Primary idiopathic optic neuritis in U.S. Air Force Aviators.

The records of 31 male aviators seen at the Ophthalmology Branch of the USAF Aeromedical Consultation Service (formerly the USAF School of Aerospace Medicine) for a diagnosis of primary idiopathic optic neuritis (PION) were reviewed. Each subject received comprehensive ophthalmologic and neurologic examinations. The long-term follow-up data were collected through repeat examinations and by survey. Despite 39% of aviators being grounded due to complications of their PION or multiple sclerosis (MS), many aviators diagnosed with PION may be safely returned to flying duties. However, any aviator diagnosed with PION has a risk of recurrence or a potential to develop systemic MS and must be carefully reevaluated and followed to ensure they remain a viable asset and do not compromise flight safety or mission completion.

Photorefractive keratectomy (PRK) in the military aviator: an aeromedical perspective.

Refractive surgery to visually rehabilitate refractive errors of the eye continues to evolve at a significant pace and is here to stay. The surgical manipulation of the cornea by carefully planned incisions, as in radial keratotomy, represented the first procedure to evolve for the correction of ametropia and is an area of continued active development and improvement. However, many concerns mitigate against this procedure in the aeromedical arena. More recently, photorefractive keratectomy using laser technology to ablate and recontour the corneal surface has emerged as a viable modality. This paper explores the aeromedical factors surrounding this new revolutionary procedure and discusses the issues relevant to evaluating its applicability to the modern military aviator as well as reviewing results of the latest clinical trials currently in progress. The goal is to provide the aeromedical community with the fundamental information required to formulate aeromedical decisions and policy-making in regard to a new procedure that is certain to have tremendous impact on the selection of future aircrew candidates.

Interrelationship of capsule thickness and breast hardness confirmed by a new measurement method.

All implants initiate a foreign-body response that leads to their encapsulation by scar tissue. In order to better understand this encapsulation process and the differences between soft (comfortable) and firm (contracted) breasts, we studied 22 patients who had come in for reaugmentation during a 2-year period. The capsules removed were prepared and measured using a new method. The capsules were (1) removed and stored in physiologic solution until the time of measurement (30 minutes to 2 hours) and (2) measured using a Mitutoyo dial-thickness gauge (MDTG) that employs a uniform pressure of 85 gm. The measurements revealed that soft breasts (Baker 1) have the thinnest scar-tissue capsules, which ranged in thickness from 0.002 to 0.010 inches. Firm breasts yielded the thickest capsules. Baker 3 measured between 0.010 and 0.078 inches thick, and Baker 4 measured between 0.018 and 0.162 inches thick. We also compared the precision of measurement between the MDTG and a standard (screw-type) micrometer by taking a series of readings on a soft, pliable substance (textured silicone rubber).