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Hindsight is 20/20: Don’t miss your opportunity for PRK

A visual screening test is shown in and out of focus to demonstrate the potential results of receiving photorefractive keratectomy eye surgery to enhance vision. The optometry clinic at Whiteman Air Force Base, Mo., performs exams to determine the eligibility of active-duty service members to receive the operation through the Warfighter Corneal Refractive Surgery program. If an Airman is a candidate for surgery, they can opt to go to any of the seven surgery centers across the United States.

A visual screening test is shown in and out of focus to demonstrate the potential results of receiving photorefractive keratectomy eye surgery to enhance vision. The optometry clinic at Whiteman Air Force Base, Mo., performs exams to determine the eligibility of active-duty service members to receive the operation through the Warfighter Corneal Refractive Surgery program. If an Airman is a candidate for surgery, they can opt to go to any of the seven surgery centers across the United States. (U.S. Air Force photo illustration by Senior Airman Jazmin Smith)

WHITEMAN AIR FORCE BASE, Mo. --

 It has been a little over two years since my vision correction surgery at Andrews Air Force Base, Maryland. I didn’t walk away with any superhuman powers, but after a week of recovery, I was officially at 20/20 vision … finally!

Although it only took a few minutes every day to pop a pair of contact lenses in, the dependence on the malleable, little pieces of plastic was something I no longer desired to have. I became envious of my perfect-sighted friends; they would never know the struggle of having to come within a foot of something to see it clearly.

Out of my desperation, and with the bit of information I had from my brother who underwent the surgery through the Marine Corps, I began fervently conducting my own research regarding vision correction offered to active-duty military.

Alas, Google offered too much information and I was overwhelmed with questions – how could I discern what was true? Shortly thereafter, I scheduled an appointment with the optometry clinic at Whiteman AFB, Missouri. Why not go to the experts?

First things first.

If you are interested in this elective procedure, schedule an appointment with the optometry clinic. There are many factors that a potential patient must meet in order to be considered for the U.S. Air Force Warfighter Corneal Refractive Surgery program. This tremendous benefit is only offered to active-duty service members at this time as a means to enhance operational readiness.

Immediate disqualifiers.

You are not eligible if you do not meet these basic requirements:

• 21 years of age or older

• Unable to provide a prescription from at least one year prior to your most recent eye exam

• Not having at least six months retainability on your contract after the projected surgery date

The prescription requirement allows the optometry clinic to determine if your vision has been stable. Please note, any eye exam taken during Basic Military Training is not an accepted prescription.

If you meet all the primary requirements during the initial appointment, you are provided with a commander’s authorization form which must be signed by your supervisor, unit deployment manager and commander who must be squadron level or higher. Once completed, you can return to the front desk to schedule your follow-up appointment.

A note of importance, this form is only valid for up to six months following the date of your commander’s signature.

It is the time to rock those glasses!

At this point, applicants must not wear contacts for at least 15 days to ensure proper test outcomes, which is vital in determining if you are a candidate. This time period is doubled to 30 day for flyers.

After what may have felt like forever, you are now ready for your follow-up exam where you are made aware of any conditions that would disqualify you from a medical standpoint to apply. The optometrist reviews the results of a pressure check, vision check, and the corneal topography, or mapping of the surface curvature of your eyes. On the latter exam, they are primarily looking for irregularities and the corneal thickness.

If everything goes well, the optometry technicians provide you with the pre-operation paperwork which includes the Warfighter CRS application, a managed care agreement which allows you to receive your post-operative care at the Whiteman clinic, a print-out of the exam results, and shortly thereafter an email with the scans are provided.

On the application form, you’ll find a list of CRS centers and their corresponding contact information. This will come in handy when you decide on which center you would like to go to. Currently this service is offered at the following bases:

- Joint Base Andrews, Maryland

- Joint Base Elmendorf-Richardson, Alaska

- Joint Base San Antonio, Texas

- Keesler AFB, Mississippi

- Travis AFB, California

- U.S. Air Force Academy, Colorado

- Wright-Patterson AFB, Ohio

The closest surgery centers in proximity to Whiteman are either at Colorado or Ohio, which makes these popular choices. However, please keep in mind you may choose any of the bases mentioned above.

Once you have a completed application package, it is now your responsibility to email the surgery center for further instructions and for Permission-to-Proceed authorization.

And now we wait.

The surgery center will review the application and other documents and reach out to the patient with the verdict. If you receive an approval, you will be provided further instructions and information and you can proceed to the next step of the process. A disapproval unfortunately can happen, and the patient would be notified of the justification for this decision. For those who are cleared for the next step, please note the refractive surgeon will have final say on the treatment decision, so nothing is set in stone at this stage.

Once your packet is processed by the surgery center, you will be contacted to set up a pre-operation exam which precedes the surgery. Due to such a high volume of applicants applying, you may wait anywhere from a couple weeks to a couple months for this appointment.

After you have an appointment, it is time to rock those glasses again. Soft contact lenses should have been removed 30 consecutive days and 90 days for hard lenses prior to your pre-operation appointment.

Don’t go AWOL, submit your leave.

According to AFI 36-3003, Section 4.2.3.2.13.1., when a specific time period is not provided for in Table 4.5, squadron commanders or equivalent commanders on G-series orders are authorized to approve your permissive temporary duty (TDY), when the period of absence is 10 days or less. In English, this means it is at your commander’s discretion on how many days are provided to travel to and from a DoD Laser Center for refractive surgery. Since this leave is classified as a permissive TDY and is unfunded, anything you need for the commute, meals or lodging is out of your own pocket.

In addition to days for travel, you will also receive convalescent leave, which permits seven days for healing and your appointments. The surgery center will provide the paperwork to be signed by your commander and returned.

Surgery time

As far as LASIK vs. PRK, the latter is more likely to be the selected method as it is much less probable that complications could arise from an eye injury in the future. The technique used is ultimately decided by the treating surgeon during your pre-operative exam and consent briefing. Depending on your surgery center of choice, you’ll likely pick up your medications after your briefings then have your surgery the following day.

Before the procedure, numbing drops are placed in each eye a few times before you head into the operating room. In my experience, I felt absolutely nothing – like my eye was made of glass and had no feeling. It was strange, but cool.

The procedure is quick, lasting seconds to a couple minutes per eye, depending on how poor your vision is. Afterwards, a "band-aid" contact is placed over the cornea to protect the eye until your follow-up appointment.

Vampire mode activated.

Patients are put on medications for pain during the first week in addition to steroid eye drops, which they would continue to use at their surgeon’s discretion, for up to four months. This allows for better results in the healing process and limits chances of long-term halos, or glares around bright light sources. During the recovery, patients experience different levels of pain and sensitivity to light while the eye works to regrow the surface of the cornea removed during treatment.

At that time, I never turned on any lights or went outside during the day time as it caused lots of discomfort, but again, this varies with each patient. Besides the medication, cold compresses were amazing for alleviating pain – I used a frozen bag of peas and it worked great.

If everything looks good at the follow-up appointment, the contacts placed on your eyes are removed. Since you’re not allowed to drive back, your wonderful designated driver is able to take you home so you can get back to work!

Surgery is done, and I’m home … now what?

As a responsible Airman, you’ve read all the forms you signed, specifically the Managed Care Agreement form, which is good as you now have some appointments to attend now. At one, three, six and 12 month post-surgery, the optometry clinic requires a follow-up to examine your eyes and make certain you’re doing what you should for a proper recovery. Results may vary, but typically prescription stabilizes at six months. Some common results may include dryness and fluctuations in vision during the healing process. I experienced some double vision when my eyes were stressed during the first month, but that went away with time. Again, this varies from patient to patient.

Feels like a distant memory.

You are not deployable for up to four months following the procedure. You are also placed on a profile for sunglasses, which allows you to wear them in formation and whenever your eyes are light sensitive. To this day, I am grateful for the opportunity to have the procedure done. Without a doubt, it greatly improved my day-to-day life and the ease in which I can accomplish my job as a photojournalist.

After making it this far in my story, if you are interested and think you may be eligible, give the Whiteman optometry clinic a call directly at 660-687-3937 to schedule an appointment!