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Cataract

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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 & 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

Disclaimer

The Clinical Practice Guideline is provided by way of guidance only and subject to the Clinical practice guidelines disclaimer