Cataract

Guidance for medical examiners when assessing a patient for either a general topic or condition – Cataract.

Aeromedical implications 

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
    • Acuity
    • Contrast sensitivity
    • Colour sensitivity
    • Absence of halo/glare.

Based on treatment

  • Uncomplicated surgery

Demonstrated stability

  • Absence of symptoms

Risk assessment protocol - information required

New cases

  • 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.

Renewal

  • Visual assessment by DAME as part of routine medical examination

Indicative outcomes

  • 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

Favourable

  • Visual acuity meets standards (No monovision)
  • Free from post-surgical adverse effects

Unfavourable

  • 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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Disclaimer

The clinical practice guidelines is provided by way of guidance only and subject to the clinical practice guidelines disclaimer.

Last updated:
Online version available at: https://www.casa.gov.au//licences-and-certificates/medical-professionals/dames-clinical-practice-guidelines/cataract
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