For the last few years, the US military has taken a very conservative approach to refractive surgery. Recent news stories demonstrate that the military is now more positive about the procedures and has expanded their refractive surgery programs and facilities.

According to a recent article in the Washington Post, "The about-face came after a Department of Defense medical panel, after evaluating several years of research by the Navy, concluded that concerns about laser surgery damaging the structure of the eyes had not been borne out and that -- to the contrary -- the surgery was a way to improve the fighting forces. Congress subsequently approved $15 million for the program."1

While these reports are encouraging, recruits should understand that waivers are still required for accession. These waivers require full pre-, peri- and post-operative information. Additionally, there are restrictions on the amount of correction that can be performed. And, LASIK is still under study for aviators - it is still considered disqualifying with no exceptions. Therefore, it is very important for individuals considering a career in the military to review the requirements for their particular branch of service and area of interest with their recruiting officer before making their final decision about LASIK.

Current military personnel should discuss their desire to have the surgery with their commanding officer. As the branches now have several laser centers available, it is our understanding that they prefer that personnel have the surgery in those centers. We also understand that some exceptions are allowed for personnel to have the surgery at private centers. However, as the military program is expanding, we do not necessarily have the most current information available. Therefore, we strongly advise all personnel to work within their command structure to determine the best course of action.

You may wish to review the Navy & USMC Accession and Retention for Active Duty policy table .

Military personnel and those who are considering entering the military should visit the US Navy Bureau of Medicine & Surgery's Corrective Eye Surgery Information page and the US Navy Optometry Refractive Surgery page for complete information and links regarding US military policies and procedures.

Coast Guard personnel and those considering entering the Coast Guard should review the branch policies.

According to the Federal Air Surgeon's Medical Bulletin, Fall 1998, the FAA accepts LASIK for its pilots, as long as the FAA examining doctor finds "the post-operative condition has stabilized," pilots have "no significant adverse effects or complications" and their eyes meet "the appropriate vision standards" one to six months post-operatively.

The bulletin states that it is the pilot's responsibility to have his or her doctor send a copy of a report documenting outcomes to the Aeromedical Certification division in Oklahoma City. This report will then become part of the pilot's permanent record.

For more information, you can write to FAA Civil Aeromedical Institute, Aeromedical Education Division, AAM-400, P.O. Box 25082, Oklahoma City, OK 73125.

However, commercial airline pilots or those planning to become pilots should be aware that airlines set their own hiring policies with respect to LASIK. Kenneth Martin, MD with the Air line Pilots Association, states that the airlines' policies toward LASIK are "evolving" and that more and more pilots are having it done. By contrast a job recruiter for Air, Inc. states that most companies will not hire pilots who have had any surgery on their eyes, regardless of whether or not such a policy officially exists.

In sum, commercial airline pilots should check with their current employers to learn their policies, official or unofficial, about LASIK. Those considering becoming commercial airline pilots should be aware that the decision to have LASIK might affect their careers. Potential pilots should carefully check with airlines that they would consider working for prior to making any decision about surgery.