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Laser eye surgery: Provides clarity for active duty service members

Close up picture of an eye ball with the words 'Laser Eye Surgery' across the top Laser eye surgery is becoming an increasingly popular treatment method for Airmen. Refractive surgeries, better known as LASIK and PRK are fully covered for Airmen meeting procedure requirements (Illustration by Air Force Airman 1st Class Collin Schmidt, 341st Missile Wing, Malmstrom Air Force Base).

Annually, more than 4,000 graduates of the U.S. military academies begin their service to the nation. About 1,000 of these individuals will have laser vision correction eye surgery before they step into their leadership roles.

Just one generation ago, prior to the advent of laser vision correction technology, an academy member's dream to be an aviator, Special Forces leader, or other tip of the spear warfighter may have been derailed due to their dependence on glasses. There was nothing academy members could do to eliminate their need for vision correction, and many still had stellar careers, but in a second or third choice for their military career.

Dr. Joe Pasternak, a retired Navy captain, recalled that when he was a midshipman, it was crushing to his classmates to discover their dependency on glasses would eliminate their preferred career selection if it was in aviation, Seals, Special Forces, explosives ordinance and demolition, etc. "If you missed just one letter on the 20/20 eye chart, your naval aviation career was doomed because you needed glasses," Pasternak explained. "It was devastating news for myself and many of my classmates."

In fact, it was Pasternak's myopia that caused him to redirect his career interest to military medicine from his initial choice of naval aviation. He served over 20 years, as an ophthalmologist, helping pioneer and introduce laser eye surgery to U.S. Naval Academy midshipman in Annapolis, Maryland.

With the introduction and continual improvement of corneal refractive surgery technology, a third of the USNA third-year class comes to Walter Reed National Military Medical Center in Bethesda, Maryland to have their laser eye surgery, by Pasternak and his colleagues.

"It is amazing, today's midshipman can have LASIK or photo refractive technology (PRK) and three to six months later, qualify for his/her choice of service selection, including naval aviation," Pasternak said.

"This procedure is an operational boost to the human vision system, preparing these midshipman to enter their military careers and professions without the burden of dependence on glasses/contacts," Pasternak continued. Although about half the 400 midshipman who have laser surgery per year are seeking aviation as a career, every midshipman who has these surgeries augments their readiness.

Picture of military health personnel performing eye surgery
Laser eye surgery is becoming an increasingly popular treatment method for Airmen. Refractive surgeries, better known as LASIK and PRK are fully covered for Airmen meeting procedure requirements (Illustration by Air Force Airman 1st Class Collin Schmidt, 341st Missile Wing, Malmstrom Air Force Base). 

"It's a pleasure and joy to provide laser eye surgery to our future officers and leaders in the United States Navy."

Our technology, combined with robust studies, have proved to our line commanders that post PRK and Lasik patients are safe and effective in all austere and deployed environments, whether it be on, under or above the oceans," Pasternak added.

The Journal of Cataract & Refractive Surgery published an article regarding a pivotal military study concerning a LASIK trial involving U.S. naval aviators. The study demonstrated a high level of safety and effectiveness in terms of the ability to see and perform their duties without glasses, reported Dr. David Tanzer, who was the lead author. According to the study, 330 naval aviators were treated with LASIK.

Navy Capt. (Dr.) Elizabeth Hofmeister, an eye physician and refractive surgeon in the study, views the excellent visual outcomes and high patient satisfaction as unprecedented. "Our uncorrected visual acuity was 20/20 or better in over 98 percent of the patients who were treated for myopia or myopia with astigmatism and over 95 percent of those who were treated for hyperopia, she said. She added many people gained lines of best corrected visual acuity. "More than 96 percent said that LASIK helped their effectiveness as naval aviators, and nearly 100 percent would recommend the same treatment to other pilots," Hoffmeister said.
Army Col. (Dr.) Buck Rodgers, former director of the West Point Refractive Surgery Center at the U.S. Military Academy in West Point, New York, said, "The ability to perform refractive surgery on USMA cadets was a complete game-changer for them."

"During my time as the ophthalmologist at the USMA, I treated over 1,000 cadets and the results were outstanding. We had an over 99 percent 20/20 or better outcomes, post-surgery for both LASIK and PRK patients."

Many cadets sought refractive surgery because they knew that it would "open doors that would otherwise be closed or more difficult with glasses or contacts, such as aviation and Special Forces or Infantry," Rogers said. "In many ways, this was the single most impactful readiness enhancing surgery I did while I was at the USMA. The benefits to the cadets are immeasurable in enhancing their readiness and safety."

Rogers was a Special Forces surgeon for more than three years with 3rd Special Forces Group and 5th Special Forces Group. He deployed once to Afghanistan and twice to Iraq. He was not medically qualified for refractive surgery and had to navigate his deployments with glasses. This put him at a disadvantage when he attended the JFK Special Warfare Center's High Level Survival, Evasion, Resistance & Escape (SERE) School, to where students are taught that one of the first things that happens to prisoners of war is their glasses are removed, hindering their ability to function.

Dependence on glasses also made it more challenging for Rogers in Afghanistan and Iraq since most of his on-site, outside "the wire" medical duties were performed in the dark with night vision goggles, which are somewhat compromised when wearing glasses.

Military health personnel looking at a close up picture of an eyeball
Refractive surgery on active duty service members is a readiness issue, as the procedure helps service members be less dependent on glasses or contacts in a deployed environment (Screenshot from video shot by Air Force Staff Sgt. Katelynn Moeller).

Understanding with firsthand knowledge the challenges of glasses and the benefits of refractive surgery in the combat environment, Rogers was enthusiastic to offer this life-changing surgery to as many cadets as were medically qualified at the USMA.

Air Force Lt. Col. (Dr.) Marcus Neuffer, an ophthalmologist and chief of refractive surgery at the United States Air Force Academy in Colorado Springs, Colorado said, "We are increasing and augmenting the opportunity for USAFA cadets to qualify for aviation careers, the backbone of today's Air Force as well as other professions that depend on excellent uncorrected distance vision. Military studies have demonstrated to our commanders and patients that LASIK and PRK are safe and effective during the demands of an aviation career, including high altitude missions as well as ejection from single seat fighter aircraft. Each year, we complete hundreds of surgeries on our USAFA cadets and the most common phrase I hear at follow up is. "Thanks so much....this surgery has changed my life and will really help my military career."

Paul Dondi, program manager of the united states air force academy refractive surgery center, said "Cadets are always telling me that the possibility of having this procedure (PRK or Lasik) is the reason they came to the academy because it would help them fulfill a lifelong dream of becoming a military pilot." Laser eye surgery is now a routine and expected rite of passage for many of our third year cadets and midshipman at the military academies.

PRK and Lasik are currently available at all 26 military laser centers for active duty military members. There is excellent access at many of these centers with waiting times from two to eight weeks. Small incision lenticule extraction, known as SMILE, is available at some military laser centers.

If you meet the medical and administrative requirements, and are active duty, speak to your local optometrist or ophthalmologist or log onto the nearest military laser center to complete an application. Remember this is an active duty readiness program and not available to retired members or family members.

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