Visual Standards

by Dr. Bill Blank, M.D.
Published in Midwest Flyer – April/May 2019 issue

Recently, several questions have come up regarding vision and certification. New Aviation Medical Examiners (AMEs) are required to attend a one-week course in Oklahoma City prior to assuming their functions as AMEs. Because vision is so important to pilots, part of the course is a comprehensive lecture on vision and certification. I have given most of these lectures for the past several years. This article is based on these lectures.

The vision standards vary with the class of medical examination. Those for first and second-class medicals are exactly the same. Third class is different.

Let’s start with “distance visual acuity.” For first and second-class medicals, 20/20 is required in each eye. The FAA no longer cares whether it is with or without correction. Previously, an uncorrected acuity worse than 20/100 required a SODA (Statement of Demonstrated Ability). If you need glasses to meet the standard, your AME no longer needs to record your uncorrected acuity. For third class, 20/40 in each eye, corrected or uncorrected, is required. When I do a third-class physical, I record acuities better than 20/40. That shows that the applicant more than meets the standard.

For all classes, 20/40 at 16 inches is required for near vision. For first and second-class airmen, 50 and older, intermediate vision must be tested at 32 inches. Again, 20/40 in each eye is required. The near and intermediate requirements must be met in each eye. It can be with or without correction. If correction is needed, contact lenses or glasses are acceptable.

One special situation needs to be discussed. Question 17b on the 8500-8 asks if you wear a contact lens in one eye which is for near vision only. What that means is that you can read up close with that eye with the contact in. It also means that you cannot see distance with that eye. The other eye would be used for distance. That eye would either have a contact lens for distance, or none, if no correction is needed. This situation is called “monovision.” The FAA does not permit this.

This question came about as the result of an MD-88 landing accident. You must answer NO to this question. If you want to fly this way, you must wait six (6) months while you adapt to monovision, take a medical flight test, and get a SODA.

I discussed this at length, because the question is poorly worded. It causes many errors because it is not understood. It is hard to believe that the question has been on the form, unchanged, for 18 years! About 3 years ago, I suggested improved wording which would solve the problem. Not surprisingly, it is still in the works.

The visual standards also require testing side vision (i.e. your visual field). It should be normal. The FAA will certify some people with visual field defects. It depends on the underlying cause, prognosis, and if a defect in the field in one eye can be compensated by the corresponding field of the other eye. An abnormal visual field would usually result in a deferral. People with one eye, sometimes are certified.

The FAA wants to be sure that airmen are not subject to double vision. Something called “phoria testing” is done only on first and second-class exams to test for this. It is hard to explain in a paragraph. The key thing is that you can honestly say that you do not experience double vision. There are limits on the amount of phoria permitted, but even if you exceed them, you can probably be certified if there is no history of diplopia (double vision).

Color vision is also tested. The FAA does not require normal color vision, just good enough. If you cannot pass one of the color vision test books, the next step is to find an AME with a Farnsworth Lantern or its equivalent. That is the alternate test you are most likely to pass. If you can pass that, you will need to take your color vision test with a Farnsworth Lantern for each subsequent exam. A work-around is to have Flight Standards District Office testing to obtain a Letter of Evidence (LOE), which is essentially a “get-out-of-jail” free card which is good for life. If you need to go this route, be sure you understand the process. If you fail once, you can never retake this test. I can’t think of any other test that you cannot ever retake. Right now, the FAA is trying to save the world from people with color-vision defects. There are alternatives. Unfortunately, the FAA has not even started thinking about this.

What if you wear contact lenses or have had cataract or refractive surgery? If you have had either of the above surgeries, you can go back to flying when your eyes have healed; the vision is stable; and you meet the standards. If you have any questions, check with your AME. After cataract surgery, you can apply for a flight physical whenever your eye has healed and the vision is stable, provided you have a single-vision intraocular lens implant. By that I mean an implant that corrects for distance vision only. You would need reading glasses or bifocals for close-up vision. If you have an implant that corrects for both distance and near, sort of like lineless bifocals, there is a three-month waiting period. One example of this type of implant is the “Symfony” lens.

What are the differences in the certification requirements for the various classes? The only difference between First and Second Class Medicals is the EKG (electrocardiogram) requirement for the First Class Medical. The Third Class Medical only requires 20/40 distance vision, rather than 20/20 for First and Second Class Medicals, and no phoria testing or EKG. That’s it. Happy flying!

EDITOR’S NOTE: William A. Blank is a physician in La Crosse, Wisconsin, and has been an Aviation Medical Examiner (AME) since 1978, and a Senior AME since 1985.

Dr. Blank is a retired Ophthalmologist, but still gives some of the ophthalmology lectures at AME renewal seminars. Flying-wise, Dr. Blank holds an Airline Transport Pilot Certificate and has 5600 hours. He is a Certified Instrument Flight Instructor (CFII) and has given over 1200 hours of aerobatic instruction. In addition, Dr. Blank was an airshow performer through the 2014 season and held a Statement of Aerobatic Competency (SAC) since 1987.

DISCLAIMER: The informatin contained in this column is the expressed opinion of the author only, and readers are advised to seek the advice of others and refer to the Federal Aviation Regulations and FAA Aeronautical Information Manual for additional information and clarification.

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