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Military 'Eyes' Laser Surgery Policy

By Staff Sgt. Kathleen T. Rhem, USA
American Forces Press Service

WASHINGTON, March 9, 2000 – DoD officials have implemented a policy allowing individuals who have had two common forms of laser eye surgery to enter the military with a medical waiver. Individuals who'd had corrective eye surgery were previously ineligible for military service.

The two waivable procedures are photorefractive keratotomy, usually referred to as PRK, and laser in-situ keratomileusis, or LASIK, according to Dr. John Mazzuchi, deputy for clinical and program policy in the Office of the Assistant Secretary of Defense for Health Affairs.

"You can get in the military, but it's harder to do so," he said in an interview. "You have to submit your medical records and receive a waiver." He said DoD's particular caution is driven by concern for service members' health.

"There are things the military exposes people to that are very different from civilian life -- things like jungle or desert atmospheres, diving or flying," he said. "What happens to the eye under those pressures?"

DoD is involved in several studies to address issues surrounding laser eye surgery and military service, because they could become readiness concerns in the future, Mazzuchi said. The department wants to know, for instance, whether the patients' vision remains stable for a long period of time and whether the rigors of military life prove detrimental to a person who has had PRK or LASIK.

"Obviously, wearing glasses on the battlefield is not as good as not having to," he said. "In battle, someone who requires glasses is not much good if they've lost or broken their glasses." While the military might prefer someone whose vision is correctable without glasses, he said, it's more important their vision be stable and that military environments don't worsen their eye condition.

Past experience with eye surgeries has shown the concern to be reasonable. Mazzuchi said the military barred individuals who had an earlier form of eye surgery called radial keratotomy after it became readily available to the public. In this procedure, the surgeon corrects vision by reshaping the cornea with knife cuts resembling spokes on a wheel.

"Subsequent studies showed that our concerns were quite justified," he said. "Some people developed difficulty with night vision, and visual acuity didn't remain constant. Some people who had had RK weren't as prepared to be in the military."

Mazzuchi said he expects DoD to relook its policy on the issue in two to three years, when preliminary data from current studies is available.

"We'll look to see if we should loosen our policy or keep it the way it is," he said. "I don't expect us to tighten our policy."

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