Air Force Flying Physical
Medical Examination Standards
Eye, Flying Classes I, IA, II, and III.
of the eyelids which impairs normal eyelid function or comfort or poten tially
threatens visual performance.
nasolacrimal duct obstruction.
any, except benign etiologies which are not progressive and do not interfere
with vision in any field of gaze or direction.
acute or chronic.
unless healed without scarring.
which encroaches on the cornea more than 1mm or interferes with vision, or is
progressive, or causes refractive problems
or acute, including history of.
ulcer of any kind, including history of recurrent corneal ulcers or recurrent
cor neal erosions.
or opacification of the cornea, from any cause, when it is progressive, interferes
with vision or causes refractive problems.
History of traumatic
corneal laceration unless it does not interfere with vision, nor is likely to
of any type, including keratoconus of any degree.
Applicants who demonstrate a topographical pattern suggestive of keratoconus,
referred to as TPSK, but who do not have any other clinical signs of keratoconus,
may be eligible for waiver. However, these members must have been processed
through EFS-Medical for eligibility. Test results from outside agen cies, or
civilian sources do not qualify. Members identified with TPSK may be waivered
into the ACS TPSK Study/Management Group, only after evaluation by the ACS.
Members identified with TPSK will be informed that their participation in this
study group is mandatory for consideration of waiverability into UFT and continued
flying. Reevaluation periodically at the ACS will be required for waiver renewal.
History of radial keratotomy (RIK) or any other surgical or laser procedure,
such as pho torefractive keratectomy (PRIK) and laser in situ keratomileusis
(LASIK) accomplished to modify the refractive power of the cornea or for any
other reason, such as phototherapeutic keratectomy (PTK), are not waiverable.
active or a history of within six months of application to UFT. A18.104.22.168. Lamellar
or penetrating keratoplasty (corneal transplant).
lJveal Tract. Acute,
chronic or recurrent inflammation of the uveal tract (iris, ciliary body, or
choroid), except for healed traumatic iritis.
Retinal detachment and history of same.
and dystrophies of the retina including retinoschisis and all types of cen tral
and peripheral pigmentary degenerations.
dystrophies of the macula, macular cysts, and holes.
chorioretinitis, or other inflammatory conditions of the retina, unless single
episode which has healed, is expected not to recur, and does not impair central
or peripheral vision.
retinal cysts and other conditions which impair or may impair vision.
or other retinal vascular disturbances.
or disturbances which may cause loss of visual acuity. A7.6.6. Optic Nerve.
Congenito-hereditary conditions that interfere or may interfere with central
or periph eral vision.
of any kind, including retrobulbar neuritis, papillitis, neuroretinitis, or
a documented history of same.
Optic atrophy (primary
or secondary) or optic pallor.
cupping greater than 0.4 or an asymmetry between the cups of greater than
of a lens, partial or complete.
or irregularities of the lens which interfere with vision or are considered
to be progresstve.
(intraocular lens implant).
Other Defects and Disorders.
unilateral or bilateral.
of any type, except on versional end points.
in any field of gaze, either constant or intermittent, including history of
field defects, any type, including hemianopsia.
pupils or loss of normal pupillary reflexes, with the exception of physiologi
of an eye.
organic, or congenital disorder of the eye or adnexa, not specified above, which
threatens to intermittently or permanently impair visual function.
or its variants, to include acephalgic migraine (See paragraph A7.23.). A22.214.171.124.
History of any ocular surgery to include lasers of any type.
REFRACTIVE ERROR STANDARDS.
Limits for Each Eye
Ani- sometro- pia
2, 10, 12,13
2, 10, 12,13
(Pilot) Note 1,13
2.50 Note 4
(other than pilot) and III Note 1,13
1. Use of hard,
rigid, or gas permeable (hard) contact lenses within 3 months before the examination
or soft contact lenses 1 month before examination is prohibited. Document SF
88 appropriately to ensure this requirement has been met.
2. These medical
standards apply for USAFA, AFROTC cadets at the time of AF commissioning physi
cal, AF active duty members, civilian applicants for flying training, and applicants
from the Reserve and Guard components during the initial flying physical.
found on routine examination to be 20/20 in one eye and 20/25 in the
other but correctable to 20/20 in each eye may continue flying until the appropriate
corrective lenses arrive. These lenses must be ordered by the most expeditious
means. Be advised that this policy should only be used if the con dition does
not cause acute change in stereopsis performance (i.e., failure of depth perception
greater than Flying Class II or III standards may be considered for waiver if
the OVI (or VTA) stereopsis is normal and the aviator has no asthenopic symptoms
due to poor fusional control, or diplopia.
refractive errors that can be corrected only by contact lenses are disqualifying.
6. All aircrew
members are prohibited from using contact lenses for treatment of medical conditions
unless they have been specifically prescribed and issued or approved by the
wear of contact lenses for aircrew members is outlined in Attachment 17.
may only be considered after the individual has a normal ophthalmological examination
to include a dilated fundus exam and possesses plastic lens spectacles which
correct them to 20/20 in each eye and meets the USAF standards for approved
commercially obtained spectacles for aircrew duties (see attachment 17.7).
flying personnel should be corrected to 20/20 at the nearest cockpit working
10. The Air
Force Chief of Staff retains Exception To Policy (ETP) authority for vision
and refractive limits for UFT applicants.
Class II aviators should be refracted to their best corrected visual acuity.
Use of spectacles to correct to better than 20/20 is at the discretion of the
12. For qualification
purposes, cycloplegic refraction readings should be recorded for that required
to read the 20/20 line in each eye. However, continue refraction to best visual
acuity and report the best achievable corrected visual acuity as a clinical
baseline. (Thus, acuity and refractive error numbers may not correlate). Cycloplegic
refractions that cannot achieve the 20/20 line will need clinical evaluation
who wear corrective spectacles or contact lenses must carry a spare set of clear
pre scription spectacles on their person while performing aircrew duties, see
AFI 11-206, paragraph 6.3.3. Additionally, only 15 percent (N-iS) transmittance
neutral density gray spectacle lenses are approved for flying duty, see AFR
167-3, para 2-4d. Consult other guidance, such as AFMOA or MAJCOM policy let
ters pertaining to aircrew spectacles.
III except InFlight Refuelers:
than 15 prism diopters.
greater than 8 prism diopters.
greater than 2 prism diopters.
greater than 15 prism diopters.
Flying Class I, IA, II, Inflight Refuelers and individuals required to perform
and record PC measurements only at the time of initial flying class 1, IA, 11-Flight
Surgeon, and III - Inflight Refueler applicant exams. The PC is no longer required
on periodic examinations.
than 10 prism diopters.
greater than 6 prism diopters.
greater than 1.5 prism diopters.
of convergence (PC) greater than 100mm.
of extraocular muscle surgery is cause for complete evaluation of ocular motil
ity by a competent eye care professional to look for residual heterophorias,
heterotropias (includ ing microtropias), and motor sensory problems.
evaluation must include all of the motility tests listed in A7. 11. Further
processing of such cases will proceed in accordance with A7. 11. as well.
Point of Accommodation.
Flying Classes II and III. No standards.
Flying Classes I and IA. Near point of accommodation less than minimum for age
specified in attachment 11.
Color Vision, Classes I, IA, II and III. Color vision testing must be performed
monocularly under an approved and standardized illummant (i.e., Illuminant C).
Five or more incorrect responses in either eye (including failure to make responses
in the allowed time interval) in reading the 14 test plates versions of one
of the following Pseudoisochromatic Plate (PIP) sets is considered a failure:
Dvorine, the original version of the AO (excludes Richmond PIP version), or
Ishihara (record responses as correct! total).
other PIP versions, such as the Richmond PIP, or Beck Engraving versions, or
other tests for color vtsion are authorized for qualification purposes. Also
note that the Farnsworth Lantern (FALANT) has been dropped as an USAF qualifying
Flying Class I/IAIII/III: Must possess normal color vision as demonstrated by
passing the approved PIP.
Flying Class Il-Flight Surgeon Applicants: Same as above.
applicants with mild color vision defects may be considered for a FCIIA waiver.
FCIIA waiver authority
is delegated to HQ AETC/SG. Controversial cases will be referred to AFMOA/SGOA.
Flying Class III (other than Inflight Refuelers and individuals required to
perform scanner duties). No standard.
Flying Class I, IA, Il-Flight Surgeon Applicant and Ill-Inflight Refueler Applicants
and individuals required to perform scanner duties. Failure of the Vision Test
Apparatus (VTA-DP) or its newer replacement, the Optec Vision Tester (OVT),
screening depth perception test with uncorrected refractive errors should be
retested with refraction correction in place, regardless of level of unaided
visual acuity. Failure even with correction is disqualifying, but may be considered
for waiver consid eration by higher waiver authorities, only after completion
of a full evaluation by an ophthalmologist or
optometrist, to include all of the following: ductions, versions, cover test
and alternate cover test in primary and 6 cardinal positions of gaze, AO Vectograph
Stereopsis Test at 6 meters (4 line version), AO Suppression Test at 6 meters,
Randot or Titmus Stereopsis Test, Red Lens Test, and 4 Diopter Base out Prism
Test at 6 meters. These tests are designed to identify and characterize motility/align
ment disorders, especially microtropias and monofixation syndrome. The results
of these tests done locally are considered to be preliminary, but will be used
by waiver authorities to determine whether a candidate should be permanently
disqualified without any waiver consideration, to identify if there are potentially
correctable causes, and to determine whether further evaluation is required.
Undergraduate Flying Training (UFT) Microtropia Study/Management Group is estab
lished at the ACS with minimally defective stereopsis secondary to monofixation
syndrome or microstra bismus that are considered appropriate for waiver consideration.
Potential Study Group members must meet the criteria established by the ACS
to be eligible for this Study/Management Group. All potential candidates must
be evaluated at the ACS Ophthalmology Branch if recommended and approved by
HQ AETC/SGPS. AETC/SGPS is the waiver authority.
Flying Class II and Ill-Inflight Refuelers and individuals required to perform
scanner duties. A new failure of the VTA-DP or OVT requires evaluation by an
ophthalmologist or optometrist to determine the cause of the failure and to
rule out correctable causes, i.e., refractive error and am sometropia. If any
new failure still is unable to pass the VTA or OVT with proper optical correction,
then all of the motility tests listed above under Flying Class I in A7. 11.
must be accomplished as a pre requisite for any further waiver consideration.
A7. 11.4. If the aviator has previously failed the VTA or OVT, and has previously
been evaluated, and has either, normal motility or a stable previously known
waivered motility disorder, and can pass another stereopsis test, such as the
Verhoeff, Titmus, Randot, or Howard Dolman, no further work-up or waiver is
required. However, such cases should already have been granted an initial waiver
for this consideration. If not, a waiver is required.
local flight surgeon feels that the degree of depth perception may not be compatible
with the present aircraft or duties of assignment, further work-up and waiver
will be required. Consultation at the ACS is indicated for any rated aircrew
member with defective, questionable or change in stereopsis or depth per ception
or a significant change in the level of stereopsis performance.
Flying Classes I, IA, II and III.
Contraction of the normal visual field in either eye to within 30 degrees of
fixation lfl any meridian.
whether active or inactive, including transitory migraine related or any other
central scotoma which is due to active pathological process.
Flying Classes I, TA, II, and III. Unsatisfactory night vision as determined
by history for initial flying. In trained aviators, this history is confirmed
by the appropriate electrophysiolog ical tests requested by the Aeromedical
Consultation Service ophthalmologists. Dark field and empty field myopia due
to accommodation are normal physiologic responses.
Flying Classes II and III (except Inflight Refuelers). No standards.
Flying Classes I and IA and Inflight Refuelers and individuals required to perform
scanner duties. Any diplopia or suppression during the Red Lens Test which develops
within 20 inches of the center of the screen (30 degrees) is considered a failure.
Complete evaluation of ocular motility/align ment by a qualified ophthalmologist
or optometrist is required as a prerequisite for higher waiver authorities to
determine if ACS evaluation is required.
Intraocular Pressure, Flying Classes I, IA, II, and III.
Glaucoma. As evidenced by intraocular pressures of 30 mmllg or greater, or the
secondary changes in the optic disc or visual field associated with glaucoma.
Trained aircrew with glaucoma require consultation (review or evaluation) with
the ACS prior to waiver consideration.
dispersion syndrome (PDS) is not medically disqualifying for flying (includes
Initial Flying Classes) unless associated with elevated intraocular pressures
above 22 mmHg. PDS with elevated TOP, referred to as Pigmentary Glaucoma Suspect,
(PGS) requires local ophthalmology evaluation. A con firmed diagnosis of Pigmentary
Glaucoma Suspect (PGS) is disqualifying for all initial Flying Classes. Trained
aircrew with PGS require consultation (review or evaluation) with the ACS prior
to waiver con sideration.
Ocular hypertension (Preglaucoma). Two or more determinations of 22 nimHg or
greater but less than 30 mmllg, or 4 mmHg or more difference between the two
eyes. (See paragraph 16.4.).
pressures obtained by a noncontact (air puff) tonometer or Schiotz must be verified
Information derived from Air Force Instruction
48-23, Current as of Dec 2000.