Glaucoma: Early Detection Keeps You in the Cockpit

Glaucoma is the second leading cause of blindness in the world. In the U.S. it's estimated that some three million people have it but only half of them know it.

The tragedy is that if left untreated blindness can result. As a matter of fact, some 10% of all blindness is caused by this disease.

Obviously, this is a common problem. If you get it, it can have a big effect on your career as a pilot. So, what is glaucoma, how can you tell if you have it, how is it treated and what does the FAA have to say about it? Glaucoma is a group of disorders that cause damage to the optic nerve. The optic nerve connects your eye with the visual centers in the brain that figure out what you're seeing.

Some symptoms of glaucoma include patchy blind spots or even tunnel vision. So, if you start missing that V-tail Bonanza at two o'clock you might want to check it out. Some forms of glaucoma can present with severe headache, nausea, vomiting, blurred vision and halos around lights. That should get you running to the eye doctor. As we said though, many forms of glaucoma have no warning signs.

It comes on gradually and you may not notice a change in vision until the condition is at an advanced stage. This is super bad news in that vision loss caused by glaucoma can not be recovered. Thus, it is important to have regular eye examinations including measurement of intraocular pressure-pressure in your eyeball. The measurement itself is a piece of cake with modern instruments.

They just blow a puff of air onto your eyeball and measure how well it bounces back. Clever, eh? If your intraocular pressure is elevated you should be consulting with a board-certified ophthalmologist.

Her/his recommended treatment should be started and continued for the rest of your life. In most cases this will control things pretty well.

Obviously, the FAA will want to take a look at things if you have been diagnosed with and treated for glaucoma. How closely they look depends on the severity of the disease and the type of treatment. If your ophthalmologist finds the condition stable and you are over age 40 you might be eligible for a CACI (Condition an AMA Can Issue). In other words, your AMA can write your medical certificate on the spot, without having to go through the FAA. You have to have the right type of glaucoma with no nerve damage or blind spots. Also, your treatment can't include any medications that could affect you vision in other ways. Your AME will have a list of good and bad eye drugs. If you can't meet all

of the criteria for a CACI Issuance your case will have to be referred to the FAA's medical division for consideration for a Special Issuance. The FAA will look at everything and if they feel you can safely pilot an aircraft, they will issue a medical certificate but require you to be reevaluated periodically (usually yearly) to make sure you still make the grade.

Glaucoma diagnosis and treatment is a complicated subject and requires the supervision of a trained eye doctor. So, get that eye examination at least yearly and if anything of concern pops up consult with the guy who knows about this stuff-an ophthalmologist. Fly wisely. See you next month.