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SICK PARADE - Look before you leap
By Hugh McKenzie
Volume 49, No. 17, September 20, 2007 |
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EYEFUL: Corrective eye surgery is worth careful contemplation.
Photo by Cpl Michael Davis |
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The development of the Excimer laser by IBM in the 1970s began a revolution in corrective eye surgery as ophthalmologists recognised its accuracy and lack of damage to surrounding tissue.
Photorefractive keratectomy (PRK), including laser epithelial keratomileusis (LASEK) and laser in-situ keratomileusis (LASIK), are the only procedures permissible for ADF personnel. Radial keratotomy (RK) is not approved for entry to or transfer within the ADF. LASIK is not permitted for ADF aircrew.
LASIK surgery involves cutting a trapdoor-like flap on the cornea then using a laser to reshape the cornea. The flap is replaced immediately. Recovery is typically rapid and comfortable.
In LASEK/PRK the corneal surface layer, the epithelium, is freed and swept back at the end of the procedure (LASEK) or removed (PRK). There is no flap created with LASEK.
The laser is directed at the uppermost surface of the cornea. The epithelium spreads back and adheres over three to five days. A contact lens is applied for three days to protect the surface and to minimise discomfort. Visual recovery takes longer than LASIK and early post-operative discomfort is variable.
Each procedure has slightly different risks, which are relatively small. The preferred treatment will depend on the degree of correction required, and is best determined by a qualified ophthalmologist after consideration of the individual case.
Refractive surgery is permissible for serving ADF personnel and applicants for entry to the ADF.
While the Defence Health Service (DHS) says there is insufficient evidence to justify the expense to the ADF of funding refractive surgery for all who may benefit from it, the situation will be closely monitored to determine if there are compelling operational, capability improvement and economic reasons to fund these procedures for more personnel.
DHS funds refractive surgery for those full-time personnel whose military duties require them to work frequently in extreme physical environments that preclude the safe use of spectacles or contact lenses, or where their use has a high probability of compromising mission performance. These are:
- aircrew posted to rotary wing flying duties;
- aircrew posted to ejection seat aircraft flying duties;
- Special Forces personnel;
- clearance divers and Army work divers posted to an active diving position;
- Explosive Ordnance Disposal (EOD) personnel posted to an active EOD role; and
- Surface Finishers posted to an active surface finisher role.
All personnel who elect to have refractive surgery regardless of whether it is funded by Defence or at their own expense are to notify their ADF health service facility and their CO, and will not be fit to deploy for a period of time following surgery.
The current policy on refractive surgery can be found on the Defence intranet in Health Bulletin 11/2002.
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