Guide for Aviation Medical ExaminersVersion 09/30/2026
Section 19
AME OFFICE-REQUIRED ANCILLARY TESTING
33 pagesPages PDF Page 476–PDF Page 508
Items 49-580 of FAA Form 8500-8
ITEM 49. Hearing
| 49. Hearing | Record Audiometric Speech Discrimination Score Below |
|---|---|
| Conversational Voice Test at 6 Feet ☐ Pass ☐ Fail |
I. Code of Federal Regulations
All Classes: 14 CFR 67.105(a)(b)(c), 67.205(a)(b)(c), and 67.305(a)(b)(c)
The person shall demonstrate acceptable hearing by at least one of the following tests:
Demonstrate an ability to hear an average conversational voice in a quiet room, using both ears, at a distance of 6 feet from the AME, with the back turned to the AME.
Demonstrate an acceptable understanding of speech as determined by audiometric speech discrimination testing to a score of at least 70 percent obtained in one ear or in a sound field environment.
Provide acceptable results of pure tone audiometric testing of unaided hearing acuity according to the following table of worst acceptable thresholds, using the calibration standards of the American National Standards Institute, 1969 (11 West 42nd Street, New York, NY 10036):
| Frequency (Hz) | 500 Hz | 1000 Hz | 2000 Hz | 3000 Hz |
|---|---|---|---|---|
| Better ear (dB) | 35 | 30 | 30 | 40 |
| Poorer ear (dB) | 35 | 50 | 50 | 60 |
No disease or condition of the middle or internal ear, nose, oral cavity, pharynx, or larynx that:
Interferes with, or is aggravated by, flying or may reasonably be expected to do so; or
Interferes with, or may reasonably be expected to interfere with, clear and effective speech communication.
No disease or condition manifested by, or that may reasonably be expected to be manifested by vertigo or a disturbance of equilibrium.
- II. Examination Equipment and Techniques
- A. Order of Examinations
The applicant must demonstrate an ability to hear an average conversational voice in a quiet room, using both ears, at a distance of 6 feet from the AME, with the back turned to the AME.
If an applicant fails the conversational voice test, the AME may administer pure tone audiometric testing of unaided hearing acuity according to the following table of worst acceptable thresholds, using the calibration standards of the American National Standards Institute, 1969:
Worse Acceptable Thresholds:
| Frequency (Hz) | 500 Hz | 1000 Hz | 2000 Hz | 3000 Hz |
|---|---|---|---|---|
| Better ear (dB) | 35 | 30 | 30 | 40 |
| Poorer ear (dB) | 35 | 50 | 50 | 60 |
If the applicant fails an audiometric test and the conversational voice test had not been administered, the conversational voice test should be performed to determine if the standard applicable to that test can be met.
If an applicant is unable to pass either the conversational voice test or the pure tone audiometric test, then an audiometric speech discrimination test should be administered. A passing score is at least 70 percent obtained in one ear at an intensity of no greater than 65 dB.
B. Discussion
Conversational voice test. For all classes of certification, the applicant must demonstrate hearing of an average conversational voice in a quiet room, using both ears, at 6 feet, with the back turned to the AME. The AME should not use only sibilants (S-sounding test materials). If the applicant is able to correctly repeat the test numbers or words, "pass" should be noted and recorded on FAA Form 8500-8, Item 49. If the applicant is unable to hear a normal conversational voice then "fail" should be marked and one of the following tests may be administered.
Standard. For all classes of certification, the applicant may be examined by pure tone audiometry as an alternative to conversational voice testing or upon failing the conversational voice test. If the applicant fails the pure tone audiometric test and has not been tested by conversational voice, that test may be administered. The requirements expressed as audiometric standards according to a table of acceptable thresholds (American National Standards Institute [ANSI], 1969, calibration) are as follows:
EAR (All classes of medical certification)
| Frequency (Hz) | 500 Hz | 1000 Hz | 2000 Hz | 3000 Hz |
|---|---|---|---|---|
| Better ear (dB) | 35 | 30 | 30 | 40 |
| Poorer ear (dB) | 35 | 50 | 50 | 60 |
Audiometric Speech Discrimination. Upon failing both conversational voice and pure tone audiometric test, an audiometric speech discrimination test should be administered (usually by an otologist or audiologist). The applicant must score at least 70 percent at intensity no greater than 65 dB in either ear.
C. Equipment
Approval. The FAA does not approve or designate specific audiometric equipment for use in medical certification. Equipment used for FAA testing must accurately and reliably cover the required frequencies and have adequate threshold step features. Because every audiometer manufactured in the United States for screening and diagnostic purposes is built to meet appropriate standards, most audiometers should be acceptable if they are maintained in proper calibration and are used in an adequately quiet place.
Calibration. It is critical that any audiometer be periodically calibrated to ensure its continued accuracy. Annual calibration is recommended. Also recommended is the further safeguard of obtaining an occasional audiogram on a "known" subject or staff member between calibrations, especially at any time that a test result unexpectedly varies significantly from the hearing levels clinically expected. This testing provides an approximate "at threshold" calibration. The AME should ensure that the audiometer is calibrated to ANSI standards or if calibrated to the older ASA/USASI standards, the appropriate correction is applied (see paragraph 3 below).
ASA/ANSI. Older audiometers were often calibrated to meet the standards specified by the USA Standards Institute (USASI), formerly the American Standards Association (ASA). These standards were based upon a U.S. Public Health Service survey. Newer audiometers are calibrated so that the zerohearing threshold level is now based on laboratory measurements rather than on the survey. In 1969, the American National Standards Institute (ANSI) incorporated these new measurements. Audiometers built to this standard have instruments or dials that read in ANSI values. For these reasons, it is very important that every audiogram submitted (for values reported in Item 49 on FAA Form 8500-8) include a note indicating whether it is ASA or ANSI. Only then can the FAA standards be appropriately applied. ASA or USASI values can be converted to ANSI by adding corrections as follows:
Conversion ASA or USASI to ANSI
Frequency (Hz) 500 Hz 1000 Hz 2000 Hz 3000 Hz
Decibels Added* 14 10 8.5 8.5
* The decibels added figure is the amount added to ASA or USASI at each specific frequency to convert to ANSI or older equivalent ISO values.
III. Aerospace Medical Disposition
Special Issuance of Medical Certificates. Applicants who do not meet the auditory standards may be found eligible for a SODA. An applicant seeking a SODA must make the request in writing to the Aerospace Medicine Certification Division, AAM-300. A determination of qualifications will be made on the basis of a special medical examination by an ENT consultant, a MFT, or operational experience.
Bilateral Deafness. See Items 25-30. If otherwise qualified, when the student pilot's instructor confirms the student's eligibility for a private pilot checkride, the applicant should submit a written request to the AMCD for an authorization for a MFT. This test will be given by an FAA inspector in conjunction with the checkride. If the applicant successfully completes the test, the FAA will issue a third-class medical certificate and SODA. Pilot activities will be restricted to areas in which radio communication is not required.
Hearing Aids. If the applicant requires the use of hearing aids to meet the standard, issue the certificate with the following restriction:
VALID ONLY WITH USE OF HEARING AMPLIFICATION
Some pilots who normally wear hearing aids to assist in communicating while on the ground report that they elect not to wear them while flying. They prefer to use the volume amplification of the radio headphone. Some use the headphone on one ear for radio communication and the hearing aid in the other for cockpit communications.
ITEMS 50-54. Vision Testing
(Updated 12/28/2022)
Visual Acuity Standards:
As listed below or better;
Each eye separately;
Snellen equivalent; and
With or without correction. If correction is used, it should be noted, and the correct limitation applied.
| First or Second Class | Third Class | |
|---|---|---|
| Distant Vision | 20/20 | 20/40 |
| Near Vision Measured at 16 inches | 20/40 | 20/40 |
| Intermediate Vision Measured at 32 inches; Age 50 and over only | 20/40 | No requirement |
ITEM 50. Distant Vision
- (Updated 12/28/2022)
- I. Code of Federal Regulations
- First- and Second-Class: 14 CFR 67.103(a) and 67.203(a)
Distant visual acuity of 20/20 or better in each eye separately, with or without corrective lenses. If corrective lenses (spectacles or contact lenses) are necessary for 20/20 vision, the person may be eligible only on the condition that corrective lenses are worn while exercising the privileges of an airman certificate
Third-Class: 14 CFR 67.303(a)
(a.) Distant visual acuity of 20/40 or better in each eye separately, with or without corrective lenses. If corrective lenses (spectacles or contact lenses) are necessary for 20/40 vision, the person may be eligible only on the condition that corrective lenses are worn while exercising the privileges of an airman certificate.
II. Examination Equipment and Techniques
Note: If correction is required to meet standards, only corrected visual acuity needs to be tested and recorded. Remember to apply the vision limitation to the medical certificate.
Equipment:
Snellen 20-foot eye chart may be used as follows:
The Snellen chart should be placed 4 feet in front of and slightly above the chart and illuminated by a 100-watt incandescent lamp equivalent (approximately 1600 lumens).
The chart or screen should be placed 20 feet from the applicant's eyes and the 20/20 line should be placed 5 feet 4 inches above the floor.
A metal, opaque plastic, or cardboard occluder should be used to cover the eye not being examined.
The examining room should be darkened except for the illuminated chart or screen.
If the applicant wears corrective lenses, only the corrected acuity needs to be checked and recorded. If the applicant wears contact lenses, see Items 31–34. Eye - Contact Lenses.
Common errors:
Failure to shield the applicant's eyes from extraneous light.
Permitting the applicant to view the chart with both eyes.
Failure to observe the applicant's face to detect squinting.
Incorrect sizing of projected chart letters for a 20-foot distance.
Failure to focus the projector sharply.
Failure to obtain the corrected acuity when the applicant wears glasses.
Acceptable Substitutes for Distant Vision Testing: Any commercially available visual acuities and heterphoria testing devices.
Directions furnished by the manufacturer or distributor should be followed when using the acceptable substitute devices for the above testing.
Examination Techniques:
Each eye will be tested separately, and both eyes together.
III. Aerospace Medical Disposition
A. For all classes of medical certificate, when corrective lenses are required to meet any of the visual acuity standards, the AME must add the following limitation to the medical certificate:
Must Use Corrective Lens(es) to meet vision standards at all required distances* Note: As of 12/28/2022 the single, simplified visual acuity limitation replaces previous visual acuity limitations.
B. An applicant who does not meet the vision standards or has an ocular muscle balance problem will require either a SODA or Special Issuance (SI) to cover the extent of the visual acuity defect.
C. To be considered for a SODA or SI, a current, detailed Clinical Progress Note from an eye specialist (optometrist or ophthalmologist) is required. It should specifically include the diagnosis; best corrected visual acuity in each eye separately, and both eyes together; must detail any pathology noted; if the condition(s) require(s) treatment; or expected to progress.
D. Any applicant eligible for a medical certificate through special issuance under these guidelines must pass a MFT, which may be arranged through the appropriate agency medical authority.
ITEM 51.a. Near Vision
ITEM 51.b. Intermediate Vision
Visual Acuity Standards:
As listed below or better;
Each eye separately;
Snellen equivalent; and
With or without correction. If correction is used, it should be noted, and the correct limitation applied.
| First or Second Class | Third Class | |
|---|---|---|
| Near Vision Measured at 16 inches | 20/40 | 20/40 |
| Intermediate Vision Measured at 32 inches; Age 50 and over only | 20/40 | No requirement |
I. Code of Federal Regulations
First- and Second Classes: 14 CFR 67.103(b) and 67.203(b)
(b) Near vision of 20/40 or better, Snellen equivalent, at 16 inches in each eye separately, with or without corrective lenses. If age 50 or older: Near vision of 20/40 or better, Snellen equivalent, at both 16 inches and 32 inches in each eye separately, with or without corrective lenses.
Third-Class: 14 CFR 67.303(b)
Near vision of 20/40 or better, Snellen equivalent, at 16 inches in each eye separately, with or without corrective lenses.
II. Equipment and Examination Techniques
Note: If correction is required to meet standards, only corrected visual acuity needs to be tested and recorded and the vision limitation must be applied.
Equipment:
FAA Form 8500-1, Near Vision Acuity Test Chart, dated April 1993.
For testing near at 16 inches and intermediate at 32 inches, acceptable substitutes: Any commercially available visual acuities and heterophoria testing devices. For testing of intermediate vision, some equipment may require additional apparatus.
Examination Techniques:
Near visual acuity and intermediate visual acuity, if the latter is required, are determined for each eye separately and for both eyes together. If the applicant needs glasses to meet visual acuity standards, the findings are recorded, and the certificate appropriately limited. If an applicant has no lenses that bring intermediate and/or near visual acuity to the required standards, or better, in each eye, no certificate may be issued. Refer the applicant to an eye specialist for appropriate visual evaluation and correction.
FAA Form 8500-1, Near Vision Acuity Test Chart, dated April 1993, should be used as follows:
The examination is conducted in a well-lighted room with the source of light behind the applicant.
The applicant holds the chart 16 inches (near) and 32 inches (intermediate) from the eyes in a position that will provide uniform illumination. To ensure that the chart is held at exactly 16 inches or 32 inches from the eyes, a string of that length may be attached to the chart.
Each eye is tested separately, with the other eye covered. Both eyes are then tested together.
The smallest type correctly read with each eye separately and both eyes together is recorded in linear value. In performing the test using FAA Form 8500-1, the level of visual acuity will be recorded as the line of smallest type the applicant reads accurately. The applicant should be allowed no more than two misread letters on any line.
Common errors:
Inadequate illumination of the test chart.
Failure to hold the chart the specified distance from the eye.
Failure to ensure that the untested eye is covered.
Practical Test. The bottom of FAA Form 8500-1 has a section for Aeronautical Chart Reading. Letter types and charts are reproduced from aeronautical charts in their actual size.
This may be used when a borderline condition exists at the certifiable limits of an applicant's vision. If successfully completed, a favorable certification action may be taken.
Acceptable substitute equipment may be used. Directions furnished by the manufacturer or distributor should be followed when using the acceptable substitute devices for the above testing.
III. Aerospace Medical Disposition (Updated 12/28/2022)
For any class of medical certificate, when corrective lenses are required to meet any part or combination of visual acuity standards, the AME must add the following limitation to the medical certificate:
Must Use Corrective Lens(es) to meet vision standards at all required distances
Note: As of 12/28/2022 the single, simplified visual acuity limitation replaces previous visual acuity limitations.
Contact lenses that correct only for near or intermediate visual acuity are not acceptable for aviation duties.
ITEM 52. Color Vision
- (Updated 01/29/2025)
- 52. Color Vision
- ☐ Pass ☐ Fail
- I. Code of Federal Regulations
- First- and Second-Classes: 14 CFR 67.103(c) and 67.203(c)
(c) Color vision: Ability to perceive those colors necessary for the safe performance of airman duties.
Third-Class: 14 CFR 67.303(c)
Color vision: Ability to perceive those colors necessary for the safe performance of airman duties.
II. Examination Equipment and Techniques
See AME Information – Color Vision Screening Steps on next page.
AME INFORMATION - COLOR VISION SCREENING STEPS
(Updated 12/12/2024) EFFECTIVE JANUARY 1, 2025: Approved computer-based color vision screening tests will be required for pilot exams performed on 01/01/2025 and after:
Testing frequency will change to a one-time color vision deficiency screening.
Testing for acquired color deficiency (e.g., due to a medical condition or a medication) will be listed under the Evaluation Data of the corresponding section in the AME Guide or in the Letter of Authorization.
- A. FOR A RETURNING PILOT WHO HAS HISTORICALLY PASSED ANY PREVIOUSLY
- FAA-APPROVED COLOR VISION TEST:
For all classes: Computer-based color vision screening test is NOT required.
Mark Item 52. “PASS”
AME should ISSUE (if otherwise qualified).
B. FOR A RETURNING PILOT WITH A PREVIOUS SODA OR LOE:
Pilot holds 3rd Class SODA or LOE :
Wants to keep 3rd Class:
o Does not need computer test.
o Issue 3rd class certificate with no color vision limitation (if otherwise qualified).
Wants to upgrade to 1st or 2nd Class:
o Administer any of the acceptable computer-based color vision screening tests. o If PASS - no limitation required. AME can issue (if otherwise qualified).
If FAIL - issue a 3rd class medical certificate with limitation #104 “Valid for day visual flight rules (VFR) only.” If the individual requests an upgrade to 1st or 2nd class, they should appeal to the Federal Air Surgeon.
Pilot holds a 1st or 2nd class LOE or SODA (previously passed OCVT and CV MFT): o Does not need computer test.
o Issue 1st or 2nd class medical certificate (if otherwise qualified). o No color vision limitation required.
C. FOR A FIRST-TIME APPLICANT:
An applicant can attempt any (or all) of the tests that are approved at the time of the exam.
If unable to pass ANY of the acceptable tests:
o Mark Item 52. “Fail” o Annotate Item 59. (Other Tests Given) with “FAILED _______.” o LIST NAME of color vision test(s) attempted AND include the scores.
ISSUE a 3rd Class medical certificate (if otherwise qualified).
Add limitation #104: “Valid for day visual flight rules (VFR) only.” If the individual requests an upgrade to 1st or 2nd class, they should appeal to the Federal Air Surgeon.
o Upload the computer-generated score report as “Eye-Color Vision Test Results.”
If the AME does not have one of the approved computer-based tests: o If the AME does not have an acceptable color vision test, they can issue a 3rd class medical certification with limitation #104. Do not defer. o Alternately, the applicant can be tested at a different location: The testing physician/clinic must provide the AME with the color vision printout for upload into DIWS. Remember to put the name of the test taken AND scores in Item 59.
IMPORTANT NOTES:
The above applies for routine color vision screening. If the individual has a medical condition or takes a medication which could affect color vision, additional color vision testing (when required) will be listed in the AME Guide or in their Letter of Authorization.
ANY tests not specifically listed are NOT acceptable methods of testing for FAA medical certificate.
Color Vision Correcting Lens (e.g., X-Chrom) are NOT acceptable to the FAA as a means for correcting a pilot's color vision deficiencies.
For questions, see:
- o Acceptable Test Instruments for Color Vision Screening – Pilots
- o Color Vision – Frequently Asked Questions
- o FAA Color Vision – Pilots Flowchart
- o Color Vision Limitation Review
For ATCS information, see the Acceptable Test Instruments for Color Vision Screening of ATCS chart or contact your RFS for any questions.
The Color Vision flow chart below shows pathways for AMEs to use to determine actions for “Returning Pilot” and “First-Time Applicant.”
ACCEPTABLE TEST INSTRUMENTS FOR COLOR VISION SCREENING – PILOTS
(Updated 08/27/2025) EFFECTIVE JAN 1, 2025, testing for pilots will be an approved computer-based color vision test. Testing must be performed in person. Virtual testing, downloaded, or printed versions of color vision tests are prohibited. AMEs must use these specific color vision tests for pilot evaluations.
The following are approved computerized color vision tests for FAA medical certification purposes.
Follow the manufacturer’s guidelines to administer.
Record test name and all required scores in Item 59.
If applicable, upload computer-generated printout into AMCS as: Eyes-Color Vision Test.
For more information, see AME Information - Color Vision Screening Steps.
For ATCS see the Acceptable Test Instruments for Color Vision Screening of ATCS chart or contact your RFS for any questions.
| TEST | MINIMUM NUMBER CORRECT TO PASS |
|---|---|
| Colour Assessment & Diagnosis (CAD test)▪ Version - Certification: “Environment and Aviation (Commercial).”▪ If passes FAST version, no further testing is needed for color.▪ If fails FAST version, the full definitive CAD must be completed.Note: US or UK keyboard can be used | Score must be:RED GREEN (RG): 1.7 if normal Less than 6 if diagnosed as Deutan; Less than 12 if diagnosed as Protan ANDYELLOW BLUE (YB) - less than 2.4NOTE: An RG score of less than 1.7 indicates Normal. The RG passing score varies by diagnosis. Less than 6 indicates Deutan; and less than 12 indicates Protan. |
| Rabin Cone Test (RCCT) Air Force/Army/Navy/Coast Guard Version▪ Test each eye separately.▪ Staircase version allowed. | Score must be 55 or higher for EACH color:REDGREENBLUE |
| Waggoner Computerized Color Vision Test* Adult Diagnostic OR FAA Color Vision Test▪ Windows: Waggoner CCVT (WCCVT) – Waggoner Diagnostics▪ iOS: Waggoner CCVT on the App Store (apple.com)▪ Android: Waggoner CCVT*What is tested in each section: Section 1: General screening for Protan (red) and Deutan (green) deficiency. Section 2: Genetic and acquired deficiencies. Section 3: Quantifies Protan (red) deficiency. Section 4: Quantifies Deutan (green) deficiency. Section 5: D-15 N/A for FAA purposes.NOTE: If applicant does not pass Section 1, Section 3 and 4 will be automatically given. | Score must be:General - 21 or higher (of 25); AND Tritan - 10 or higher (of 12)ORProtan - 20 or higher (of 32); AND Deutan - 20 or higher (of 32); AND Tritan - 10 or higher (of 12) |
COLOR VISION - FREQUENTLY ASKED QUESTIONS (FAQS)
(Updated 08/27/2025)
1. Why is the FAA Changing their policy now?
Several factors necessitate the change: Proliferation of color displays, concern that current testing might not be adequate for the existing and future color-rich environment, poor standardization in administration of current tests, incorrect testing by some AMEs, and NTSB safety recommendation (for commercial pilots). Advances in testing technology and completion of test evaluations at the Civil Aerospace Medical Institute enabled the change.
If I am unable to obtain one of the computer-based tests, can the pilot be tested at a different location?
YES. The testing physician/clinic must provide you with the color vision printout for upload into DIWS. Remember to put the name of the test taken AND scores in Item 59.
If the AME does not have an acceptable color vision test, they can issue a 3rd class medical certification with limitation #104. Do not defer.
Note: Online or virtual testing is not acceptable. Testing must be in person.
Does the test need to be performed within 90 days of the AME exam?
NO. The FAA can accept a previous test result provided it is one of the acceptable computer-based tests. (E.g., Some individuals may have had this testing in the military. Those scores may be submitted.)
Should the AME defer a new applicant if they are unable to pass any of the acceptable color vision screening tests?
NO. The AME should ISSUE a 3rd class medical certificate (if otherwise qualified) with limitation #104 “Valid for day visual flight rules [VFR] only.”
Is the individual limited to taking only ONE of the computer-based tests?
NO. The individual can take any of the three acceptable computer-based tests. Passing ANY of the three is acceptable and failure of one test does not preclude an attempt to pass another.
Can the individual submit a test taken at home or a free trial version?
NO. If a computer color vision test was done outside the AME’s office, the AME must verify that the results belong to the individual. To maintain test integrity, the test must be performed by a practitioner who can verify the individual’s identity (similar to an EKG). If the results of the test cannot be linked to a specific individual, it cannot be used.
Will the individual be given a more restrictive certificate with this new policy?
NO. Whatever the individual has walking into the AME’s office (e.g., LOE, restricted certificate/any class, unrestricted, failed) is what they will walk out with, unless they take a new color test.
Does the FAA require normal color vision for pilots?
Pilots must possess the ability to perceive colors necessary to discern cockpit display colors, aircraft signaling, and airport lighting for the safe performance of airman duties.
What are common causes of acquired color vision deficiency?
This list is not all inclusive, but common causes include:
Eye conditions such as glaucoma, age-related macular degeneration, retinal detachment, or cataracts.
Brain and nervous system conditions such as Alzheimer’s, multiple sclerosis, or certain tumors.
Medical conditions such as diabetes, alcoholism, leukemia.
Medications such as Plaquenil (chloroquine or hydroxychloroquine), blood pressure medications, erectile dysfunction medications.
If the pilot has a special issuance for an eye or neurology condition, why do they now need an additional color vision test?
Certain medical conditions or medications may cause a red/green or blue/yellow color deficiency. While we do not need to test everyone for an acquired color vision defect, conditions which may also have a color vision deficiency will require specific testing. The pilot should refer to their Letter of Authorization.
How does an individual apply for a Color Vision Limitation removal or upgrade?
The individual can take any or all the acceptable computer-based tests. If they pass, they do not need further testing.
If they don’t pass, they need to request review by completing a Color Vision Limitation Review request. The AME should upload into AMCS:
An “Eye-Color Vision Limitation Review.”
Results of the Color Vision Test as “Eye- Color Vision Test Results.”
Do I test all pilots with a new computer-based test as of January 1, 2025?
NO. See the Color Vision Flow Chart. The AME only needs to test NEW pilots, those with a limitation 16 or 17 who want it removed, or those with a current LOE or SODA who want to upgrade. The individual can take any or all the acceptable computer-based tests.
Will the FAA consider adding additional computer-based tests in the future?
The FAA will consider approval for new computerized tests if the manufacturer provides reliability, validity, and sensitivity/specificity documentation along with evidence of cut scores aligning with those specified for CCT, CAD, and CCVT.
How many times can an individual take the same computer-based test?
There is no limit to the number of trials allowed. However, if multiple attempts are unsuccessful, the AME should question if the problem is test taking skills or color vision deficiency.
Does the AME have to upload the actual color vision test report, or can they notate Pass/Fail and add comments?
The AME must upload a copy of the score report into AMCS under tag “Eye-Color Vision Test Results.” AMCS can accept a photo of the results by uploading file types as PDF, DOC, DOCX, JPG, JPEG, and XPS.
Can the AME accept a color vision test report brought in by the individual?
Like an EKG performed outside the AME office, the AME should verify the person tested and the testing facility. We can accept a test signed by a provider (preferably with their clinic information on the test results) or with an attached Detailed Clinical Progress Note (if performed in another clinic) with the correct pilot identification.
If identification is uncertain, the FAA cannot accept the test.
How does this policy change affect Air Traffic Control Specialists (ATCS)?
There is no change to the current requirements for ATCS at this time.
If the individual is an ATCS who is also a pilot and is seeking pilot certification for the first time (considered a first-time pilot), must they be tested using one of the new CV testing options?
While not required, an ATCS has the option of taking a computer-based test (those tests were added to the AME Guide as allowed for ATCS approximately one year ago). However, if the ATCS is a first-time pilot seeking pilot medical certification, they must take one of the computer-based tests.
COLOR VISION LIMITATION REVIEW
(Updated 01/29/2025) Name: _______________________________________PI#: _____________________
Address: ____________________________________ Date of Birth: _____________
INSTRUCTIONS TO THE AME
Submit this only if the individual is unable to pass ANY of the acceptable computer-based color vision tests and wants an upgrade to 1st or 2nd class, is requesting a color vision limitation be removed, or is requesting an upgrade based on new testing.
Note: if the individual passes ANY of the acceptable computer tests: No limitation, no LOE, no SODA is needed for any class for color vision. Issue the class of certificate applied for (if otherwise qualified).
For EXPEDITED review, upload into AMCS:
This document as “Eye-Color Vision Limitation Review.”
Results of the Color Vision Test(s) as “Eye - Color Vision Test Results.”
INSTRUCTIONS TO THE PILOT
(Check all that apply)
☐ I was unable to pass ANY of the acceptable computer-based color vision tests (you can take any of the acceptable tests, any number of times).
☐ I was given a 3rd class with limitation and want to be evaluated for an upgrade to 1st or 2nd class.
☐ I was given 3rd class because the AME did not have a test. I have a test now and want to upgrade to 1st or 2nd class.
☐ I have a SODA/LOE for 3rd class and want to be evaluated for an upgrade to 1st or 2nd class.
☐ I have a medical certificate with limitation [#16] “Not valid for flights requiring color signal control during daylight hours.”
☐ I have a previous medical certificate with limitation [#17] “Not valid for night flying or by color signal control.”
Pilot Signature: ___________________________________ Date:__________________
NOTE: Requests are reviewed on a case-by-case basis. Additional information may be required.
ACCEPTABLE TEST INSTRUMENTS FOR COLOR VISION SCREENING OF ATCS (FAA EMPLOYEE 2152 SERIES and CONTRACT TOWER ATCS)
(Updated 08/27/2025)
COMPUTER-BASED TESTS (Added 05/31/2023. Updated 08/27/2025):
Testing must be performed in person. Virtual testing, downloaded, or printed versions of color vision tests are prohibited. The following are approved computerized color vision tests for FAA medical certification purposes:
Follow the manufacturer’s guidelines to administer.
Record test name and all required scores in Item 59.
If applicable, upload computer-generated printout into AMCS as: Eyes-Color Vision Test.
| TEST | MINIMUM NUMBER CORRECT TO PASS |
|---|---|
| Colour Assessment & Diagnosis (CAD test)▪ Version - Certification: “Environment and Aviation (Commercial).”▪ If passes FAST version, no further testing is needed for color.▪ If fails FAST version, the full definitive CAD must be completed.NOTE: US or UK keyboard can be used. | Score must be:RED GREEN (RG): 1.7 if normal Less than 6 if diagnosed as Deutan; Less than 12 if diagnosed as Protan AND YELLOW BLUE (YB) - less than 2.4NOTE: An RG score of less than 1.7 indicates Normal. The RG passing score varies by diagnosis. Less than 6 indicates Deutan; and less than 12 indicates Protan. |
| Rabin Cone Test (RCCT) Air Force/Army/Navy/Coast Guard Version▪ Test each eye separately.▪ Staircase version allowed. | Score must be 55 or higher for EACH color:REDGREENBLUE |
| Waggoner Computerized Color Vision Test* Adult Diagnostic OR FAA Color Vision Test▪ Windows: Waggoner CCVT (WCCVT) – Waggoner Diagnostics▪ iOS: Waggoner CCVT on the App Store (apple.com)▪ Android: Waggoner CCVT*What is tested in each section: Section 1: General screening for Protan (red) and Deutan (green) deficiency. Section 2: Genetic and acquired deficiencies. Section 3: Quantifies Protan (red) deficiency. Section 4: Quantifies Deutan (green) deficiency. Section 5: D-15 N/A for FAA purposes.NOTE: If applicant does not pass Section 1, Section 3 and 4 will be automatically given. | Score must be:General - 21 or higher (of 25); AND Tritan - 10 or higher (of 12)ORProtan - 20 or higher (of 32); AND Deutan - 20 or higher (of 32); AND Tritan - 10 or higher (of 12) |
See the following page for additional acceptable ATCS color vision tests.
ADDITIONAL ACCEPTABLE TESTS (ATCS):
| TESTS | DOES NOT MEET THE STANDARD (FAILS) IF: | SUPPLIER |
|---|---|---|
| Richmond-HRR, 4th edition | Any error on plates 5-10 | Richmond Products |
| All Ishihara test plates approved for airmen: | Ishihara | |
| 14-Plate (plates 1-11) | More than 6 errors on plates 1-11 | |
| 24-Plate (plates 1-15) | More than 2 errors on plates 1-15 | |
| 38-Plate (plates 1-21) | More than 4 errors on plates 1-21 | |
| Keystone View Telebinocular | No errors on the 6 total trials on plates 4 and 5 | Keystone View |
| Titmus testers approved for airmen: Titmus | Any errors on any of the 6 plates | Titmus |
| OPTEC 2000 | Any errors on any of the 6 Stereo Optical Co., Inc., plates | Stereo Optical Co., Inc. |
| AOC-HRR, 2nd, 1-11 | Any errors on plates 5-10 | Richmond Products |
| Dvorine 2nd Edition | More than 2 errors on plates 1-15 | Richmond Products |
| SPECIAL INSTRUCTIONS | |
|---|---|
| Test Administration | The AME must document the color vision test instrument used, version, answer sheet with the actual subject responses and the score. If MEDExpress is used the AME should fax or mail the results to the Flight Surgeon or may document the findings in Block 60. |
| AME Office Inspection | AME office inspections: The inspector must visually inspect the condition of the color vision test instrument, for fading, fingerprints, pen, or pencil smudges; and lights used. Only a Macbeth Easel or a Verilux True Daylight Illuminator (F15T8VLX) are acceptable. Room lights must be off. |
| False Negatives | Any test device with a restricted test set, like the Titmus testers, generally have a high false alarm test. If a disproportionally high number of subjects are failing, it may be necessary to review the acceptability of that test instrument. Regional Medical Offices are expected to monitor this situation. |
UNACCEPTABLE TEST INSTRUMENTS FOR COLOR VISION SCREENING OF ATCS
(FAA EMPLOYEE 2152 SERIES and CONTRACT TOWER ATCSs
| AOC-PIP | Mast | Stereo-Optic |
|---|---|---|
| Bausch & Lomb Vision Tester | OPTEC 900, 2500*, 5000* | Titmus i400* |
| D-15 | Prism | Vision Chart - color letters |
| FALANT | Richmond-HRR Versions 2 and 3 | |
| H-O Chart | Schilling |
Except for the computerized tests listed, any computer applications, downloaded, or printed versions of color vision tests are prohibited.
ITEM 53. Field of Vision
| 53. Field of Vision |
| ☐ Normal |
| ☐ Abnormal |
- I. Code of Federal Regulations
- First- and Second-Classes: 14 CFR 67.103(d) and 67.203(d)
- (d) Field of Vision: Normal
- Third-Class: 14 CFR 67.303(d)
Field of Vision: No acute or chronic pathological condition of either eye or adnexa that interferes with the proper function of an eye, that may reasonably be expected to progress to that degree, or that may reasonably be expected to be aggravated by flying.
II. Examination Equipment and Techniques
Fifty-inch square black matte surface wall target with center white fixation point; 2-millimeter white test object on black-handled holder:
The applicant should be seated 40 inches from the target.
An occluder should be placed over the applicant's right eye.
The applicant should be instructed to keep the left eye focused on the fixation point.
The white test object should be moved from the outside border of the wall target toward the point of fixation on each of the eight 4-degree radials.
The result should be recorded on a worksheet as the number of inches from the fixation point at which the applicant first identifies the white target on each radial.
The test should be repeated with the applicant's left eye occluded and the right eye focusing on the fixation point.
Alternative Techniques:
A standard perimeter may be used in place of the above procedure. With this method, any significant deviation from normal field configuration will require evaluation by an eye specialist.
Direct confrontation. This is the least acceptable alternative since this tests for peripheral vision and only grossly for field size and visual defects. The AME, standing in front of the applicant, has the applicant look at the AME's nose while advancing two moving fingers from slightly behind and to the side of the applicant in each of the four quadrants. Any significant deviation from normal requires ophthalmological evaluation.
III. Aerospace Medical Disposition
Ophthalmological Consultations.
If an applicant fails to identify the target in any presentation at a distance of less than 23 inches from the fixation point, an eye specialist's evaluation must be requested. This is a requirement for all classes of certification. The AME should provide FAA Form 8500-14, Ophthalmological Evaluation for Glaucoma, for use by the ophthalmologist if glaucoma is suspected.
Glaucoma.
The FAA may grant an Authorization under the special issuance section of part 67 (14 CFR 67.401) on an individual basis. The AME can facilitate FAA review by obtaining a report of Ophthalmological Evaluation for Glaucoma (FAA Form 8500-14) from a treating or evaluating ophthalmologist.
NOTE: See AASI for History of Glaucoma
If considerable disturbance in night vision is documented, the FAA may limit the medical certificate: NOT VALID FOR NIGHT FLYING
Other Pathological Conditions.
See Items 31-34.
ITEM 54. Heterophoria
(Updated 12/12/2024)
54. Heterophoria 20’ (in prism diopters) Esophoria Exophoria Right Hyperphoria Left Hyperphoria
I. Code of Federal Regulations
First- and Second Classes: 14 CFR 67.103(f) and 67.203(f)
(f) Bifoveal fixation and vergence-phoria relationship sufficient to prevent a break in fusion under conditions that may reasonably be expected to occur in performing airman duties. Tests for the factors named in this paragraph are not required except for persons found to have more than 1 prism diopter of hyperphoria, 6 prism diopters of esophoria, or 6 prism diopters of exophoria. If any of these values are exceeded, the Federal Air Surgeon may require the person to be examined by a qualified eye specialist to determine if there is bifoveal fixation and an adequate vergence-phoria relationship. However, if otherwise eligible, the person is issued a medical certificate pending the results of the examination.
- Third-Class: No Standards
- II. Examination Equipment and Techniques
Equipment:
Red Maddox rod with handle.
Horizontal prism bar with graduated prisms beginning with one prism diopter and increasing in power to at least eight prism diopters.
Acceptable substitutes: Any commercially available visual acuities and heterophoria testing devices.
Examination Techniques:
Test procedures to be used accompany the instruments. If the AME needs specific instructions for use of the horizontal prism bar and red Maddox rod, these may be obtained from a RFS.
III. Aerospace Medical Disposition
First- and second-class: If an applicant exceeds the heterophoria standards (1 prism diopter of hyperphoria, 6 prism diopters of esophoria, or 6 prism diopters of exophoria), but shows no evidence of diplopia or serious eye pathology and all other aspects of the examination are favorable, the AME should not withhold or deny the medical certificate. The applicant should be advised that the FAA may require further examination by a qualified eye specialist.
Third-class: Applicants for a third-class certificate are not required to undergo heterophoria testing. However, if an applicant has strabismus or a history of diplopia, the AME should defer issuance of a certificate and forward the application to the AMCD. If the applicant wishes further consideration, the AME can help expedite FAA review by providing the applicant with a copy of FAA Form 8500-7, Report of Eye Evaluation.
ITEM 55. Blood Pressure
- (Updated 10/28/2015)
- 55. Blood Pressure Systolic Diastolic
- (Sitting mm of Mercury)
- I. Code of Federal Regulations
- All Classes: 14 CFR 67.113(b)(c), 67.213(b)(c), and 67.313(b)(c)
(b). No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds -
(1). Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
(2). May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
(c). No medication or other treatment that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved finds -
(1). Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
(2). May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
Measurement of blood pressure is an essential part of the FAA medical certification examination. The average blood pressure while sitting should not exceed 155 mm mercury systolic and 95 mm mercury diastolic maximum pressure for all classes. A medical assessment is specified for all applicants who need or use antihypertensive medication to control blood pressure. (See Section III. B. below.)
II. Examination Techniques
In accordance with accepted clinical procedures, routine blood pressure should be taken with the applicant in the seated position. An applicant should not be denied or deferred first-, second-, or third-class certification unless subsequent recumbent blood pressure readings exceed those contained in this Guide. Any conditions that may adversely affect the validity of the blood pressure reading should be noted.
- III. Aerospace Medical Disposition
- A. Examining Options
An applicant whose pressure does not exceed 155 mm mercury systolic and 95 mm mercury diastolic maximum pressure, who has not used antihypertensive medication for 30 days, and who is otherwise qualified should be issued a medical certificate by the AME.
If the airman’s blood pressure is elevated in clinic, you have any of the following options:
Recheck the blood pressure. If the airman meets FAA specified limits on the second attempt, note this in Block 60 along with both readings.
Have the airman return to clinic 3 separate days over a 7-day period. If the airman meets FAA specified limits during these re-checks, note this and the readings in Block 60. Also note if there was a reason for the blood pressure elevation.
Send the airman back to his/her treating physician for re-evaluation. If medication adjustment is needed, a 7-day no-fly period applies to verify no problems with the medication. If this can be done within the 14 day exam transmission period, you could then follow the Hypertension Disposition Table.
The AME must defer issuance of a medical certificate to any applicant whose hypertension has not been evaluated, who uses unacceptable medications, whose medical status is unclear, whose hypertension is uncontrolled, who manifests significant adverse effects of medication, or whose certification has previously been specifically reserved to the FAA. See Hypertension FAQs, Hypertension Disposition Table, and CACI – Hypertension Worksheet.
B. Initial and Follow-up Evaluation for Hypertensives Under Treatment - See CACI - Hypertension Worksheet (in the dispositions table, Item 36. Heart)
ITEM 56. Pulse
Pulse (Resting)
The medical standards do not specify pulse rates that, per se, are disqualifying for medical certification. These tests are used, however, to determine the status and responsiveness of the cardiovascular system. Abnormal pulse rates may be reason to conduct additional cardiovascular system evaluations.
II. Examination Techniques
The pulse rate is determined with the individual relaxed in a sitting position.
III. Aerospace Medical Disposition
If there is bradycardia, tachycardia, or arrhythmia, further evaluation is warranted and deferral may be indicated (see Item 36., Heart). A cardiac evaluation may be needed to determine the applicant’s qualifications. Temporary stresses or fever may, at times, result in abnormal pulse readings. If the AME believes this to be the case, the applicant should be given a few days to recover and then be retested. If this is not possible, the AME should defer issuance, pending further evaluation.
ITEM 57. Urine Test/Urinalysis
Urine Test (If abnormal, give results) Albumin Sugar ☐ Normal ☐ Abnormal
I. Code of Federal Regulations
All Classes: 14 CFR 67.113(a)(b), 67.213(a)(b), and 67.313(a)(b)
No established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control.
No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds:
Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
II. Examination Techniques
Any standard laboratory procedures are acceptable for these tests.
III. Aerospace Medical Disposition
Glycosuria or proteinuria is cause for deferral of medical certificate issuance until additional studies determine the status of the endocrine and/or urinary systems. If the glycosuria has been determined not to be due to carbohydrate intolerance, the AME may issue the certificate. Trace or 1+ proteinuria in the absence of a history of renal disease is not cause for denial.
The AME may request additional urinary tests when they are indicated by history or examination. These should be reported on FAA Form 8500-8 or attached to the form as an addendum.
See Item 48., General Systemic.
ITEM 58. ECG
- (Updated 05/29/2024)
- 58. ECG (Date)
- MM DD YYYY
- I. Code of Federal Regulations
- First-Class: 14 CFR 67.111(b)(c)
A person applying for first-class medical certification must demonstrate an absence of myocardial infarction and other clinically significant abnormality on electrocardiographic examination:
At the first application after reaching the 35th birthday; and
On an annual basis after reaching the 40th birthday.
An electrocardiogram will satisfy a requirement of paragraph (b) of this section if it is dated no earlier than 60 days before the date of the application it is to accompany and was performed and transmitted according to acceptable standards and techniques.
Note: Any applicant for certification may be required to provide ECGs when indicated by history or physical examination.
II. Examination Techniques
A. When an ECG/EKG is required:
| Class | Applicant age on day of exam | ECG is required at the following intervals |
|---|---|---|
| 1st | 34 or younger | Not required |
| 1st | 35 to 39 | A single baseline ECG is required at the first exam performed after reaching the 35th birthday. |
| 1st | 40 or older | Annually |
| 2nd or 3rd | Any age | Not required**If the AME performed an EKG, it should be submitted along with notes in Block 60 describing why it was performed. |
Other times an ECG/EKG can be requested by an AME (for All classes):
Any time the airman has a history or physical examination finding that suggests a clinically significant abnormality.
Substitution for an ECG/EKG:
If a first-class airman does not have a current resting ECG on file, but the FAA has the tracings of any type of stress test (pharmaceutical stress, Bruce stress, nuclear stress, or stress echocardiogram) which was done within the last 60 days, the information may be accepted on a case-by-case basis. The image must be of good quality. Stress test or ECG images that have been faxed do not have enough clarity/definition for adequate review. In most cases, they will not be acceptable. A cardiac catheterization and/or a Holter monitor test are NOT acceptable in place of a resting 12-lead ECG. (A full 12-lead ECG is required. Anything less than a 12-lead will not be accepted.)
Additional Work-Up/Evaluation (All classes):
If additional work up was performed based on history or ECG findings, copies of the work up (cardiovascular evaluation, clinic notes, stress testing, etc.) should also be submitted to the FAA with notes in Block 60 describing the findings. If any pathology was identified, refer to the appropriate, individual section.
AMCS notification regarding ECG will appear as:
ECG is Required:
A Red X will precede the words ECG Date. No date will be in the box.
ECG is Not Required:
The AMCS screen will show the word “Ok” along with a date in the box. Can I submit an ECG performed on a day other than the date of exam?
Yes, but it must be considered current
B. Currency of ECG/What is considered a current ECG:
Only an ECG performed up to 60 days prior to the exam is considered current.
There is no provision for issuance of a first-class medical certificate based upon a promise that an ECG will be obtained at a future date.
As of the August 2014 changes in AMCS, an AME cannot transmit the exam until the required ECG is attached.
C. ECG equipment/technical requirements (Updated 05/29/2024):
The FAA does not require a specific type of machine, however the ECG machine used must give a clear picture AND meet the following technical requirements:
A full 12-lead ECG is required. (Anything less than a 12-lead will not be accepted.)
Must generate an image that can be converted to a PDF;
Must be recorded at 25mm/sec at 10mV. (This is standard in the US). 5mV waveforms may not have sufficient voltage for interpretation.
Recordings at 50mm/sec will NOT be accepted. Many international programs are set at 50mm/sec as a baseline; the AME must change this to 25mm/sec for the FAA to accept the tracing; and
300 dpi color resolution (or better)
D. AME Review and Interpretation of the ECG:
The AME must review the ECG for the following PRIOR to transmitting:
Quality - It is not uncommon for the FAA to receive an ECG that has leads missing or even an asystole picture. If the quality is poor and the ECG cannot be interpreted, the airman will receive a letter requiring a new ECG.
Correct airman/Correct exam - Verify you attach the correct ECG to the correct airman file. Also verify NO OTHER documents are attached.
Abnormalities/pathology - Review the ECG for any abnormalities which may cause you to defer or inform the airmen that a work up is required.
See
The following common ECG findings are considered normal variants and are not cause for deferment unless the airman is symptomatic or there are other concerns. Airmen who have these findings may be certified, if otherwise qualified:
Early repolarization
Ectopic atrial rhythm
First-degree AV (atrioventricular) block with PR interval less than 300 ms (0.30 sec)
Incomplete Right Bundle Branch Block (IRBBB)
Indeterminate axis
Intraventricular conduction delay (IVCD)
Left atrial abnormality
Left axis deviation, less than or equal to -30 degrees
Left ventricular hypertrophy by voltage criteria only
Low atrial rhythm
Low voltage in limb leads (May be a sign of obesity or hypothyroidism.)
Premature Atrial Contraction (PAC) – multiple, asymptomatic
Premature Ventricular Contraction (PVC) - single only; 2 or more on ECG require evaluation.
Short QT – if no history of arrhythmia
Sinus arrhythmia
Sinus bradycardia. Up to age 49 if heart rate is >44; Age 50 and older if heart rate is >48
Sinus tachycardia – heart rate < 110
Wandering atrial pacemaker
E. Transmitting/uploading the ECG:
Complete instructions can be found on the AMCS User Guide. As of October 2014, all Senior AMEs in the United States and International AMEs are required to upload a PDF version of an ECG into the correct section on the 8500-8. Clicking on the icon will launch an ECG Import window, where the applicant’s current ECG can be uploaded as a PDF attachment and eventually transmitted to the FAA with the exam.
Date - The AME no longer fills in the date. The date entered in the ECG import window will populate this field (Item 58).
One ECG - You may attach only one ECG to the exam:
o Only the last ECG attached will be saved and transmitted with the exam. Ex: If you attach ECG #1 and then attach ECG #2, ECG #1 will be replaced and not sent to the FAA.
o If an incorrect ECG is uploaded, a new one may be attached. You will receive a warning at the top of the window if an ECG has already been attached.
AME Comments - The AME can comment on findings when uploading the ECG.
Non-AME transmissions:
o ECGs must be electronically attached to an 8500-8 by the AME.