Symptoms & Questions & short introduction...

Discussion in 'Optometry Archives' started by John Yasar, May 30, 2005.

  1. John Yasar

    John Yasar Guest

    Folks,

    I'd like to start with a short introduction and my brief vision history
    and then I have some questions in my quest to become a military pilot.

    I am just about to turn 28. I became a commercial pilot around 7 years
    ago overseas (originally from Turkey) and 6 years ago, I immigrated to
    the US to pursue a career in aviation in the States. I am currently with
    the US Army and stationed in Korea. I work on the AH-64D Longbow Apache
    helicopters as an avionics and armament systems specialist. My goal is
    to apply for Warrant Officer Flight Training as soon as I get my
    citizenship. US Army requires 20/50 uncorrected distant vision for its
    pilots which is even more difficult than the current US Air Force
    distant visual acuity requirements. In 1994, I was told that I had
    slight myopia (-.50 right eye, -.25 left eye), in 1996, this was -.25
    myopic astig. right eye only. These were not refraction exams, no
    paralyzing agent was used. Throughout 1996 to 1999, I passed 3 ICAO
    flight physicals with 20/20 vision although these were only visual
    acuity exams and I had to squint somewhat. In 1999 I took a First Class
    FAA flight medical in Oklahoma and passed that with 20/20 also. Nothing
    different than what you do in DMV. In February 2003, I had a detailed
    refraction eye exam in South Dakota where I was told I had -.50 right
    eye(20/20-), -.25 left eye(20/20), both eyes 20/15. In January 2004, I
    took the military entrance processing medical and I looked through the
    Armed Forces Vision Tester box and was able to read 20/20 on both eyes.
    Another visual acuity test where I missed a lot on the 20/20 line with
    the right eye and had to go 20/25 read that and come back to 20/20
    again. My vision started to deteriorate (at least I felt that way) since
    I started Basic training last July. Today I am somewhat able to read
    20/15 line in the mornings right after I get up. My bad eye would be in
    20/20-20/25 range, but this changes throughout the day, towards the
    evening my vision gets worse. I can still squint and see the 20/20 line
    at night, by night my bad eye would see 20/40.

    I don't get any headaches, it can be said that my vision is good during
    sunny day time outdoors, I do feel that eyestrain and blurriness when
    indoors and under-lit areas. Recently I was inquiring about my symptoms
    on a military discussion forum and some lady who claimed to be a ABO
    certified optician and who has worked with ophthalmologists and
    optometrists for over a decade had different things about my symptoms.
    One of my main complaints is that I know I have some astigmatism on my
    right eye, since I see the vertical objects somewhat blurry. Horizontal
    objects are fine, so that should be the axis. However I was wondering,
    how would -.75 astigmatism look like, and I am trying to figure out what
    I have right now. It apparently was too low a couple years ago, my OD
    didn't want to prescribe anything. I asked her that I am able to see
    20/20, sometimes on good days 20/15, but usually since I use a lot of
    computer I see 20/30, my right eye goes up to 20/40, once they paralyze
    the ciliary muscle during cycloplegic exam, how bad would one's
    refraction get? Since I was told yes I can read the 20/20 line maybe but
    once paralyzed, my refraction can go up to -1.00, I was wondering if
    that was true? I was also wondering if there is a range for possible
    refraction error for a person who can see average 20/20 - 20/30? She
    replied and said my problem is NOT astigmatism but something called
    OVERFOCUS since it made sense to her that my refraction would go up,
    especially when I tried to read. She also told me that "an average OD
    would want to do refraction to look inside the eye and make sure that
    the optic nerve is in good shape as well as the rods and cones. When the
    pupil is paralyzed it lets in more light which makes it a lot harder to
    read. This in turn makes the person over focus even more. The OD can put
    muscle relaxing drops into the eyes and then check my eyesight to see if
    my problem is really over focusing. If it is over focusing, then I would
    have an easy time fixing it. I will have to wear glasses to help train
    my eye and doing some Bates kind of eye exercises wouldn't hurt either.
    It would strengthen the eye muscles so over focusing wouldn't happen as
    often." This was something I heard first time in my life. I asked about
    the variations between day and night, dawn to dusk, she replied that if
    I am indeed over focusing then it is entirely possible to vary up to 1
    diopter, especially towards the end of the day. Her final advice was to
    get an eye check up soon, and to go first thing in the morning when my
    eyes are fresh and haven't been strained all day long. This didn't make
    sense to me since I can NOT tell the Army, hey my eyes are not fresh I
    am not flying this night mission. A military pilot should respond to
    this kind of demand without any problems. This is one of my wishes I
    want perfect mil-spec vision.

    I continued to talk to this lady and I explained one of my symptoms. I
    would appreciate input on this. I don't know what this condition is
    called but whenever I blink I have different clarity of vision... Most
    of the time, when I read the snellen chart first thing in the morning, I
    have 20/16 left, 20/25 - 20/20 right, 20/16 both, but only in the
    mornings for an hour maybe. Then back to normal 20/25 - 20/30 average.
    Wide opening eyes helps sometimes, it makes the picture cleaner and
    sharper, also blinking the eyes has the same effect. Say I am looking at
    a light post at the distance. When I blink my eyes and look at the post,
    I see the post very sharp but very sharp, like I say 20/15 I am sure,
    but it is in a haze on the both sides, when I open my eyes wide when
    this happens, this hazing slowly disappears but the vision goes back to
    average of 20/30 - 20/40 etc. Another example; when I look at a light
    post in the distance, say it appears as there are two of them very
    close, I blink, now it is sharp and the other one is gone, I blink
    again, this time the post appears to have a faint second one close to
    it, to the left, I blink again, this time there is nothing again but
    sharp image, I blink again, this time there are faint posts on both
    sides of the sharp image of the post...

    This lady I was talking to explained that over focusing strains the eye
    and it is when while you are trying to focus on something, your eyes
    strain and become tired, blurry; sometimes you can see double vision.
    But with my double vision it sounded less like over focusing and more
    like dry eyes and protein build up to her. She still thought that I tend
    to over focus as the day progresses, but the reason she thought I have
    dry eyes and protein build up was because when I described what was
    happening with my eye sight while looking at the light post, as above
    that I have to blink to make the double vision and blurriness go away.
    She suggested me to use eye drops. But not Visine. She suggested using
    Patanol. She suggested I use itl 2 or 3 times a day, once mid-day and
    once in the evening. And then if I am experiencing a lot of protein
    build one day then go ahead and use another drop.

    I don't know I didn't buy any eye drops because the website for Patanol
    says it is an allergy drop. Now for my eyesight, I am hoping to schedule
    an eye exam with a flight surgeon as soon as possible and I want to find
    out how bad my refraction would get once my eyes are dilated for
    refraction. Transposed with astigmatism I can only have -1.50 diopters,
    that of course is not the thing you want, if my application for flight
    school is delayed another year, who knows my refraction won't be -2.00
    next year? I'd prefer to have something like stable -1.00. I am fine
    with that as wearing glasses are authorized for flying in the Army which
    I confirmed. What are the chances for a 28 year old to have progressing
    myopia? I never used glasses for nearsightedness and my last refraction
    exam my OD didn't prescribe any glasses. She told me I could use for
    driving at night maybe but not mandatory.

    I tried this plus lense method for 8 months but it doesn't seem to help
    in my case. As a matter of fact, I started getting these faint double
    images shadows after extensive use of reading glasses. I used them
    everywhere for everything but they did not help nor reversed my myopia.
    8 months is a long time to reverse it instead of progressing it. It
    feels like my myopia progressed.

    Another thing is I am considering PRK in case my refraction is over the
    desired limit. I read that it takes more time to heal but it is more
    stable as far as the results are concerned. All I gotta do is to get in
    flight school, once I am a pilot candidate or a rated Army aviator then
    wearing glasses or contact lenses or getting PRK with the commander's
    permission is not a big deal.

    Thanks for your time, please comment on anything you feel like, and
    enlighten me about my symptoms.

    --
    PV2 Yasar, M
    U.S. ARMY
    AH-64D "Armt Dawg"
    A Co/602d ASB/2ID/EUSA - South Korea
    Tuesday, 31 May 2005 / 00:30:27 Korea Standard Time (+0900)
     
    John Yasar, May 30, 2005
    #1
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  2. John Yasar

    Tom Guest

    Your idea of short and brief is different from mine..
     
    Tom, May 30, 2005
    #2
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  3. John Yasar

    Dr. Leukoma Guest

    Just a few quick observations:

    Eyes are typically less nearsighted/more farsighted in the a.m.

    Think of your pupil as an aperture. The smaller the aperture, the
    greater the depth of field. Smaller pupils tend to block out more of
    the natural aberrations of the eye. This is why you see better in
    bright sunlight.

    Blinking redistributes tears. You may have a corneal irregularity such
    that a redistribution of tears momentarily makes things seem clearer.
    People with dry eye also have similar symptoms. They tend to blink
    alot to clear their vision.
    astigmatism.

    Without serial refractions, it's difficult to comment on the
    fluctuating prescription theory. Anyhow, I don't believe in Bates, and
    I don't believe in plus lens treatments of the sort recommended by
    Otis.

    A cycloplegic refraction would be useful, and would have to be done
    prior to PRK or LASIK anyhow.

    DrG
     
    Dr. Leukoma, May 30, 2005
    #3
  4. are the chances

    Otis another one for your files.

    Roland J. Izaac
    John yasar :-

    What are the chances for a 28 year old to have progressing
    myopia? I never used glasses for nearsightedness and my last refraction
    exam my OD didn't prescribe any glasses. She told me I could use for
    driving at night maybe but not mandatory.

    I tried this plus lense method for 8 months but it doesn't seem to help
    in my case. As a matter of fact, I started getting these faint double
    images shadows after extensive use of reading glasses. I used them
    everywhere for everything but they did not help nor reversed my myopia.
    8 months is a long time to reverse it instead of progressing it. It
    feels like my myopia progressed.


    --
    PV2 Yasar, M
    U.S. ARMY
    AH-64D "Armt Dawg"
    A Co/602d ASB/2ID/EUSA - South Korea
    Tuesday, 31 May 2005 / 00:30:27 Korea Standard Time (+0900)

    eadfreenews.net...
     
    Philip D Izaac, May 31, 2005
    #4
  5. John Yasar

    John Yasar Guest

    The effect of plus was almost non-existent except the relief from close
    work, accomodation, I thought I was reversing my myopia, not in my case
    at least.

    --
    PV2 Yasar, M
    U.S. ARMY
    AH-64D "Armt Dawg"
    A Co/602d ASB/2ID/EUSA - South Korea
    Tuesday, 31 May 2005 / 16:41:13 Korea Standard Time (+0900)
     
    John Yasar, May 31, 2005
    #5
  6. John Yasar

    John Yasar Guest

    Sorry Tom, didn't mean to write this long...

    -
    PV2 Yasar, M
    U.S. ARMY
    AH-64D "Armt Dawg"
    A Co/602d ASB/2ID/EUSA - South Korea
    Tuesday, 31 May 2005 / 16:46:15 Korea Standard Time (+0900)
     
    John Yasar, May 31, 2005
    #6
  7. John Yasar

    John Yasar Guest

    Dr. Leukoma,

    Got an exam done today, it was not a cycloplegic exam but I will post
    about it seperately.


    --
    PV2 Yasar, M
    U.S. ARMY
    AH-64D "Armt Dawg"
    A Co/602d ASB/2ID/EUSA - South Korea
    Tuesday, 31 May 2005 / 16:48:13 Korea Standard Time (+0900)
     
    John Yasar, May 31, 2005
    #7
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