EU guidelines give optimal correction licence to fly

By Stefanie Petrou-Binder MD

BERLIN — The new EU Joint Aviation Requirements-Flight-Crew Licensing (JAR-FCL 3) guidelines, scheduled to take effect this month, significantly broaden the range of permissible visual correction for candidate pilots.
“Air and space experts have simplified the rules governing pilot licensing in the EU and have stretched the ophthalmological limits for acquiring a pilot licence to include healthy eyes which are optimally corrected,” said Harvey Schwarz MD, who is an expert witness for the Federal Department of Aviation and a member of the faculty of the German Academy for Air and Space Medicine.

While professional pilot licensing strictly enforced a maximum correction of 3.0 D irrespective of corrected visual acuity, the licensing EU committee has expanded the inclusion criteria for future pilot candidates.
The new European guidelines, reviewed by Dr Schwarz at the German Ophthalmological Society meeting, stipulate that as long as no significant deviations from the norm or pathological changes exist, and vision is optimally corrected, both private and professional pilots can be licensed with visual acuity up to 5.0 D measured in the first-time examination.

Highly myopic candidates up to -8.0 D may obtain and keep a licence if monitored every two years by an ophthalmologist. A specialised ophthalmological examination is required only for the first-time eye examination, as well as in cases that deviate from the norm or appear unclear to the examiner.
This examining ‘flight doctor’ must be a medical specialist with additional training in air and space medicine.
The EU committee has condensed what was formerly known as Classes I and II professional pilot licences into one category to make up the new European Class I licence.

Private pilots, previously Class III, are to comprise the new Class II. According to Dr Schwarz, the former classes were not categorised according to differences in ophthalmological limits and a regrouping was logical.
The experts set the astigmatism limit for professional pilots at 1.5 D. There is no limit for private pilots. At the first examination, professional pilots may not exceed 2.0 D, or 3.0 D at the follow up visits. Private pilots must wear contact lenses or glasses to correct astigmatisms in excess of 3.0 D.
Candidates with anisometropia may not present with values above 3.0 D. However the limit for professional pilots at the first exam is set at 2.0 D and may not exceed 3.0 D in monitoring exams.

Pilots that have undergone photorefractive procedures may obtain a licence after a 12 month waiting period. Only those Class I candidates will be licensed with preoperative refractive values of ± 5.0 D and those Class II candidates with preoperative values of below +5.0 D or less than –8.0 D.
Dr Schwarz explained that the officials believe these limitations may serve as a rationale to help dissuade potential pilots from undergoing this type of surgery for the purposes of obtaining a licence.

Candidates must also be able to prove that daytime fluctuations do not exceed 0.75 D and that they do not experience increased glare sensitivity or reduced contrast sensitivity after dark adaptation.
The committee set no limiting values for these factors, however. Dr Schwarz therefore recommended adhering to the rules established by the Traffic Commission of the German Ophthalmological Society (contrast levels 1:2, 7) which govern automobile driver licensing.
He noted that certain visual stipulations had also been added on to the new guidelines. Until now, professional pilots have obtained licenses with corrected or uncorrected binocular visual acuity of 1.0 D. Now, they are required to have 0.7 in each eye and 1.0 binocularly.

Private pilots, who up until now needed a minimum visual acuity of 0.5 on both sides, now require binocular visual acuity of 1.0 with the same lower limit.
Candidates with amblyopia must have a minimal visual acuity of 0.32 in the amblyopic eye but only if the partner eye is emmetropic with an acuity of 1.0.
One-eyed pilots, who have been able to obtain private licences under certain circumstances up until now, will no longer be issued a licence to fly.

If certain stipulations are met, they may prolong their licences in accordance with a ruling that permits them to fly with a qualified co-pilot.
Both Class I and II licenses are to have guidelines for near and intermediate vision. Candidates must be able to read the Nieden tables or an equivalent N1 from 30 cm to 50 cm and N9 from 100 cm.
Pilots requiring different strengths of correction must use multifocal spectacles as changing glasses while flying in order to look out the cockpit or focus on the instrument panel and read charts which is by no means a practical or safe thing to do, Dr Schwarz said.

Limiting values for the different degrees of convergence and divergence have only slightly changed. Although these rarely show up in practice, one should be aware that the guidelines have adopted the prism dioptre as the new standard unit.
To convert grades into prism dioptres, an easy rule of thumb equates 1° with 2.0 prism D, although the actual conversion equates 1° with 1.745 prism D. These will be monitored for far (6.0 m) and near (33 cm). Any sign of double vision will exclude the candidate.

The relevance of colour vision is always a point of disagreement for expert witness committees. Modern colour-coded multifunctional displays in aircraft necessitate viable colour vision, unlike the former the analogue days of monochrome dials.
Dr Schwarz noted that a poor detection of reds caused particularly long delays in recognition in the examinations he carried out on the A 340 simulator. Unfortunately, the International Civil Aviation experts have not yet reached a consensus in terms of where to set the limits.
The Ishihara pseudochromatic colour tables, Nagel Anomaloscope and signal light tests are options the ophthalmologist may consider to determine a candidate’s colour perception.

Private pilot candidates who have poor colour perception have the option to become licensed for daytime flying using visual flight rules (VFR) only within the flight-information-area in JAR-member-states.
Patients undergoing cataract surgery must wait three months after surgery until they can apply for a licence to fly. As long as patients can pass the visual examination, they can obtain Class I or Class II licences.
Visual field defects are additional exclusion criteria. An expert witness must be called in cases of doubt. A six-month time frame was set for (re)-licensing in retinal-operated and glaucoma-operated candidates.

These surgeries preclude Class I licensing. Private pilots who have had retinal surgery must be monitored yearly, while glaucoma patients require half-year exams.
“Some of these rules may seem illogical, as unnecessarily rigid requirements have been made more flexible while in other areas additional stipulations have been added on. All in all, we feel these changes will be for the best,” Dr Schwarz said.
He is the author of several ophthalmological air and space books and co-author of Practical Air and Space Medicine, a new book documenting the new European pilot guidelines.

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