REFRACTIVE EYE SURGERY

Corrective laser surgery is not offered at Reynolds; however, Active Duty may obtain information at the Optometry Clinic about the Army's Refractive Surgery Initiative. There are several prerequisites Soldiers must meet to be considered for laser refractive eye surgery. To begin the screening process, Soldiers must make a screening appointment with the Optometry Clinic by calling 558-2296. Soldiers who meet the criteria for surgery and are deemed good candidates will be scheduled for surgery at the Joint Warfighter Refractive Surgery Center on Lackland Air Force Base, Texas.

INTRODUCTION TO LASIK AND PRK

The most popular eye surgery to correct vision problems in the United States is Laser Assisted In Situ Keratomileusis (LASIK). In this procedure, the doctor uses a micro cutting instrument to create a flap in the outermost layer of the cornea. The flap is folded back, allowing a computer-guided laser to re-shape the surface of the cornea. This re-shaping is called photoablation. The flap is then replaced on the cornea. Most patients recover quickly from this procedure, often seeing much better without glasses within a few days.
PRK stands for Photorefractive Keratectomy. The procedure re-shapes the surface of the cornea in the same way as LASIK - with photoablation. However, a flap is not created. Instead, the surgeon removes the outer skin of the cornea. The laser re-shapes the corneal surface, and the skin cells are then allowed to grow back to cover the cornea once again. PRK patients take longer to recover and are usually functional after the fourth postoperative day. Vision gradually improves further over several weeks.
The surgery is performed by an ophthalmologist, a medical doctor with special training in diseases and surgery of the eye. Optometrists are specialists in the treatment of eye and vision disorders. Optometrists actively manage the care of Soldiers before and after laser surgery, but do not perform the surgery. After refractive surgery, a strict regimen of medications is prescribed, as well as a physical activity profile to minimize the chance of injury to the healing eye. Convalescent leave is given for seven days after surgery. The powerful pain control regimen provided to PRK patients allows most Soldiers to experience only minimal post-operative pain; however this varies, and occasionally patients experience significant discomfort for several days following surgery. LASIK usually causes mild ocular irritation postoperatively for a day or two. Driving vision is often achieved by day 6 after either type of surgery.

BACKGROUND

Military personnel perform their duties in a variety of operational environments that are poorly suited to wearing standard spectacle glasses or contact lenses. These include operating complicated sighting systems, wearing protective masks or night vision goggles, working in rain, mud, and sand, among other challenges. To increase combat readiness, the Department of Defense has established the Warfighter Refractive Eye Surgery Program (WRESP). Under this program, eligible active duty service members receive laser refractive eye surgery. The goal is to minimize or eliminate the need to wear corrective eyewear. Surveys from returning Soldiers who had undergone refractive surgery before deployment credit the surgery with increasing their combat effectiveness and overall confidence to perform the mission. All surgical procedures involve risks, and it should therefore be understood that this program is completely voluntary. No one may be coerced into having surgery due to the “needs of the service” or to fill a quota.

ELIGIBILITY

Active duty military and activated National Guard and Reserve Soldiers, including service members from other branches of the military, are eligible for refractive surgery if they meet criteria:

• Must wear their glasses or contact lenses for the vast majority of their activities, but can't have had a significant change in their glasses or contact lenses for more than a year.
• Must have unit and battalion commander approval.
• Must have at least 18 months remaining on active duty at the time of surgery or in conjunction with an executed reenlistment action
• No adverse personnel actions pending.
• Soldier must be at 21 years old and have the ability to meet all pre-operative and post-operative appointments.
• Soldier must be free from medications, pregnancy or medical diagnosis that the Federal Drug Administration deems unsafe.
• Soldier must not be scheduled for a change in duty station within six months of the surgery.

PRIORITIES

Category 1: Any Soldier who is combat arms, and Soldiers of any specialty who are deploying.
Category 2: Non-combat arms Soldiers who are not deploying are, and are treated on a space-available basis.

SURGERY, FOLLOW-UP, AND DEPLOYMENT

It is crucial for Soldiers and authorizing commanders to be aware of the requirements surrounding refractive surgery in order to plan for training and deployment.

After surgery, Soldiers will have bandage contact lenses placed on the eyes that allow the eyes to recover over a three-to-four-day period. It cuts down on discomfort after surgery.
Soldiers are on a limited profile for 30 days post-operatively to minimize injury to the healing eyes. This limits PT, wear of the protective mask, and active training in dirty/dusty/field conditions.
In general, most Soldiers will require 90 days of follow up prior to deployment. Occasionally, Soldiers with LOW refractive error and a small treatment may be released after about 60 days of follow up. If requested, we are able to inform the Soldier which category they will likely fall into during the pre-operative exam. The follow up period is necessary to ensure refractive stability and prevent the deployment of a Soldier who may still require a small amount of spectacle correction or medical treatment.
While most Soldiers meet these healing time estimates, Commanders must understand that there are a small number of soldiers who will be outliers, requiring more intense or longer follow-up for a variety of reasons.