SUBJ: EXPANDED NAVY FLIGHT SCHOOL ELIGIBILITY FOR INDIVIDUALS WHO
HAVE RECEIVED PHOTOREFRACTIVE KERATECTOMY (PRK)
A. MEDICAL MANUAL COMDTINST M6000.1B
1. THIS ALCOAST IS TO INFORM POTENTIAL COAST GUARD STUDENT AVIATOR
CANDIDATES THAT THE NAVY IS CONDUCTING AN ACCESSIONING STUDY TO
DETERMINE THE EFFECTS PRK HAS ON STUDENT AVIATOR PERFORMANCE. IN AN
EFFORT TO EXPAND THE POOL OF ELIGIBLE COAST GUARD CANDIDATES FOR
NAVY FLIGHT SCHOOL, THE COAST GUARD WILL BE ALLOWED TO SEND
CANDIDATES WHO HAVE HAD PRK (ANTERIOR CORNEAL STROMAL SURFACE LASER
ABLATION WITH NO STROMAL FLAP) AND MEET ALL OF THE FOLLOWING
ENROLLMENT CRITERIA:
A. INCLUSION CRITERIA:
(1) MALE OR FEMALE, OF ANY RACE, WHO IS AT LEAST 18 YEARS OLD AT
THE TIME OF THE EXAMINATION.
(2) APPLYING FOR AVIATION TRAINING AS A STUDENT COAST GUARD
AVIATOR.
(3) HAD A PREOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS 6 OR MINUS 8.00 TOTAL DIOPTERS IN ANY MERIDIAN WITH
LESS THAN OR EQUAL TO PLUS OR MINUS 3.00 DIOPTERS OF CYLINDER AND
ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS. CANDIDATES WHOSE
PREOPERATIVE REFRACTIVE ERROR WAS GREATER THAN MINUS 5.50 TOTAL
DIOPTERS IN ANY MERIDIAN AND LESS THAN OR EQUAL TO MINUS 8.00 TOTAL
DIOPTERS IN ANY MERIDIAN MUST HAVE UNDERGONE PRK NO SOONER THAN 6
MONTHS PRIOR TO ENROLLMENT. CANDIDATES WHOSE PREOPERATIVE
REFRACTIVE ERROR WAS GREATER THAN OR EQUAL TO MINUS 0.25 TOTAL
DIOPTERS IN ANY MERIDIAN AND LESS THAN OR EQUAL TO MINUS 5.50 TOTAL
DIOPTERS IN ANY MERIDIAN MUST HAVE UNDERGONE PRK NO SOONER THAN 3
MONTHS PRIOR TO ENROLLMENT. CANDIDATES WHOSE PREOPERATIVE
REFRACTIVE ERROR WAS GREATER THAN OR EQUAL TO PLUS 0.25 TOTAL
DIOPTERS IN ANY MERIDIAN AND LESS THAN OR EQUAL TO PLUS 6.00 TOTAL
DIOPTERS IN ANY MERIDIAN MUST HAVE UNDERGONE PRK NO SOONER THAN 6
MONTHS PRIOR TO ENROLLMENT.
(4) DEMONSTRATED REFRACTIVE STABILITY AS CONFIRMED BY CLINICAL
RECORDS. NEITHER THE SPHERICAL OR CYLINDRICAL PORTION OF THE
REFRACTION MAY HAVE CHANGED MORE THAN 0.50 DIOPTERS DURING THE TWO
MOST RECENT POSTOPERATIVE MANIFEST REFRACTIONS, SEPARATED BY AT
LEAST ONE MONTH. THE FINAL MANIFEST REFRACTION SHALL BE PERFORMED
NO SOONER THAN THE END OF THE MINIMUM WAITING PERIOD AS SPECIFIED
IN PARAGRAPH 2(A)(3) ABOVE (3 OR 6 MONTHS DEPENDING ON THE DEGREE
OF PREOPERATIVE REFRACTIVE ERROR).
(5) POST OPERATIVE BEST SPECTACLE CORRECTED DISTANCE AND NEAR
VISUAL ACUITY OF AT LEAST 20/20 IN EACH EYE.
(6) NORMAL COLOR VISION. FOR FALANT, MUST GET 9/9 CORRECT TO
PASS. IF FAILED ONCE, MUST REPEAT TWO SERIES OF 9, ONE PASS
COUNTERCLOCKWISE, WITH 16/18 CORRECT TO PASS. FOR PIP OR ISHIHARA
PLATES, TO PASS MUST GET 10/15 CORRECT ON A 15 PLATE TEST.
(7) BE ABLE TO PROVIDE DETAILED CLINICAL RECORDS OF THE
PREOPERATIVE REFRACTIVE ERROR, DETAILED COPY OF THE OPERATIVE
REPORT INCLUDING TYPE OF PROCEDURE AND AT LEAST TWO POSTOPERATIVE
EYE EXAMINATIONS SEPARATED BY AT LEAST ONE MONTH INCLUDING VISUAL
ACUITY AND REFRACTION THAT DEMONSTRATE REQUIRED REFRACTIVE
STABILITY AS DEFINED ABOVE.
(8) MEET ALL OTHER AVIATION APPLICANT ENTRANCE CRITERIA.
(9) POSTOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS 3.00 OR MINUS 2.00 DIOPTERS SPHERE IN ANY MERIDIAN,
LESS THAN OR EQUAL TO 0.75 DIOPTER TOTAL CYLINDER, AND
ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS ON BOTH THE FINAL
MANIFEST REFRACTION AND THE REQUIRED CYCLOPLEGIC REFRACTION
COMPLETED NO SOONER THAN THE END OF THE MINIMUM WAITING PERIOD AS
SPECIFIED IN PARAGRAPH 1(A)(3) ABOVE (3 OR 6 MONTHS DEPENDING ON
THE DEGREE OF PREOPERATIVE REFRACTIVE ERROR).
(10) POST OPERATIVE UNCORRECTED VISUAL ACUITY OF AT LEAST 20/50
EACH EYE.
(11) HETEROPHORIA OF LESS THAN OR EQUAL TO 10 PRISM DIOPTERS
ESOPHORIA, 10 PRISM DIOPTERS OF EXOPHORIA OR 1.5 PRISM DIOPTERS OF
HYPERPHORIA.
(12) NORMAL STEREOPSIS. FOR VERHOEFF, 8/8 CORRECT TO PASS.
IF FAILED ONE OR MORE, MUST REPEAT TWO SERIES OF 8 WITH 16/16
CORRECT TO PASS. FOR AFVT, A-D CORRECT TO PASS.
B. EXCLUSION CRITERIA:
(1) ANY TYPE OF REFRACTIVE SURGERY OTHER THAN PRK. LASER IN-
SITU KERATOMILEUSIS (LASIK) IS SPECIFICALLY PROHIBITED.
(2) CURRENT USE OF TOPICAL OPHTHALMIC STEROID DROPS.
(3) VISUAL SYMPTOMS RELATED TO THE PROCEDURE.
2. ACCESSIONS FROM ACTIVE DUTY 0-1/0-2 APPLICANTS AND OCS
APPLICANTS: ACTIVE DUTY FLIGHT SCHOOL CANDIDATES WHO ELECT TO HAVE
PRK MUST FOLLOW GUIDELINES FOR ELECTIVE HEALTH CARE CONTAINED IN
REF A. THEY WILL APPLY FOR AVIATION TRAINING IN ACCORDANCE WITH
CURRENT USCG REGULATIONS. ALL OF THE NECESSARY PAPERWORK INCLUDING
THE PRK PREOPERATIVE REFRACTION, THE OPERATIVE REPORT, AND THE
POSTOPERATIVE FOLLOW-UP WILL BE ASSEMBLED. CGPC WILL DETERMINE IF
THE CANDIDATE MEETS NAVY FLIGHT SCHOOL ACCESSION STUDY PARAMETERS
AND ASCERTAIN THAT HE/SHE IS OTHERWISE MEDICALLY QUALIFIED AS A
STUDENT COAST GUARD AVIATOR. THE MEDICAL RECORDS WILL THEN BE FAXED
TO THE NAVAL AEROSPACE MEDICAL INSTITUTE (NAMI) FOR REVIEW BY THE
OPHTHALMOLOGY DEPARTMENT. PENDING A POSITIVE ENDORSEMENT FROM NAMI,
CGPC WILL THEN CONSIDER GRANTING A WAIVER FOR "HISTORY OF
PHOTOREFRACTIVE KERATECTOMY." IF THE WAIVER IS GRANTED AND THE
APPLICANT IS SELECTED BY THE FLIGHT SCHOOL SELECTION PANEL, THE
CANDIDATE WILL BE ISSUED ORDERS TO FLIGHT TRAINING AT NAVY
PENSACOLA. UPON ARRIVAL AT PENSACOLA, NAMI WILL EXAMINE THE
APPLICANT AND VERIFY THAT HE/SHE MEETS CRITERIA TO ENROLL IN THE
PRK AVIATOR ACCESSIONING STUDY AND OFFER ENROLLMENT.
3. THIS ALCOAST DOES NOT CHANGE ANY OF THE CURRENT POLICY FOR RATED
AVIATORS AND AIRCREW. REFER TO REF A FOR COAST GUARD POLICIES
AFFECTING RATED AVIATORS AND AIRCREW WITH REGARDS TO REFRACTIVE
SURGERY. THE RESULTS OF THE VARIOUS NAVY STUDIES ON PRK AND AVIATOR
PERFORMANCE WILL BE USED, WHEN COMPLETED, TO UPDATE COAST GUARD
POLICIES FOR RATED AVIATORS AND AIRCREW.
4. POC: LCDR FRANK GENCO, CGPC (OPM-2), 202-267-6025
5. INTERNET RELEASED AUTHORIZED
6. RADM JOYCE JOHNSON, USPHS, DIRECTOR OF HEALTH AND SAFETY SENDS
HAVE RECEIVED PHOTOREFRACTIVE KERATECTOMY (PRK)
A. MEDICAL MANUAL COMDTINST M6000.1B
1. THIS ALCOAST IS TO INFORM POTENTIAL COAST GUARD STUDENT AVIATOR
CANDIDATES THAT THE NAVY IS CONDUCTING AN ACCESSIONING STUDY TO
DETERMINE THE EFFECTS PRK HAS ON STUDENT AVIATOR PERFORMANCE. IN AN
EFFORT TO EXPAND THE POOL OF ELIGIBLE COAST GUARD CANDIDATES FOR
NAVY FLIGHT SCHOOL, THE COAST GUARD WILL BE ALLOWED TO SEND
CANDIDATES WHO HAVE HAD PRK (ANTERIOR CORNEAL STROMAL SURFACE LASER
ABLATION WITH NO STROMAL FLAP) AND MEET ALL OF THE FOLLOWING
ENROLLMENT CRITERIA:
A. INCLUSION CRITERIA:
(1) MALE OR FEMALE, OF ANY RACE, WHO IS AT LEAST 18 YEARS OLD AT
THE TIME OF THE EXAMINATION.
(2) APPLYING FOR AVIATION TRAINING AS A STUDENT COAST GUARD
AVIATOR.
(3) HAD A PREOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS 6 OR MINUS 8.00 TOTAL DIOPTERS IN ANY MERIDIAN WITH
LESS THAN OR EQUAL TO PLUS OR MINUS 3.00 DIOPTERS OF CYLINDER AND
ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS. CANDIDATES WHOSE
PREOPERATIVE REFRACTIVE ERROR WAS GREATER THAN MINUS 5.50 TOTAL
DIOPTERS IN ANY MERIDIAN AND LESS THAN OR EQUAL TO MINUS 8.00 TOTAL
DIOPTERS IN ANY MERIDIAN MUST HAVE UNDERGONE PRK NO SOONER THAN 6
MONTHS PRIOR TO ENROLLMENT. CANDIDATES WHOSE PREOPERATIVE
REFRACTIVE ERROR WAS GREATER THAN OR EQUAL TO MINUS 0.25 TOTAL
DIOPTERS IN ANY MERIDIAN AND LESS THAN OR EQUAL TO MINUS 5.50 TOTAL
DIOPTERS IN ANY MERIDIAN MUST HAVE UNDERGONE PRK NO SOONER THAN 3
MONTHS PRIOR TO ENROLLMENT. CANDIDATES WHOSE PREOPERATIVE
REFRACTIVE ERROR WAS GREATER THAN OR EQUAL TO PLUS 0.25 TOTAL
DIOPTERS IN ANY MERIDIAN AND LESS THAN OR EQUAL TO PLUS 6.00 TOTAL
DIOPTERS IN ANY MERIDIAN MUST HAVE UNDERGONE PRK NO SOONER THAN 6
MONTHS PRIOR TO ENROLLMENT.
(4) DEMONSTRATED REFRACTIVE STABILITY AS CONFIRMED BY CLINICAL
RECORDS. NEITHER THE SPHERICAL OR CYLINDRICAL PORTION OF THE
REFRACTION MAY HAVE CHANGED MORE THAN 0.50 DIOPTERS DURING THE TWO
MOST RECENT POSTOPERATIVE MANIFEST REFRACTIONS, SEPARATED BY AT
LEAST ONE MONTH. THE FINAL MANIFEST REFRACTION SHALL BE PERFORMED
NO SOONER THAN THE END OF THE MINIMUM WAITING PERIOD AS SPECIFIED
IN PARAGRAPH 2(A)(3) ABOVE (3 OR 6 MONTHS DEPENDING ON THE DEGREE
OF PREOPERATIVE REFRACTIVE ERROR).
(5) POST OPERATIVE BEST SPECTACLE CORRECTED DISTANCE AND NEAR
VISUAL ACUITY OF AT LEAST 20/20 IN EACH EYE.
(6) NORMAL COLOR VISION. FOR FALANT, MUST GET 9/9 CORRECT TO
PASS. IF FAILED ONCE, MUST REPEAT TWO SERIES OF 9, ONE PASS
COUNTERCLOCKWISE, WITH 16/18 CORRECT TO PASS. FOR PIP OR ISHIHARA
PLATES, TO PASS MUST GET 10/15 CORRECT ON A 15 PLATE TEST.
(7) BE ABLE TO PROVIDE DETAILED CLINICAL RECORDS OF THE
PREOPERATIVE REFRACTIVE ERROR, DETAILED COPY OF THE OPERATIVE
REPORT INCLUDING TYPE OF PROCEDURE AND AT LEAST TWO POSTOPERATIVE
EYE EXAMINATIONS SEPARATED BY AT LEAST ONE MONTH INCLUDING VISUAL
ACUITY AND REFRACTION THAT DEMONSTRATE REQUIRED REFRACTIVE
STABILITY AS DEFINED ABOVE.
(8) MEET ALL OTHER AVIATION APPLICANT ENTRANCE CRITERIA.
(9) POSTOPERATIVE REFRACTIVE ERROR IN EACH EYE LESS THAN OR
EQUAL TO PLUS 3.00 OR MINUS 2.00 DIOPTERS SPHERE IN ANY MERIDIAN,
LESS THAN OR EQUAL TO 0.75 DIOPTER TOTAL CYLINDER, AND
ANISOMETROPIA LESS THAN OR EQUAL TO 3.50 DIOPTERS ON BOTH THE FINAL
MANIFEST REFRACTION AND THE REQUIRED CYCLOPLEGIC REFRACTION
COMPLETED NO SOONER THAN THE END OF THE MINIMUM WAITING PERIOD AS
SPECIFIED IN PARAGRAPH 1(A)(3) ABOVE (3 OR 6 MONTHS DEPENDING ON
THE DEGREE OF PREOPERATIVE REFRACTIVE ERROR).
(10) POST OPERATIVE UNCORRECTED VISUAL ACUITY OF AT LEAST 20/50
EACH EYE.
(11) HETEROPHORIA OF LESS THAN OR EQUAL TO 10 PRISM DIOPTERS
ESOPHORIA, 10 PRISM DIOPTERS OF EXOPHORIA OR 1.5 PRISM DIOPTERS OF
HYPERPHORIA.
(12) NORMAL STEREOPSIS. FOR VERHOEFF, 8/8 CORRECT TO PASS.
IF FAILED ONE OR MORE, MUST REPEAT TWO SERIES OF 8 WITH 16/16
CORRECT TO PASS. FOR AFVT, A-D CORRECT TO PASS.
B. EXCLUSION CRITERIA:
(1) ANY TYPE OF REFRACTIVE SURGERY OTHER THAN PRK. LASER IN-
SITU KERATOMILEUSIS (LASIK) IS SPECIFICALLY PROHIBITED.
(2) CURRENT USE OF TOPICAL OPHTHALMIC STEROID DROPS.
(3) VISUAL SYMPTOMS RELATED TO THE PROCEDURE.
2. ACCESSIONS FROM ACTIVE DUTY 0-1/0-2 APPLICANTS AND OCS
APPLICANTS: ACTIVE DUTY FLIGHT SCHOOL CANDIDATES WHO ELECT TO HAVE
PRK MUST FOLLOW GUIDELINES FOR ELECTIVE HEALTH CARE CONTAINED IN
REF A. THEY WILL APPLY FOR AVIATION TRAINING IN ACCORDANCE WITH
CURRENT USCG REGULATIONS. ALL OF THE NECESSARY PAPERWORK INCLUDING
THE PRK PREOPERATIVE REFRACTION, THE OPERATIVE REPORT, AND THE
POSTOPERATIVE FOLLOW-UP WILL BE ASSEMBLED. CGPC WILL DETERMINE IF
THE CANDIDATE MEETS NAVY FLIGHT SCHOOL ACCESSION STUDY PARAMETERS
AND ASCERTAIN THAT HE/SHE IS OTHERWISE MEDICALLY QUALIFIED AS A
STUDENT COAST GUARD AVIATOR. THE MEDICAL RECORDS WILL THEN BE FAXED
TO THE NAVAL AEROSPACE MEDICAL INSTITUTE (NAMI) FOR REVIEW BY THE
OPHTHALMOLOGY DEPARTMENT. PENDING A POSITIVE ENDORSEMENT FROM NAMI,
CGPC WILL THEN CONSIDER GRANTING A WAIVER FOR "HISTORY OF
PHOTOREFRACTIVE KERATECTOMY." IF THE WAIVER IS GRANTED AND THE
APPLICANT IS SELECTED BY THE FLIGHT SCHOOL SELECTION PANEL, THE
CANDIDATE WILL BE ISSUED ORDERS TO FLIGHT TRAINING AT NAVY
PENSACOLA. UPON ARRIVAL AT PENSACOLA, NAMI WILL EXAMINE THE
APPLICANT AND VERIFY THAT HE/SHE MEETS CRITERIA TO ENROLL IN THE
PRK AVIATOR ACCESSIONING STUDY AND OFFER ENROLLMENT.
3. THIS ALCOAST DOES NOT CHANGE ANY OF THE CURRENT POLICY FOR RATED
AVIATORS AND AIRCREW. REFER TO REF A FOR COAST GUARD POLICIES
AFFECTING RATED AVIATORS AND AIRCREW WITH REGARDS TO REFRACTIVE
SURGERY. THE RESULTS OF THE VARIOUS NAVY STUDIES ON PRK AND AVIATOR
PERFORMANCE WILL BE USED, WHEN COMPLETED, TO UPDATE COAST GUARD
POLICIES FOR RATED AVIATORS AND AIRCREW.
4. POC: LCDR FRANK GENCO, CGPC (OPM-2), 202-267-6025
5. INTERNET RELEASED AUTHORIZED
6. RADM JOYCE JOHNSON, USPHS, DIRECTOR OF HEALTH AND SAFETY SENDS