Guidance for medical examiners when assessing a patient for either a general topic or condition – Cataract.
Effect of aviation on condition
- High levels of ultraviolet light
- High reflectivity
- High G can move IOL’s that are not fixed
Effect of condition on aviation
- Glare - both veiling and disabling
- Degraded contrast sensitivity
- Degraded stereopsis
- Degraded colour vision
Effect of treatment on aviation
- Postoperative complications of cataract surgery causing reduced visual acuity including choroidal haemorrhage, retinal detachment, cystoid macular oedema and opacification of posterior lens capsule
- Multifocal contact and multifocal intraocular lenses cause unacceptable impairment of vision
Approach to medical certification
Based on the condition
- Visual function meets standards
- Contrast sensitivity
- Colour sensitivity
- Absence of halo/glare.
Based on treatment
- Uncomplicated surgery
- Absence of symptoms
Risk assessment protocol - information required
- Ophthalmic surgeon’s report
- Confirmed diagnosis
- Aetiology (History of eye trauma etc)
- Completed opthalmic surgery report
- Details of surgery
- Follow-up plan
- CASA Eye Report
- Clearance from DAME.
- Visual assessment by DAME as part of routine medical examination
- Clearance by DAME or CASA to recommence flying or controlling requires a post-operative report from the operating surgeon and satisfactory CASA Eye Report
- Post-Nd:YAG laser capsulotomy is at risk of raised intraocular pressure and necessitates grounding for 30 days
- Visual acuity meets standards (No monovision)
- Free from post-surgical adverse effects
- Failure to meet standards
- Functional impairment
- Multifocal intraocular lens
- Non-physiological tinted intraocular lens
- Monovision (where one eye is corrected for near and the other for distance vision. Spectacles are required to restore binocular vision).
Pilot and controller information
- Any change in condition must be reported to the DAME
- Important note: Multifocal contact and multifocal intraocular lenses cause unacceptable impairment of vision
- A period of grounding for will be required until post-surgical recovery is complete and a satisfactory review from the operating surgeon has been received (minimum 2 weeks grounding)
- Treatment is not risk-free and better to practice cataract prevention
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The clinical practice guidelines is provided by way of guidance only and subject to the clinical practice guidelines disclaimer.