Advice for AROTC Cadets that want PRK, LASEK or LASIK

[Falcon A]

Section 1: The following is NOT official Army policy, and I am NOT a doctor; but, what follows is reflective of our experience going through the process for Corneal Refractive Surgery (CRS) along with good advice and input we received along the way. (Would like to give a huge shout out to @GoCubbies for his tremendous help, as well as input from AROTC ROO @clarksonarmy. DISCLAIMER IANAL: Everything below is my interpretation of the advice we received . . . your mileage may vary.) By the way, “CRS” is the broader term for PRK, LASEK or LASIK surgery.

We began the process with a lot of mis-information, mis-understandings and “myths” that almost caused my DS to miss out on the opportunity to Branch Aviation. We could not find an official “single source” of accurate information on the topic of when and how to get CRS done as an AROTC Cadet. This input is written from that perspective – if there is a consolidated Army official source that we missed or has been created in the meantime, use that.

(Also of note, I recently learned from reading on the Forum that the Air Force ROTC process for CRS is very different from what is described below – so don’t assume the AROTC process is applicable to you if you are in another ROTC – always check with your Cadre!)

 

[Falcon A]

Section 2: First things to know . . .

As an AROTC cadet, you have to make all of the arrangements for the CRS procedure yourself with a civilian provider, and you have to pay for your PRK, LASEK, or LASIK yourself. (Army pays for West Point cadets’ CRS procedure, but not for AROTC cadets.) CRS costs between $1000 - $3000 per eye depending on the provider and whether you have vision coverage in your health insurance.

Keep in mind many CRS providers won’t do CRS until you are at least 18 years old, and many ophthalmologists recommend not to get CRS performed until you are 20 year old – this is because the doctors want your eyes to have “matured” and be stable. (As an aside, CRS is performed on West Point cadets sometime during their junior year, when most are near 20 years of age.)

One of the “myths” we had heard was if you went and got CRS done prior to going through DoDMERB for your AROTC contract/scholarship, when you did go through DoDMERB they would “DQ you” because you had CRS done. The other version of this “myth” we heard was that if you had already gone through and passed DoDMERB and were on AROTC contract/scholarship, and then you went and got CRS done without “approval”, you would be declared “DQ” and you would lose you contract/scholarship. Needless to say, my DS (who was on scholarship) kept asking for how to get “approval” . . . what we eventually learned was – you do NOT need to get “approval” but you do need to communicate and inform your AROTC Detachment Cadre. Here are the details:

The “DoDMERB Reg” is DoDI 6130.03, dated March 30, 2018:

http://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/613003p.pdf?ver=2018-05-04-113917-883

Page 12, Section 5.3.c says, if you have radial keratotomy done (the old procedure where they use a scalpel to cut slits in your cornea), then that will be a DQ.

If you get one of the modern CRS procedures (PRK, LASIK, LASEK), and things afterward are fine, and your pre-surgical refractive error and astigmatism met the standard, then you are good.

If you have complications after surgery as defined in the regulation, or your pre-surgical refractive error and astigmatism did NOT meet the standard as described in the regulation, you will probably get a DQ and you would then need to go through the medical waiver process.

As far as “approval” for those already AROTC contracted/on scholarship, the requirement per your DA-597 would be to inform your PMS of your plan to get CRS. You do NOT have to get “approval” from your AROTC Cadre to have CRS performed. However, you should make sure the AROTC Cadre at your college/university know your plans regarding having the CRS procedure done. Even if you are not contracted, let your AROTC Detachment Staff know of your CRS plans, because you need their input about upcoming required AROTC events and training that you should take into account from a scheduling point of view. For instance, if you are going through a “4th Class System” at a SMC, and/or if you are going to AROTC Basic Camp or Advanced Camp, or some other Army ROTC training, you wouldn’t want to be on an unnecessary medial restriction that would prevent you from attending and/or participating in your SMC’s and/or Army ROTC training.

Last thing – Taking the SIFT: Typically, AROTC allows you to take the “Selection Instrument for Flight Training” (SIFT) sometime in your Junior year. It seems like many cadets take it in the Jan-Mar timeframe second semester of the Junior year. Test score range is from 20-80, with a mean of 50, standard deviation of 10. Minimum passing score is 40. If you score over 50, a Class 1 medical exam (e.g. Flight Physical) is supposedly automatically scheduled for you to occur during Advanced Camp – the Army training in the summer between your Junior and Senior year. After taking the SIFT and getting your results, you should confirm with your AROTC Detachment Cadre that such a Class 1 medical exam appointment will be made for you. Here is the kicker . . . depending on when you are allowed to take the SIFT, you may have to make the decision on whether to have CRS performed PRIOR to knowing if you passed the SIFT and are qualified in aptitude for Aviation.

 

[Falcon A]

Section 3: Below is a suggested 10 Step “process” you might follow for CRS . . .

STEP 1 – Talk to your AROTC Detachment Cadre: Make sure your AROTC Detachment Cadre at your college/university know you are interested in branching Aviation. Work with your ROO, but the AROTC detachment staff member that deals with medical waivers may be the most knowledgeable on how CRS can work for you. Get to know that medical waiver person! Some AROTC Detachments do an early medical screen to give you an indication on whether you need CRS. Ask your Cadre if they do this.

STEP 2 – Eye Appt #1: If your detachment doesn’t do a “prescreen” and you haven’t already gotten CRS performed, it might be good for you to go to your family eye doctor over Christmas Break between your 1st and 2nd semester of your freshman year for your annual eye exam. Make sure your eye doctor dilates your eyes for the exam. (The dilation drops prevent you from squinting and falsely improving your vision during the visual acuity check – cheating on this eye exam does you no good.) Have your family eye doctor assess your eyes against the Army Class 1 vision standards outlined in AR 40-501:

https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/ARN3801_AR40-501_Web_FINAL.pdf

STEP 3 – Eye Appt #2: If you didn’t get CRS performed yet, get another eye exam during Christmas break between 1st and 2nd semester of your sophomore year.

STEP 4 – The Results: If your family eye doctor assesses that you meet the Army vision standards from both exams (the one over Christmas Break your Freshman year and the one over Christmas Break your Sophomore year) . . . that is a good indicator. If however you are “borderline” or you do not meet the standard, you should ask your family eye doctor if CRS would be able to bring you into Army standards. . . if so, then you have a decision to make.

STEP 5 – The DECISION: There is a Low Risk that the CRS could go wrong and cause you to become medically disqualified and lose your ability to commission as an Army officer (if it happens you also lose your AROTC scholarship). The risk is Low, but it is present. After considering the risk, you need to decide if you still want to try and branch Aviation. If not, fine . . . your eyesight is probably good enough for the other Army branches if you’ve already cleared DoDMERB (although you may be restricted from some Army special career fields). If you do still want to try and branch Aviation, and you need to have CRS done -- go on to step 6.

STEP 6 – When to get CRS done? – or – “I sure wish somebody had told me this way before now when I’m a Junior or Senior!”:

-Most likely the BEST time to go get your CRS done is the summer before your Junior year if you have turned 20, and you can do it after any Army training occurring over the summer. (You have probably not yet taken the SIFT.)

-The most likely NEXT BEST time to have CRS performed is over Christmas Break (early in the Christmas break so you can heal while home) between the 1st and 2nd semester of your Junior year. (You have probably not yet taken the SIFT.)

-The LAST time you can get CRS done, and POTENTIALLY make the required healing timeline, is during Spring Break 2nd semester of your Junior year. Planning for this timeframe is RISKY since your CRS procedure must be completed at least 3 months before you report to Advanced Camp at Ft Knox, so if you get your CRS done at the end of March, you can’t afford too many complications to arise, and you can only go to the Advanced Camp Regiments that start in July. [The Class 1 medical exam is typically given early (like the first week) during Advanced Camp.] For some AROTC detachments, waiting until Spring Break to have CRS performed is considered too late as they may want you to have healed for 6 months between completing surgery and showing up for Advanced Camp. Check with your AROTC Cadre at your college/university to see if they require the 6 months, or if they follow the stated Army medical policy of 3 months between CRS surgery and the Army Class 1 medical exam. (You should have completed the SIFT and know if you have passing score by this timeframe.)

STEP 7 – CRS Prep Exams: Typically, you will need a “pre-CRS” eye exam with your family eye doctor. This can occur a few days or weeks prior to the CRS. That is typically followed by a “CRS consult” with the surgery center where they will confirm your eye doctor’s assessment and will determine for themselves if you are a good candidate for CRS.

(NOTE: If you wear contacts you will need to stop wearing them 2 to 3 weeks prior to the appointment with your eye doctor and the CRS consult. You will also most likely not be allowed to wear them for two or three weeks prior to surgery. Check with your eye doctor to verify when you need to stop wearing contacts.)

Surgery can then occur within a few days or weeks after the CRS consult depending on the surgeon’s schedule.

(NOTE: discuss with your CRS surgeon the type of CRS they recommend. There are pros and cons to each procedure. Some civilian providers will only perform one type of CRS for someone as young as 18-20 years old – usually PRK. CRS surgeons also seem to prefer PRK for anyone whose job might include hand-to-hand combat. Talk it through with the surgeon to come to what is best for you.)

STEP 8 – Healing, Follow-up Eye Appointments, and THE PAPERWORK: Typically your family eye doctor will do a follow-up exam the day after surgery, then 4 days to 1 week (sometimes an additional appt 2 weeks after), then 1 month, then 3 months, then 6 months, then 1 year, so you will have to figure out how to get these post-surgical exams done.

Your family eye doctor and the CRS surgeon will need to provide you copies of their exam and surgical notes from the pre-op exams, from the surgery, and then from the 1 week, 1 month and 3 month follow-up exams. In addition they will need to fill out the CRS related medical paperwork your AROTC detachment should have given you. Here is a good link that can get you to paperwork that was current in 2015. Pages 12-20 apply to CRS:

https://www.tamc.amedd.army.mil/offices/Ophthalmology/docs/Army Aviation Refractive Surgery Policy.pdf

The first part of the Corneal Refractive Surgery Worksheet needs to be filled out by your family eye doctor (or CRS surgeon) to document your eyesight prior to CRS, then your CRS surgeon will fill out some information from the actual surgery itself – the majority of the Corneal Refractive Surgery Worksheet needs to be filled out with information from the eye exam conducted by your family eye doctor 3 months after surgery.

Make sure once the Corneal Refractive Surgery Worksheet is COMPLETELY filled out, you keep a copy (or several copies) of the filled out forms and exam notes for yourself.

STEP 9 – Go to Advanced Camp & Take the Class 1 Exam: Hand carry to Advanced Camp a hard copy of the CRS paperwork your eye doctor and surgeon filled out. As long as you have healed properly and your eyes are “stable”, no medical waiver will be required . . . The flight surgeon will just make a note in your military medical file that you have had CRS performed.

(NOTE: Remember, the CRS has to have been done a minimum of 3 months prior to reporting to Advanced Camp. If it hasn’t been 3 months or more from when you had your CRS procedure to the day of the Class 1 exam, the Army Flight Surgeon will not perform the eye exam, and may not perform the entire physical during your Class 1 physical appt at Advanced Camp, and that may put you into medical qualification limbo.)

STEP 10 – File the Army Branching Paperwork: Report to school in the Fall for your Senior year. Once you hear back you have passed the Class 1 medical exam, file your Branching paperwork by the deadline (usually late September/early October) listing Aviation as your #1 choice. Expect to hear back around Thanksgiving Break what Branch you’ve been assigned.

Best Wishes and Good Luck!