave
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2d Lt (Join to see)
Thanks man! I'm not overly light sensitive. It's highly possible no one mentioned it until now because none of the other optometrists saw an issue. The doc literally said "It's probably just your anatomy and the AF will review it each year at your annual eye exam" and not to "worry". Of course, it's hard sometimes. He didn't say it wouldn't DQ me, but the doc also couldn't tell me much of anything other than what he noticed. I wonder isf this "condition" is why my eyesight is so sharp...he commented on that several times. I am just trying to not get my hopes up if this is going to be an issue for the AETC.
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TSgt David L.
Hopefully it's the same as mine 2d Lt (Join to see). This Doc had studied many conditions so he had a slight knowledge of it. He buffed up on it more and took good care of me. Nobody else had. Like I said, good luck.
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I worked Physical Exams and Standards for a bit before retirement, but I have to admit, I have never heard of "Enlarged Optic Nerves" nor am I familiar with testing for it. HQ AETC may require additional testing, but again, I am unsure as to what that would be. The Instruction that would cover it would be AFI 48-123. I do find it odd that the Flight Doc that accomplished your exam, or the Tech that is processing it couldn't have given you more/better information referencing your exam. But if HQ AETC does require additional testing, they (The Tech processing your exam) will definitely contact you.
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2d Lt (Join to see)
I appreciate it. His exact words were "Your optical nerves are larger in diameter than what we usually see". I knew the Air Force likes to get into the weeds regarding eye health for pilot candidates and currently rated pilots -- as it should -- but I must say I was a little taken aback when he said that. My response was more or less "I didn't even know that was a thing"? It was also strange that even though he thought it was important enough to point out to me, he also kept reiterating to not be concerned. I'll research the AFI that you referenced -- thank you for that by the way. If you still have access to any of your contacts (military optometrists, flight docs) when you worked at Medical Standards, mind reaching out to them if they're on here? Point them in my direction if you can. I would really appreciate it. Thank you again.
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