PRK & LASIK Laser Eye Surgery Considerations and Requirements for Army,
Navy, Marine & Air Force Military Personnel
Reviewed by Brad Spagnolo, M.D.
LASIK Eye Surgery is often considered by a great number of people in the military. Army, Navy, Marine & Air Force personnel perform their duties in a wide variety of environments and under conditions that are poorly suited to wearing glasses or contact lenses.\ Military personnel perform better if they don't have to worry about breaking eyeglasses, losing contact lenses, or glasses and lenses fogging up at crucial moments. Moreover, the compatibility of eyewear with night vision goggles, gas masks, aiming devices and other systems is a constant source of concern in terms of safety as well as performance of duties. One can only imagine the challenges presented to those who are dependent on eyeglasses or contact lenses while attempting to operate complicated sighting systems, wearing protective masks or night vision goggles, working in the rain, mud and sand or other conditions that are difficult for most of us to comprehend.
Based on ongoing research as well as actual field and clinical data and feedback that has been observed and collected before, during and after deployment there are limits on the actual types of Laser Eye Surgery (PRK vs. LASIK) that personnel may be eligible for.
Virtually any active-duty and activated National Guard and Reserve soldiers-Army, Navy, Air Force or Marines-are eligible for Laser Eye Surgery under the Warfighter Refractive Eye Surgery Program (WRESP) if they meet certain criteria. However each service branch may have slightly different polices regarding new accessions or retention on active duty for PRK and LASIK. In general, there are few if any restrictions on PRK, but LASIK may be prohibited in Special Forces troops and anyone considering SCUBA or HALO school. LASIK may be permitted in those considering Special Forces so long as the LASIK surgery is completed prior to entering Special Forces.
The Navy and Marines will routinely grant a waiver for pilots or student naval aviators to fly after PRK, assuming preoperative standards are met, no complications in the healing process were encountered and passing their standard vision tests. Candidates who have had PRK can get a blanket waiver for the Special Forces Qualification, Combat Diving Qualification and Military Free Fall courses. PRK and LASIK are both waived for Airborne, Air Assault and Ranger schools. However, those who have had LASIK must enroll in an observational study, if a slot is available, to undergo training in Special Forces qualification. LASIK is disqualifying/non-waiverable for several United States Army Special Operations Command (USASOC) schools (HALO, SCUBA, SERE) according to Army Regulation 40-501.
Again, the Army, Navy, Air Force and Marines have policies that may differ slightly from each other's eye surgery policies, so it is important to contact your nearest same service Warfighter Refractive Eye Surgery Center and review specific questions and eligibility and waiver requirements.
General Eligibility Requirements
- Active Duty, Activated National Guard and Activated Reserve Personnel
- Approval of Commanding Officer
- At Least 18 Months Remaining On Active Duty After Surgery or in Conjunction with an Executed Reenlistment Action
- No Adverse Personnel Actions Pending
- At Least 18 Years of Age
- Ability to Attend all Pre-Operative and Post-Operative Appointments
General Information About PRK & LASIK for Military Personnel
Laser Eye Surgery Follow-Up and Deployment
Military personnel and Commanding Officers should be aware of and comfortable with the requirements associated with Laser Eye Surgery in order to effectively plan for training and deployment.
After Laser Eye Surgery, each person treated will have a strict protocol of medications prescribed as well as a physical activity profile in order to optimize healing minimize the risk of injury to healing eyes. Most often, a few days of quarters is recommended after Laser Eye Surgery. PRK patients are typically given oral pain medications to minimize post-operative discomfort, however, rare patients experience significant pain for several days following surgery. LASIK usually causes only minimal or mild discomfort for one or two days after the treatment. Vision sufficient for the normal driving standard usually retunes within 1-2 days after LASIK and within a few days after PRK.
It is important to use protective eyewear after refractive surgery, as by eliminating the need for eyeglasses, personnel are now vulnerable to projectile objects that could injure the naked eye. The use of protective eyewear is essential following refractive surgery should either be provided by the home unit or the Laser Eye Center where the procedure is performed.
The time required for the actual treatment procedures of PRK or LASIK is generally less than 30 minutes in total per patient for both eyes. However, you may find that you actually spend the better part of a morning or afternoon at the Laser Eye Center, as there are pretreatment preparation and protocols and post treatment examination protocols to be administered.
Typical Minimum Post Operative Visit Requirements & Deployment Profile
- Post-op appointments one day, one week & one month after LASIK.
- Post-op appointments one day, one week, one month & three months after PRK.
- After LASIK you should get a minimum 6-week nondeployable profile. *
- After PRK you should get a 3-month nondeployable profile.
In the June 2009 edition of Ophthalmology Times according to Lt. Col. Charles D. Reilly, M.D., Chief of Cornea/External Disease & Refractive Surgery at Wilford Hall Medical Center in San Antonio, Texas, Laser Eye Surgery for correcting common refractive eye problems such as nearsightedness, farsightedness and astigmatism has had "a remarkable record of safety and efficacy" among soldiers engaged in Operation Iraqi Freedom in Iraq and Operation Enduring Freedom in Afghanistan. Dr. Reilly has served as the Chief of the Warfighter Refractive Eye Surgery Center at Lackland Air Force Base in San Antonio and as a Refractive Surgery Consultant to the Air Force Surgeon General.
Dr. Reilly relayed, "As the Consultant for Refractive Surgery in the Air Force, I was interested primarily in what kinds of complications we were seeing in the patients on whom we performed refractive surgery, both before and after we get them deployed." More that 15,000 members of the armed forces have LASIK or PRK each year. The most common complication was deploying too soon after surgery-often they were back in the active theater within 2 weeks of surgery. Dr. Reilly commented that trying to put your post operative "drops in your eyes while dodging bullets from the enemy is just not a good idea". Overall the complication rate was pretty unremarkable with more military personnel coming back home with basketball injuries than refractive surgery complications. Even with a number of troops suffering significant eye trauma in the theaters, there were no flap dislocations in LASIK patients. He cautioned that this data was primarily for Air Force personnel and it is possible that the complication rate might have been higher among ground troops. The Army recently released a policy stating that personnel cannot deploy for 90 days following PRK, which Dr. Reilly feels, is a prudent course.
Profiles are given to optimize healing and minimize the risk of injury to the eyes after Laser Eye Surgery. Adherence to the profile’s restrictions is imperative. For 30 days after surgery, treated personnel should not live in tents, work in sunny, dusty or windy environments, swim, wear protective masks or face paint, fire weapons or drive military vehicles. Also, when in sunny or bright environs, treated personnel should be allowed to wear sunglasses at all times for one year after Laser Eye Surgery to minimize the risk of ultraviolet light.