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The U.S. Navy's Doctrine of Laser Eye Surgery
The New York Times reports that laser eye surgery — now performed on nearly a third of every new class of midshipmen — is transforming Naval careers. Navy doctors are performing these operations with "assembly-line efficiency," allowing older pilots to continue flying, and those who might otherwise have been disqualified to pursue flight school. The number of procedures has reportedly climbed from 50 to 349 over the past five years. The Navy uses a different procedure than that used on civilians — grinding the cornea rather than cutting a flap — out of fears that the flap could come loose in supersonic combat.
BETHESDA, Md., June 17 -- Almost every Thursday during the academic year, a bus carrying a dozen or so Naval Academy midshipmen leaves Annapolis for the 45-minute drive to Bethesda, where Navy doctors perform laser eye surgery on them, one after another, with assembly-line efficiency.
Nearly a third of every 1,000-member Naval Academy class now undergoes the procedure, part of a booming trend among military personnel with poor vision. Unlike in the civilian world, where eye surgery is still largely done for convenience or vanity, the procedure's popularity in the armed forces is transforming career choices and daily life in subtle but far-reaching ways.
Aging fighter pilots can now remain in the cockpit longer, reducing annual recruiting needs. And recruits whose bad vision once would have disqualified them from the special forces are now eligible, making the competition for these coveted slots even tougher.
But the surgery is also causing the military some unexpected difficulties. By shrinking the pool of people who used to be routinely available for jobs that do not require perfect eyesight, it has made it harder to fill some of those assignments with top-notch personnel, officers say.
When Ensign Michael Shaughnessy had the surgery in his junior year at the Naval Academy, his new 20-20 vision qualified him for flight school. And that is where he decided to go after graduating last month ranked in the top 10 percent of his class, rather than pursuing a career as a submarine officer.
"The cramped environment in submarines is something that turned me off," Ensign Shaughnessy, 22, said.
For generations, Academy graduates with high grades and bad eyes were funneled into the submarine service. But in the five years since the Naval Academy began offering free eye surgery to all midshipmen, it has missed its annual quota for supplying the Navy with submarine officers every year.
Officers involved say the failure to meet the quota is due to many factors, including the perception that submarines no longer play as vital a national security role as they once did. But the availability of eye surgery to any midshipman who wants it is also routinely cited.
"Some of the guys with glasses who would have gone to submarines or become navigators are getting the chance to do something they'd rather do, and the communities that are losing the people are not as happy about it as the aviation community, which is gaining better candidates," said Cmdr. Joseph Pasternak, the ophthalmologist who oversees the program at the National Naval Medical Center in Bethesda.
In the Naval Academy's class of 2006, 349 of the 993 midshipmen had the surgery, up from 50 five years ago, according to Naval Academy records. Fewer than 30 percent of the academy students whose eyes qualify for the surgery choose not to get it, and the number of holdouts is dropping every year, Commander Pasternak said.
Last week, a little after 10:40 a.m., Colin Carroll, a 21-year-old midshipman from Olney, Md., put anesthetic drops in his eyes and lay down under the laser as Capt. Kerry Hunt, a Navy doctor, and two assistants prepared to begin. "We're locking the laser on now," Captain Hunt told him.
Midshipman Carroll had originally hoped to enter flight school but discovered not only that his eyes were not good enough, but also that he was prone to kidney stones, ruling him out of aviation entirely. He said he was "resigned" to entering the Marine Corps or becoming an officer on a surface ship, neither an assignment requiring perfect vision.
But he decided to get the surgery anyway.
By 10:49, both eyes were done, though extremely bloodshot, and Mr. Carroll walked out wearing sunglasses, declaring he could already see better.
The procedure used by the Navy, photorefractive keratectomy, or PRK, is different from the one used on most civilians. That approach, known as laser-in situ keratomileusis, or Lasik, requires cutting a flap in the surfa
The method the Navy uses has been available to civilians for years now. I should know - I had it. In LASIK SURGERY the potential for the flap to come apart exists because only the outer edge of where the cut is made heals. You recover in 3 - 5 days instead of 5 - 8 with PRK. But with PRK you don't have the heebie geebie factor of eye flaps busting loose. In fact most eye doctors will recommend PRK to those under 30 with any kind of an active lifestyle for sports, scuba diving, etc.
While taking a week or more off work is tough for some - YOU'RE PUTTING FRIKKIN' LASERS IN YOUR EYES in either way. Why not take the more permanent / durable approach? Don't chose 'Hi Dr. Nick' budget solution either. That's just stupid.
They must have, if your opinion was ever valid in the first place. I was an operating room tech (Surgeon: "Scalpel." Me: Passes scalpel) at Naval Hospital San Diego in the mid '90s, and the surgery they were doing was absolutely first class. We had lots of famous visitors - a friend of mine got to scrub in on a chest case with Dr. DeBakey - and we performed a lot of routine operations that you're only now seeing in the civilian world.
I won't say that there aren't any bad doctors in the military, but there are plenty of brilliant ones to bring up the average. I wouldn't have thought twice about getting medical care for me or my family from the Navy.
Dewey, what part of this looks like authorities should be involved?
Photorefractive Keratectomy (PRK) is available to consumers and is actually a better procedure than LASIK, but is more expensive, requires a longer healing period and fewer physicians are trained to perform it (takes longer to get certified, LASIK certs can be obtained via short, vendor classes).
In PRK, the outer surface of the cornea is ablated by the laser (on an lower power) and then reshaped at a higher power. A protective contact lens is applied to patient and remains on for about 5 days, then is removed by the doctor. The patient applies drops to the eye several times a day for about a month while the outer cornea heals.
The benefits of PRK are the lack of any "flap" problems (incorrect cut, complete cut [ouch], misalignment, dislodgment, halo effects, etc...) and ability to correct some visioin situations not correctable via LASIK.
While my wife wasn't a good candidate for the procedure and didn't have it performed, I highly recommend the physician who evaluated her, Dr. Bruce Bodner Associate Professor of Ophthalmology at EVMS.
It must have been something you assimilated. . . .
Military pay is also better than what a medical resident makes. So you graduate med school with no debt, AND you get paid better for the next 3-5 years while you train. Then go find a nice job when you get out.
My friend is a Army dentist in Germany. The army picked up his 3 years of dental school, which cost around $200,000. He owes them 3 years now. He gets paid less than the average dentist, but he's stationed in Germany and since he left he's travled to the Olympics and the World Cup, not to mention all around Europe.
Also, the Army eye surgery isn't LASIK. It's PRK, which is a different procedure. They don't cut a flap in your eye for this one. My brother, a LT in the army, had it done. He had to use eye drops to treat dry eyes about 6 months.
Well boys and girls, I had my "eyes done" at age 40, which was 10 years ago. I had terrible myopia and astigmatism so bad, I couldn't wear contacts of any kind.
:o)
I was in the Air Force in the 70's and tried to fly; no dice with 20/400 vision.
It was never vanity, but practical reasons that caused me to take a chance on eye surgery. I've always been involved in sports and martial arts. I've had a zillion cuts and bruises on my face (nose especially) from that. Then in 1995, I started fighting full contact with some serious folks. Now, I always fought WITHOUT glasses because I only had to see the shape in front of me, right?
Nope. A circular technique like a roundkick didn't "show up" in my field of vision until too late to block or duck effectively. After two concussions and some broken bones, I went under the knife on both eyes. Today, I'm still 20/20 in both eyes and love it.
I retired from fighting about a year ago but my last fight was in a small ring with 3 opponents at least 10 years younger than me. We went about 20 minutes non-stop and as one of them commented later "we never got a clean shot in even once!"
Yeah...I'm real unhappy with eye surgery...NOT!
Seriously, do a lot of research and shopping for a good doctor. Check with his patients who are 1, 2, 5 and 10 years out from their work. See what they say. Then, do it!
Hell, it was worth it not to have permanent furrows on either side of my nose anymore from the weight of the coke bottle bottom glasses I had to wear from age 5 on.
I am my own gestalt.