Guide for Aviation Medical ExaminersVersion 09/30/2026
Section 05
ITEMS 31-34. Eye
38 pagesPages 90–127
CHECK EACH ITEM IN APPROPRIATE COLUMN Normal Abnormal
Eyes, general (vision under Items 50 to 54)
Ophthalmoscopic
Pupils (Equity and reaction)
Ocular motility (Associated parallel movement nystagmus)
- I. Code of Federal Regulations
- All Classes: 14 CFR 67.103(e), 67.203(e), and 67.303(d)
No acute or chronic pathological condition of either the eye or adnexa that interferes with the proper function of the eye, that may reasonably be expected to progress to that degree, or that may reasonably be expected to be aggravated by flying.
II. Examination Techniques
For guidance regarding the conduction of visual acuity, field of vision, heterophoria, and color vision tests, please see Items 50-54.
The examination of the eyes should be directed toward the discovery of diseases or defects that may cause a failure in visual function while flying or discomfort sufficient to interfere with safely performing airman duties.
The AME should personally explore the applicant's history by asking questions concerning any changes in vision, unusual visual experiences (halos, scintillations, etc.), sensitivity to light, injuries, surgery, or current use of medication. Does the applicant report inordinate difficulties with eye fatigue or strain? Is there a history of serious eye disease such as glaucoma or other disease commonly associated with secondary eye changes, such as diabetes? (See Item 53. Field of Vision and Item 54. Heterophoria)
It is recommended that the AME consider the following signs during the course of the eye examination:
Color — redness or suffusion of allergy, drug use, glaucoma, infection, trauma, jaundice, ciliary flush of Iritis, and the green or brown Kayser-Fleischer Ring of Wilson's disease.
Swelling — abscess, allergy, cyst, exophthalmos, myxedema, or tumor.
Other — clarity, discharge, dryness, ptosis, protosis, spasm (tic), tropion, or ulcer.
It is suggested that a routine be established for ophthalmoscopic examinations to aid in the conduct of a comprehensive eye assessment.
Cornea — observe for abrasions, calcium deposits, contact lenses, dystrophy, keratoconus, pterygium, scars, or ulceration.
Pupils and Iris — check for the presence of synechiae and uveitis. Size, shape, and reaction to light should be evaluated during the ophthalmoscopic examination. Observe for coloboma, reaction to light, or disparity in size.
Aqueous — hyphema or iridocyclitis.
Lens — observe for aphakia, discoloration, dislocation, cataract, or an implanted lens.
Vitreous — note discoloration, hyaloid artery, floaters, or strands.
Optic nerve — observe for atrophy, hemorrhage, cupping, or papilledema.
Retina and choroid — examine for evidence of coloboma, choroiditis, detachment of the retina, diabetic retinopathy, retinitis, retinitis pigmentosa, retinal tumor, macular or other degeneration, toxoplasmosis, etc.
Ocular Motility. Motility may be assessed by having the applicant follow a point light source with both eyes, the AME moving the light into right and left upper and lower quadrants while observing the individual and the conjugate motions of each eye. The AME then brings the light to center front and advances it toward the nose observing for convergence. End point nystagmus is a physiologic nystagmus and is not considered to be significant. It need not be reported. (For further consideration of nystagmus, see Item 50., Distant Vision.)
Monocular Vision. An applicant will be considered monocular when there is only one eye or when the best corrected distant visual acuity in the poorer eye is no better than 20/200. An individual with one eye, or effective visual acuity equivalent to monocular, may be considered for medical certification, any class, through the special issuance section of part 67 (14 CFR 67.401).
Although it has been repeatedly demonstrated that binocular vision is not a prerequisite for flying, some aspects of depth perception, either by stereopsis or by monocular cues, are necessary. It takes time for the monocular airman to develop the techniques to interpret the monocular cues that substitute for stereopsis; such as, the interposition of objects, convergence, geometrical perspective, distribution of light and shade, size of known objects, aerial perspective, and motion parallax.
In addition, it takes time for the monocular airman to compensate for his or her decrease in effective visual field. A monocular airman’s effective visual field is reduced by as much as 30% by monocularity. This is especially important because of speed smear; i.e., the effect of speed diminishes the effective visual field such that normal visual field is decreased from 180 degrees to as narrow as 42 degrees or less as speed increases. A monocular airman’s reduced effective visual field would be reduced even further than 42 degrees by speed smear.
For the above reasons, a waiting period of 6 months is recommended to permit an adequate adjustment period for learning techniques to interpret monocular cues and accommodation to the reduction in the effective visual field.
Applicants who have had monovision secondary to refractive surgery may be certificated, providing they have corrective vision available that would provide binocular vision in accordance with the vision standards, while exercising the privileges of the certificate. The certificate issued must have the appropriate vision limitations statement.
Contact Lenses. The use of contact lens(es) for monovision correction is not allowed:
The use of a contact lens in one eye for near vision and in the other eye for distant vision is not acceptable (for example: pilots with myopia plus presbyopia).
The use of a contact lens in one eye for near vision and the use of no contact lens in the other eye is not acceptable (for example: pilots with presbyopia but no myopia).
Additionally, designer contact lenses that introduce color (tinted lenses), restrict the field of vision, or significantly diminish transmitted light are not allowed.
Please note: the use of binocular contact lenses for distance-correction-only is acceptable. In this instance, no special evaluation or SODA is routinely required for a distance-vision-only contact lens wearer who meets the standard and has no complications. Binocular bifocal or binocular multifocal contact lenses are acceptable under the Protocol for Binocular Multifocal and Accommodating Devices.
Intraocular Devices. Binocular airman using multifocal or accommodating ophthalmic devices may be issued an airman medical certificate in accordance with the Protocol for Binocular Multifocal and Accommodating Devices.
Orthokeratology (Ortho-K) is the use of rigid gas-permeable contact lenses, normally worn only during sleep, to improve vision through reshaping of the cornea. It is used as an alternative to eyeglasses, refractive surgery, or for those who prefer not to wear contact lenses while awake. The correction is not permanent and visual acuity can regress while not wearing the Ortho-K lenses. There is no reasonable or reliable way to determine standards for the entire period the lenses are removed. Therefore, to be found qualified, applicants who use Ortho-K lenses must meet the applicable vision standard while wearing the Ortho-K lenses AND must wear the Ortho-K lenses while piloting aircraft.
The limitation “must use Ortho-K lenses while performing pilot duties” must be placed on the medical certificate.
Glaucoma. The AME should deny or defer issuance of a medical certificate to an applicant if there is a loss of visual fields or a significant change in visual acuity.
The FAA may grant an Authorization under the special issuance section of Part 67 (14 CFR 67.401) on an individual basis. The AME must obtain a report of Ophthalmological Evaluation for Glaucoma (FAA Form 8500-14) from an ophthalmologist. See Glaucoma Worksheet. Because secondary glaucoma is caused by known pathology such as; uveitis or trauma, eligibility must largely depend upon that pathology. Secondary glaucoma is often unilateral, and if the cause or disease process is no longer active and the other eye remains normal, certification is likely.
Applicants with primary or secondary narrow angle glaucoma are usually denied because of the risk of an attack of angle closure, because of incapacitating symptoms of severe pain, nausea, transitory loss of accommodative power, blurred vision, halos, epiphora, or iridoparesis. Central venous occlusion can occur with catastrophic loss of vision. However, when surgery such as iridectomy or iridoclesis has been performed satisfactorily more than 3 months before the application, the likelihood of difficulties is considerably more remote, and applicants in that situation may be favorably considered.
An applicant with unilateral or bilateral open angle glaucoma may be certified by the FAA (with follow-up required) when a current ophthalmological report substantiates that pressures are under adequate control, there is little or no visual field loss or other complications, and the person tolerates small to moderate doses of allowable medications. Individuals who have had filter surgery for their glaucoma, or combined glaucoma/cataract surgery, can be considered when stable and without complications. Applicants using miotic or mydriatic eye drops or taking an oral medication for glaucoma may be considered for Special Issuance certification following their demonstration of adequate control. These medications DO NOT qualify for the CACI program. Miotics such as pilocarpine cause pupillary constriction and could conceivably interfere with night vision. Although the FAA no longer routinely prohibits pilots who use such medications from flying at night, it may be worthwhile for the AME to discuss this aspect of the use of miotics with applicants. If considerable disturbance in night vision is documented, the FAA may limit the medical certificate: NOT VALID FOR NIGHT FLYING.
Sunglasses. Sunglasses are not acceptable as the only means of correction to meet visual standards, but may be used for backup purposes if they provide the necessary correction. Airmen should be encouraged to use sunglasses in bright daylight but must be cautioned that, under conditions of low illumination, they may compromise vision. Mention should be made that sunglasses do not protect the eyes from the effects of ultraviolet radiation without special glass or coatings and that photosensitive lenses are unsuitable for aviation purposes because they respond to changes in light intensity too slowly. The so-called "blue blockers" may not be suitable since they block the blue light used in many current panel displays. Polarized sunglasses are unacceptable if the windscreen is also polarized.
Refractive Procedures. The FAA accepts the following Food and Drug Administration approved refractive procedures for visual acuity correction:
Radial Keratotomy (RK)
Epikeratophakia
Laser-Assisted In Situ Keratomileusis (LASIK), including Wavefront-guided
LASIK
SMILE (Small Incisional Lenticular Extraction)
Photorefractive Keratectomy (PRK)
Conductive Keratoplasty (CK)*
Please be advised that these procedures have potential adverse effects that could be incompatible with flying duties, including: corneal scarring or opacities; worsening or variability of vision; and night-glare.
The FAA expects that airmen will not resume airman duties until their treating health care professional determines that their post-operative vision has stabilized, there are no significant adverse effects or complications (such as halos, rings, haze, impaired night vision and glare), the appropriate vision standards are met, and they have been reviewed by an AME or AMCD. When this determination is made, the airman should have the treating health care professional document this in the health care record, a copy of which should be forwarded to the AMCD before resumption of airman duties. If the health care professional's determination is favorable and after consultation and review by an AME, the applicant may resume airman duties, unless informed otherwise by the FAA.
An applicant treated with a refractive procedure may be issued a medical certificate by the AME as outlined on the Eyes-Refractive Surgery Disposition Table. There should be no other pathology of the affected eye(s).
If the procedure was done 3 months ago or longer, the FAA may accept the AME's eye evaluation and a statement regarding the absence of adverse sequela.
If the procedure was performed within the last 3 months, The AME should reference the Eyes-Refractive Surgery Status Summary. *Conductive Keratoplasty (CK): CK is used for correction of farsightedness. As this procedure is not considered permanent and there is expected regression of visual acuity in time, the FAA may grant an Authorization for special issuance of a medical certificate under 14 CFR 67.401 to an applicant who has had CK.
The FAA evaluates CK procedures on an individual basis following a waiting period of 6 months. The waiting period is required to permit adequate adjustment period for fluctuating visual acuity. The AME can facilitate FAA review by obtaining all pre- and post-operative medical records, a Report of Eye Evaluation (FAA Form 8500-7) from a treating or evaluating eye specialist with comment regarding any adverse effects or complications related to the procedure.
III. Aerospace Medical Disposition
Applicants with many visual conditions may be found qualified for FAA certification following the receipt and review of specialty evaluations and pertinent medical records.
Examples include retinal detachment with surgical correction, open angle glaucoma under adequate control with medication, and narrow angle glaucoma following surgical correction.
The AME may not issue a certificate under such circumstances for the initial application, except in the case of applicants following cataract surgery. The AME may issue a certificate after cataract surgery for applicants who have undergone cataract surgery with or without lens(es) implant. If pertinent medical records and a current ophthalmologic evaluation (using FAA Form 8500-7 or FAA Form 8500-14) indicate that the applicant meets the standards, the FAA may delegate authority to the AME to issue subsequent certificates.
The following is a table that lists the most common conditions of aeromedical significance, and course of action that should be taken by the AME as defined by the protocol and disposition in the table. Medical certificates must not be issued to an applicant with medical conditions that require deferral, or for any condition not listed in the table that may result in sudden or subtle incapacitation without consulting the AMCD or the RFS. Medical documentation must be submitted for any condition in order to support an issuance of an airman medical certificate.
QUALITY OF VISION QUESTIONNAIRE FOR PILOT/ATCS
(Updated 08/27/2025) The following questions should be answered by the PILOT/ATCS. Complete all sections as appropriate. Please add additional comments at the bottom as necessary. Bring this page to your AME for upload into your file as Eye – Quality of Vision Questionnaire.
| A. Do you have any of these visual symptoms? (Circle)Blurred vision Glare Halos Starbursts Loss of contrast | NO | YES* |
| B. Do the symptoms impair your visual functioning? (If no symptoms, mark “NO”) | NO | YES* |
| C. Do you notice any areas of your vision that are distorted, dark, or missing? (Central vision or peripheral field of vision.) | NO | YES* |
| D. Do you have difficulty driving at night or in low light conditions due to your vision? | NO | YES* |
| E. Do you have double vision (diplopia) in any direction of gaze or under any special condition such as fatigue? If YES, describe in the space below what you see (ex. prisms, etc.) and any treatments. | NO | YES* |
| F. Do you have any history of past or current abnormalities affecting your eyes or vision? (Check “YES” even if resolved). | NO | YES* |
| G. Have you ever had any eye-related procedures/surgery? Include intraocular, refractive, orbit, eyelid, lasers, injections, corneal sculpting with contacts, etc. | NO | YES* |
| H. Have you ever been told you have weakness with color vision? | NO | YES* |
| I. Are you taking any medication(s) for your eyes? | NO | YES* |
If you responded YES* to any above questions, please explain below. Include how often, how severe, and does it affect your day-to-day activities. Please enter additional explanation or comments for ANY part of this questionnaire:
Pilot/ATCS Name ___________________________ MID#, PI#, or App ID#_________________
Pilot/ATCS Signature ________________________ Date completed ___________________
ITEM 31. Eyes – General
AMBLYOPIA
All Classes (Updated 08/26/2026)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Amblyopia or decreased distant vision which meets all the following:• Simple Refractive or Strabismic• One eye only• Unaffected eye Distance Vision is 20/20 or better (for all classes)Decreased vision caused by a process strictly limited to one eye with a fully normal fellow eye and an onset consistent with developmental adaptation | Submit the following for FAA review:1. Amblyopia Status SummaryOR a current, detailed Clinical Progress Note generated from a clinic visit with their treating ophthalmologist or optometrist no more than 90 days before the AME exam which addresses all items on the Status Summary.2. Any associated progress notes. |  DEFERSummarize findings in Item 60.Submit the information to the FAA.In Item 60, specify the airman’s preferred FSDO if a Medical Flight Test (MFT) is required. |
| B. All others• Any “Yes*” items on the Amblyopia Status Summary• Both eyes affected• Not congenital/early childhood and adapted• Any other eye disease• Medication use• Concerns/unstable vision• Does not meet 20/20 DVA in unaffected eye• Both eyes fail to achieve corrected normal vision because of refractive errors (high hyperopia, myopia, or astigmatism). | Submit the following for FAA review:1. Amblyopia Status Summary 2. Complete eye evaluation by a boardcertified ophthalmologist which specifically includes if there is evidence of any other eye pathology. 3. Any associated progress notes. 4. Copies of testing already performed for any eye condition(s). |  DEFERSummarize findings in Item 60.Submit the information to the FAA.In Item 60 specify the airman’s preferred FSDO if a Medical Flight Test (MFT) is required. |
Amblyopia (Lazy Eye) Status Summary (Developmental adaptation to unilateral visual impairment*)
(Updated 08/26/2026) Name: _______________________________ Birthdate: ______________________
Applicant ID: __________________________ PI#: ___________________________
Please have your ophthalmologist or optometrist provide the requested information in the space provided. Submit this summary or a current, detailed Clinical Progress Note addressing each item. Attach a copy of any additional testing already performed and submit all items to your AME for upload into your FAA file:
Check affected eye(s) BEST corrected vision (enter both) circle correction used
_____ Right (OD) 20 / ________ no correction / glasses / contacts / other*
_____ Left (OS) 20 / ________ no correction / glasses / contacts / other*
| No | Yes* |
|---|---|
| No | Yes* |
| No | Yes* |
| No | Yes* |
Does this individual have any ophthalmological diagnosis OTHER than a stable, non-progressive childhood condition (such as mild refractive, strabismus, or juvenile/congenital amblyopia, or developmental adaptation to unilateral visual impairment*)?
Does this condition affect BOTH eyes or is there any non-refractive issue that could compromise vision in the better eye?
Do they use any eye medication(s) or drops for an eye condition, or have they had EYE surgery other than strabismus surgery of any type?
Do you have any concerns with their overall quality of vision, or is the condition Unstable or likely to progress?
Explain any “Yes*” answers or other concerns. If glasses or contacts are used but are not sufficient to correct vision to standards, please explain. Attach any current, detailed Clinical Progress Note(s).
________________________________________________ __________________ Treating Physician Signature and credentials (MD/DO/OD) Date of Evaluation
________________________________________________ __________________ Name or Office Stamp Phone Number
*This status summary can be used for decreased vision caused by a process strictly limited to one eye, with a fully normal fellow eye, and an onset less than age 12 and consistent with developmental adaptation.
AME actions: DEFER for initial review. This status summary is NOT required; however, it will help to streamline and significantly DECREASE FAA review time.
BLEPHARITIS and CONJUNCTIVITIS
All Classes
(Updated 08/27/2025)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Blepharitis Blepharoconjunctivitis Conjunctivitis(e.g., allergy eye)The individual meets the vision standards for class applied: | Generally, not of aeromedical concern.If the AME can determine the treatment is acceptable (cleansing washes, drops and/or eye ointment), with no visual impairment or symptoms that would interfere with flight or safety-related dutiesORCondition has resolved: |  ISSUEAnnotate this information in Block 60.Warn the individual they must meet visual acuity standards when using drops or ointments. |
| B. Conjunctivitis, active due to infectious cause | For active infection, should not fly in accordance with 61.53.Individuals should not resume duties until signs and symptoms have resolved (when discharge, excessive tearing, irritation, and redness have cleared).Once resolved, see Row A. | Once resolved, see Row A.Best practice is not measured in days held out from work, but until signs and symptoms have resolved. Should not return to flight or safety-related duties until discharge, excessive tearing, irritation, and redness have cleared. |
| BLEPHARITIS and CONJUNCTIVITISC. All others including:• Does not meet vision standards• Symptoms which would impair flight or safety sensitive dutiesFor Keratoconjunctivitis---see that page | Submit the following for FAA review:1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating optometrist or ophthalmologist no more than 90 days prior to the AME exam. It must include:• A detailed summary of the history of the condition;• Current medications, dosage, and side effects (if any);• Physical exam findings;• Results of any testing performed;• Diagnosis;• Assessment and plan;• Prognosis; and• Follow-up.2. The Clinical Progress note must specifically include the best corrected visual acuity for distant and near vision (intermediate - if age 50 or older and First or Second Class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.3. Copies of any testing performed (visual fields, etc.) |  DEFER Submit the information to the FAA for a possible Special IssuanceAnnotate (elements or findings) in Block 60. |
CATARACT(S)
All Classes
(Updated 09/24/2025)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Cataract(s) present;The individual meets the vision standards for class applied; andquality of vision is not affected:For more information see Pilot Vision | If the AME can determine the condition is under control and vision meets standards with no symptoms that would interfere with flight or safetyrelated duties such as:• Glare• Halos• Loss of contrast sensitivity• Poor night vision |  ISSUEAnnotate Block 60.If correction was needed to meet standards, apply Limitation 102 to certificate.Warn the pilot CFR 61.53 applies if any change or worsening in vision. |
| B. Others:• Does not meet vision standards• Quality of vision is affected• AME or ophthalmologist or optometrist have concerns | Submit the following for FAA review:1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating ophthalmologist or optometrist no more than 90 days prior to the AME exam. It must include:• A detailed summary of the history of the condition;• Current medications, dosage, and side effects (if any);• Physical exam findings;• Results of any testing performed;• Diagnosis;• Assessment and plan;• Prognosis; and Follow-up.2. The Clinical Progress note must specifically include the best corrected visual acuity for distant and near vision (intermediate - if age 50 or older and first or second Class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.3. Copies of any testing performed (visual fields, etc.)4. Quality of Vision Questionnaire |  DEFER Submit the information to the FAA for a possible Special IssuanceAnnotate (elements or findings) in Block 60.Note: If unable to meet 1st or 2nd class visual acuity standards, but they will accept a lower class, the AME should issue 3rd class and annotate block 60. |
| C. If cataract surgery has been performed, see Lens Implant Disposition Table. |  |
See Cataracts and Intraocular Lenses (IOL) Frequently Asked Questions (FAQS).
DIPLOPIA (DOUBLE VISION)
All Classes
Updated 08/26/2026
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Any history or current symptoms.Include persistent or intermittent. | Submit the following for FAA review:1. A current, detailed Clinical Progress Note generated from a clinic visit with their treating ophthalmologist, neurologist, or neuroophthalmologist no more than 90 days before the AME exam.It should include a summary of the history of the condition or diagnosis; current medications, dosages, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.2. It must specifically include:• A thorough assessment identifying the underlying CAUSE of the diplopia.• Objective evidence of stability or resolution of the misalignment. (e.g. a resolved 6th nerve paresis)• Documentation of effective treatment (e.g., prism, surgical correction), if used.3. Visual acuity. The best corrected visual acuity for distant and near vision (intermediate if age 50 or older and 1st or 2nd class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.4. Copies of any testing already performed (visual fields, etc.) |  DEFERSubmit the information to the FAA for a possible Special Issuance.Summarize findings in Item 60. |
| B. Due to a neurological condition | If due to a neurological condition, see corresponding page. |
OCULAR HISTOPLASMOSIS
All Classes
(Updated 08/27/2025)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Any history of ocular histoplasmosis(single or multiple episodes; resolved or currently being treated) | Submit the following for FAA review:1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating ophthalmologist or retinal specialist (preferred) no more than 90 days prior to the AME exam. It must include:• A detailed summary of the history of the condition;• Current medications, dosage, and side effects (if any);• Physical exam findings;• Results of any testing performed;• Diagnosis;• Assessment and plan;• Prognosis; and Follow-up.2. It must specifically include:• Clinical correlation of any findings including if treatment is indicated;• A highly descriptive retinal fundus exam (including periphery) with retinal drawing;• Specific comment whether the condition is static or progressive; and• OCT (optical coherence test) with statement if any neovascularization3. The Clinical Progress Note must specifically include the best corrected visual acuity for distant and near vision (intermediate - if age 50 or older and first or second Class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.4. Visual field testing (30-2) of both eyes performed no more than 90 days prior to the AME exam.• If any macular involvement, central visual field testing (10-2 or 12-2) is also required.5. Copies of any other testing already performed. |  DEFER Submit the information to the FAA for a possible Special IssuanceAnnotate (elements or findings) in Block 60. |
EYES – GENERAL, OTHER CONDITIONS
All Classes
(Updated 08/26/2026)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| Congenital or acquired conditions (whether acute or chronic) of either eye or adnexa, that may interfere with visual functions, may progress to that degree, or may be aggravated by flying (tumors and ptosis obscuring the pupil, acute inflammatory disease of the eyes and lids, or keratoconus.) | Provide completed FAA Form 8500-7Submit all pertinent medical information and current status reportFor keratoconus, include if available results of imaging studies such as kertatometry, videokeratography, etc., with clinical correlationNote: applicant should be at best corrected visual acuity before evaluation | Requires FAA Decision |
| Pterygium | Document findings in Item 60 | If less than 50% of the cornea and not affecting central vision- IssueOtherwise - Requires FAA Decision |
| Any ophthalmic pathology reflecting a serious systemic disease (e.g., diabetic and hypertensive retinopathy) | Submit all pertinent medical information and current status report. (If applicable, see Diabetes and Hypertensive Protocols) | Requires FAA Decision |
EYES – PROCEDURES
All Classes
(Updates 08/27/2025)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| Aphakia/Lens Implants Intraocular Devices | See Lens Implant Disposition TableSee Eyes-Lens Implant Status SummarySee Cataract(s) Disposition TableSee Cataracts and Intraocular Lenses (IOL) Frequently Asked Questions (FAQS) | See applicable disposition table |
| Conductive Keratoplasty (CK) - Farsightedness | See Protocol for Conductive Keratoplasty | See Protocol for Conductive Keratoplasty |
| Refractive Procedures other than CK | See Eyes – Refractive Surgery Disposition TableSee Eyes – Refractive Surgery Status Summary | See applicable disposition table |
LENS IMPLANT
Crystalline Lens Replacement (Cataract or Refractive). (Use for VISION surgery such as Lens Implantation, Intraocular Lens [IOL], or cataract surgery with Lens Implant.)
(Updated 08/27/2025)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Surgery three (3) or more months agoAND• Full recovery;• Released from postoperative care; and• Off all medications.The individual meets the vision standards for class applied: | Generally, not of aeromedical concern.If the AME can determine the condition is under control and vision meets standards with no symptoms that would interfere with flight or safety related duties such as• Glare• Halos• Loss of contrast sensitivity• Poor night visionAND the individual meets the vision standards for class appliedReminder: Annotate if correction was needed to meet standards and if so, apply Limitation 102. |  ISSUEAnnotate this information including the reason the surgery was performed (cataracts, visual acuity performance, etc.) in Block 60. |
| B. Surgery within the past 3 months. | The AME should review a completed and signed Eyes - Lens Implant Status Summary from the ophthalmologist or optometrist.If all items fall into the “YES” column, the individual meets vision standards, and the AME has no concerns: |  ISSUEAnnotate Block 60 and submit the evaluation to the FAA for retention in the file. |
| C. All others including:• Complications• Does not meet vision standards• Quality of vision affected | Submit the following for FAA review:2. A current, detailed Clinical Progress Note generated from a clinic visit with the treating ophthalmologist no more than 90 days prior to the AME exam. It must include:• A detailed summary of the history of the condition;• Current medications, dosage, and side effects (if any);• Physical exam findings;• Results of any testing performed;• Diagnosis;• Assessment and plan;• Prognosis; and |  DEFERSubmit the information to the FAA for a possible Special IssuanceAnnotate (elements or findings) in Block 60. |
| • Follow-up.2. The Clinical Progress Note must specifically include the best corrected visual acuity for distant and near vision (intermediate - if age 50 or older and First or Second Class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.3. Copies of any testing performed (visual fields, etc.) |
Use this table with the Eyes - Lens Implant Status Summary for:
Monofocal lens (standard implant). Toric or astigmatism correcting lens.
Light adjustable lens (LAL).
Presbyopic lens.
Multifocal or extended depth of focus (EDOF) lens Also see Cataracts and Intraocular lenses (IOL) Frequently Asked Questions (FAQS)
EYES - LENS IMPLANT STATUS SUMMARY
(Updated 08/27/2025) Surgery which replaced the natural crystalline lens of the eye. May be called Lens Implantation; Lens Replacement; Intraocular Lens (IOL); or Cataract surgery with Lens Implant Name _______________________________ Birthdate ________________
Applicant ID#__________________________ PI# _____________________
If the pilot or ATCS has an AASI/SI/SC for any other EYE condition, conductive keratoplasty (CK), INTACS, clear lens extraction, ICL or Phakic lenses, visual field loss or this is a non-FDA approved procedure: STOP. Do not use this summary, submit all clinical progress notes, or see the corresponding AME Guide page.
Please have your ophthalmologist or optometrist complete, sign, and date this sheet or submit a current, detailed Clinical Progress Note that addresses ALL items below.
- Right Eye (OD) Left Eye (OS)
- DATE OF SURGERY _______/________/_____ _______/______/______
Has the MINIMUM RECOVERY PERIOD been met? (Circle type of lens)
☐ Two (2) weeks
MONOfocal lens (standard implant)
Toric or astigmatism correcting lens ☐ If Light Adjustable Lens (LAL) - Six (6) weeks total to include two (2) weeks after the final adjustment/lens lockdown and taken off UV avoidance.
☐ Twelve (12) weeks
Presbyopia correcting lenses
MULTIfocal or Extended Depth of Focus (EDOF) lens
Absent from surgical or post-operative complications (e.g., macular edema, elevated pressure, corneal edema, delayed healing), released from postoperative care, and NO clinical concerns*.
Off all prescription eye medication or on surgeon’s usual medication taper.
Without adverse visual symptoms which interfere with visual functioning: glare, halo, photophobia, multiple images, blurred vision, decreased quality of vision in low light conditions (dusk, dawn, night), no difficulty with nighttime driving.
Visual result has stabilized, received lens correction (if needed) and best corrected vision meets standards. Annotate VA below.
| Visual Acuity [Medical Standards] | Right (OD) | Left (OS) | Correction used (yes or no) |
|---|---|---|---|
| Distant (1st and 2nd class 20/20 or better; 3rd class 20/40 or better) | 20/ | 20/ | |
| Near (16”) (All classes 20/40 or better) | 20/ | 20/ | |
| Intermediate (32”): Age 50 and over, 1st or 2nd class (20/40 or better); 3rd class not required | 20/ | 20/ |
*If any concerns, please describe below or attach a Clinical Progress Note.
Ophthalmologist or Optometrist signature _______________________ Date _____________________________
Printed name or office name __________________________________ Office phone number ________________ YES NO*
Pilots: Submit either this summary or all supporting documentation addressing each item to your AME for electronic upload to the FAA.
ATCS: Submit the information to your Regional Flight Surgeon’s Office.
AME: If ALL items fall into the clear “YES” column and the individual meets vision requirements for class, the AME may issue.
If Any Single Item falls into the shaded “NO” column, the AME MUST DEFER. The AME should note what aspect caused the deferral and explain any “NO” answers. Attach the most recent detailed Clinical Progress Note(s) which addresses these items.
NOTE: This Status Summary is NOT required (clinical records may be submitted); however, it will help to streamline and significantly DECREASE FAA review time.
CATARACTS AND INTRAOCULAR LENSES (IOL)
FREQUENTLY ASKED QUESTIONS (FAQS)
(Updated 08/27/2025)
1. What is a cataract?
A cataract is a condition where the lens can become progressively opaque, interfering with vision. It often presents as blurry vision, like viewing things through a cloudy piece of glass. It may also be noted at night and with reading fine print. Most cases occur in people over 60 but can occur at younger ages in patients with diabetes mellitus, chronic use of steroids, or with a history of eye trauma. It is the most common cause of blindness. In some cases, visual acuity may be 20/20 or better, but the individual still has poor quality of vision that could affect the ability to fly or control traffic.
What do I need to consider when choosing an implanted (intraocular) lens if I am a pilot or ATCS?
The type of lens implanted may result in adverse effects such glare, halos, loss of contrast sensitivity, or poor quality of vision, especially at night. These adverse effects can be disqualifying.
The individual should discuss with the eye doctor that as a pilot or ATCS, night vision and the absence of halos or glare is very important.
Simple lenses or monofocal lenses correct for only one vision distance (near, mid, or distant) and are less likely to result in adverse visual effects. However, the individual may still require reading glasses.
Multifocal and extended depth of focus (EDOF) lenses reduce the need for reading or intermediate (computer length) glasses but are more likely to have visual side effects.
What type of lenses are currently available?
Monofocal lens: Correct an individual's vision at only one distance (either near, intermediate, or distant). They tend to be less expensive and less likely to cause halos or night vision abnormalities. However, the individual may continue to need glasses to read or see instrument panels.
Multifocal lens: Are designed to correct vision at multiple distances—such as near, intermediate, and distant—similar to bifocal or trifocal contact lenses. There are multiple brand names available. Multifocal lenses are typically more expensive. They may not provide vision as sharp as monofocal lenses, and can sometimes worsen night vision, especially when driving. Some people may also notice glare or halos around lights, and may still need reading glasses.
Light Adjustable Lens (LAL): LAL is not multifocal. It requires additional time after implant before returning to flight or safety-related duties as the lens must be locked in. Eyes must be protected from UV light until locked in.
Presbyopia* correcting lenses: This includes both multifocal and EDOF lenses. *Presbyopia is a condition in which the individual loses the ability to see things up close as a normal part of aging.
How do I tell which lens type I have?
Check with the eye doctor.
How long do I have to wait after lens replacement surgery or cataract surgery? It depends on the type of lens implanted. Before return to flight or safety-related duties, the individual must meet all criteria outlined in the FAA Eyes - Lens Implant Status Summary sheet AND meet the vision standards for the class of medical certificate held.
Is there a specific wait time between surgery on each eye?
The treating eye professional will make that determination. There is no FAA required wait time between left and right eye procedures. (Many institutions correct one eye first and then 2 weeks later, correct the other eye, while some use 1 week, and others do surgery on both eyes the same day.)
What if I have lens replacement and can no longer meet the FAA vision standards? If no longer correctable to standards, the AME will need to defer. A medical flight test may be authorized for a possible SODA or Special Issuance.
My eye doctor has released me, what do I need to check before I fly or control traffic? The individual should ask themselves the following questions and discuss any concerns with the eye doctor or AME:
“Has my night vision returned? “
“Can I drive at night without glare?”
“Does light bother my eyes less than before my surgery?”
EYES - REFRACTIVE SURGERY (Use for elective vision surgery such as Excimer Laser Corneal Refractive Surgery [LASIK, PRK, SMILE])
All Classes
(Updated 08/27/2025)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Surgery three (3) or more months agoAND• Full recovery,• Released from post operative care, and• Off all medications.The individual meets the vision standards for class applied: | Generally, not of aeromedical concern.If the AME can determine the condition is under control and vision meets standards with no symptoms that would interfere with flight or safety related duties such as• Glare• Halos• Loss of contrast sensitivity• Poor night visionAND the individual meets the vision standards for class appliedReminder: Annotate if correction was needed to meet standards and if so, apply Limitation 102. |  ISSUEAnnotate this information in Block 60. |
| B. Surgery within the past 3 months. | The AME should review a completed and signed Eyes - Refractive Surgery Status Summary from the ophthalmologist or optometrist.If all items fall into the “YES” column, the individual meets vision standards, and the AME has no concerns: |  ISSUEAnnotate Block 60 and submit the evaluation to the FAA for retention in the file. |
| C. All others including:• Complications• Does not meet vision standards• Quality of vision affected | Submit the following for FAA review:2. A current, detailed Clinical Progress Note generated from a clinic visit with the treating ophthalmologist no more than 90 days prior to the AME exam. It must include:• A detailed summary of the history of the condition;• Current medications, dosage, and side effects (if any);• Physical exam findings;• Results of any testing performed;• Diagnosis;• Assessment and plan;• Prognosis; and• Follow-up. |  DEFERSubmit the information to the FAA for a possible Special IssuanceAnnotate (elements or findings) in Block 60. |
| 2. The Clinical Progress Note must specifically include the best corrected visual acuity for distant and near vision (intermediate - if age 50 or older and First or Second Class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.3. Copies of any testing performed (visual fields, etc.) |
Use this table with the Eyes - Refractive Surgery Status Summary for:
LASIK (Laser-assisted in situ keratomileusis)
SMILE (Small Incisional Lenticular Extraction)
PRK (photorefractive keratectomy)
EYES – REFRACTIVE SURGERY STATUS SUMMARY
(Updated 08/272025) Use for elective corneal refractive surgery such as LASIK, SMILE, PRK Name _______________________________ Birthdate ________________
Applicant ID#__________________________ PI# _____________________
If the pilot or ATCS has an AASI/SI/SC for any other EYE condition, KERATOCONUS, conductive keratoplasty (CK), clear lens extraction, visual field loss or this is a non-FDA approved procedure: STOP. Do not use this summary, submit all clinical progress notes, or see corresponding AME Guide page.
Please have your ophthalmologist or optometrist complete, sign, and date this sheet or submit a current, detailed Clinical Progress Note that addresses ALL items below.
- Right Eye (OD) Left Eye (OS)
- DATE OF SURGERY _______/________/_____ _______/______/______
Has the MINIMUM RECOVERY PERIOD been met? (Circle procedure)
Two (2) weeks: LASIK (Laser-assisted in situ keratomileusis)
SMILE (Small Incisional Lenticular Extraction)
Twelve (12) weeks: PRK (photorefractive keratectomy)
Absent from surgical or post-operative complications (e.g., elevated pressure, delayed healing), released from postoperative care, and NO clinical concerns*.
Off all prescription eye medication or on surgeon’s usual medication taper.
Without adverse visual symptoms which interfere with visual functioning: glare, halo, photophobia, multiple images, blurred vision, decreased quality of vision in low light conditions (dusk, dawn, night), no difficulty with nighttime driving. CAUTION: these procedures may interfere with nighttime vision – please ask specifically about quality of night vision.
Visual results have stabilized, lens correction received (if needed) and best corrected vision meets standards. Annotate VA below.
| Visual Acuity [Medical Standards] | Right (OD) | Left (OS) | Correction used (yes or no) |
|---|---|---|---|
| Distant (1st and 2nd class 20/20 or better; 3rd class 20/40 or better) | 20/ | 20/ | |
| Near (16”) (All classes 20/40 or better) | 20/ | 20/ | |
| Intermediate (32”): Age 50 and over, 1st or 2nd class (20/40 or better); 3rd class not required | 20/ | 20/ |
*If any concerns, please describe below or attach a Clinical Progress Note.
Ophthalmologist or Optometrist signature _______________________ Date _____________________________
Printed name or office name __________________________________ Office phone number ________________ YES NO*
Pilots: Submit either this summary or all supporting documentation addressing each item to your AME for electronic upload to the FAA.
ATCS: Submit the information to your Regional Flight Surgeon’s Office.
AME: If ALL items fall into the clear “YES” column and the individual meets vision requirements for class, the AME may issue.
If Any Single Item falls into the shaded “NO” column, the AME MUST DEFER. The AME should note what aspect caused the deferral and explain any “NO” answers. Attach the most recent detailed Clinical Progress Note(s) which addresses these items.
NOTE: This Status Summary is NOT required (clinical records may be submitted); however, it will help to streamline and significantly DECREASE FAA review time.
ITEM 32. Ophthalmoscopic
- OPHTHALMOSCOPIC
- All Classes
- (Updated 0826/2026)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| Corneal Ulcer or Dystrophy; Optic Atrophy; Papilledema; or Retinal Degeneration or Detachment; Uveitis | Submit all pertinent medical information and detailed Clinical Progress Note. | Requires FAA Decision |
| Glaucoma (treated or untreated) | Review all pertinent medical information and current detailed Clinical Progress Note, or Form 8500-14 | Follow CACI - Glaucoma Worksheet. If airman meets all certification criteria – Issue.All others require FAA decision. Submit all evaluation data.Initial Special Issuance - Requires FAA DecisionFollow-up Special Issuances - See AASI Protocol |
| Macular Degeneration; Macular Detachment | Submit all pertinent medical information and detailed Clinical Progress Note. | Requires FAA Decision |
| Tumors | Submit all pertinent medical information and detailed Clinical Progress Note. | Requires FAA Decision |
| Vascular Occlusion; Retinopathy | Submit all pertinent medical information and detailed Clinical Progress Note. | Requires FAA Decision |
CHORIORETINITIS
All Classes
(Updated 08/26/2026)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A.• 5 or more years ago and No treatment needed in past 5 years• Single episode• Completely resolved• Meets all visual acuity (VA) specifications | The AME should review the following:Chorioretinitis Status Summaryora current, Detailed Clinical Progress Note from the treating ophthalmologist which verifies all questions on the status summary.If this documentation verifies: Single episode, 5 or more years ago, without visual field loss, is unlikely to recur and meets VA requirements: |  ISSUEExplain this information in Item 60.Submit a copy of the Chorioretinitis Status Summary and any progress notes or testing for retention in the file. |
| B. All others• Treatment in previous 5 years• Multiple episodes• Likely to recur• Does not meet VA specifications | Submit the following for FAA review:1. A current, detailed Clinical Progress Note generated from a clinic visit with treating retinal specialist (preferred) or ophthalmologist no more than 90 days before the AME exam.It should include a summary of the history of the condition or diagnosis; current medications, dosages, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.2. It must specifically include:• Diagnosis & Etiology: Specific cause/etiology and presence of any underlying immunodeficiency.• Date treatment was completed and verification that the condition is fully resolved with no active disease.• Prognosis and confirmation of no current visual impairment. |  DEFERSubmit the information to the FAA for a possible Special Issuance.Summarize findings in Item 60.Note: If unable to meet visual acuity or a visual field defect remains, a MFT may be required. Annotate which FSDO the airman wants to use. |
| 3. Visual Acuity. Best corrected visual acuity for distant and near vision (intermediate - if age 50 or older and First or Second Class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.4. Visual field testing (24-2 or 30-2) performed no more than 90 days prior to the AME exam.5. Optical Coherence Tomography (OCT) testing performed no more than 90 days prior to the AME exam. |
COLOBOMA
All Classes
(Updated 08/27/2025)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Isolated eyelid coloboma onlyNot associated with other eye pathology or syndrome (e.g., Treacher-Collins, Goldenhar) | The individual should bring the following to their AME exam:1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating ophthalmologist no more than 90 days prior to the AME exam.2. If must specifically describe this is lid condition only,• No functional problems due to exposure;• No other eye pathology;• No syndrome;• If lid reconstructed, please describe.If the Clinical Progress Note verifies stable condition with no functional concerns or other eye pathology, vision meets standards with no symptoms that would interfere with flight or safety-related duties, and AME has no concerns: |  ISSUEAnnotate this information in Block 60. Submit the information to the FAA for retention in the file. |
| B. Coloboma - All othersOther structure affectedAssociated with syndromeProgression or symptomaticVisual field loss | Submit the following for FAA review:1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating ophthalmologist no more than 90 days prior to the AME exam. It must include:• A detailed summary of the history of the condition;• Current medications, dosage, and side effects (if any);• Physical exam findings;• Results of any testing performed;• Diagnosis;• Assessment and plan;• Prognosis; and Follow-up.2. If must specifically describe extent of defect• Eyelid and all ocular structures• Any associated conditions (e.g. micro-ophthalmia, cataract, glaucoma, nystagmus, retinal detachment, staphyloma) or syndromes (e.g. Frazier Syndrome) Any associated visual field loss/defect.• Functional implications3. The Clinical Progress note must specifically include the best corrected visual acuity for distant and near vision (intermediate - if age 50 or older and First or Second Class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.4. Visual field testing of both eyes (30-2 preferred). |  DEFER Submit the information to the FAA for a possible Special IssuanceAnnotate (elements or findings) in Block 60. |
CACI - Glaucoma Worksheet (Updated 04/13/2022)
To determine the applicant’s eligibility for certification, the AME must review a current, detailed Clinical Progress Note generated from a clinic visit with the treating physician or specialist no more than 90 days prior to the AME exam. If the applicant meets ALL the acceptable certification criteria listed below, the AME can issue. Applicants for first- or second- class must provide this information annually; applicants for third-class must provide the information with each required exam.
| AME MUST REVIEW | ACCEPTABLE CERTIFICATION CRITERIA |
|---|---|
| Treating ophthalmologist finds the condition stable on current regimen and no changes recommended. | [ ] Yes |
| Age at diagnosis | [ ] 40 or older |
| FAA Form 8500-14 or equivalent treating physician report that documents the considerations below: | [ ] Yes |
| Acceptable types of glaucoma | [ ] Open Angle being monitored and stable, Ocular Hypertension or Glaucoma Suspect being monitored and stable, or previous history of Narrow Angle/Angle Closure Glaucoma which has been treated with iridectomy/iridotomy (surgical or laser) and is currently stable.NOT acceptable: Normal Tension Glaucoma, secondary glaucoma due to inflammation, trauma, or the presence of any other significant eye pathology (e.g. neovascular glaucoma due to proliferative diabetic retinopathy or an ischemic central vein occlusion or uveitic glaucoma) |
| Documented nerve damage or trabeculectomy (filtration surgery) | [ ] No |
| Medications | [ ] None or Prostaglandin analogs (Xalatan, Lumigan, Travatan or Travatan Z), Carbonic anhydrase inhibitor (Trusopt and Azopt), Beta blockers (Timoptic, etc), or Alpha agonist (Alphagan). Combination eye drops are acceptableNOT acceptable for CACI: Pilocarpine or other miotics, cycloplegics (Atropine), or oral medications. |
| Medication side effects | [ ] None |
| Intraocular pressure | [ ] 23 mm Hg or less in both eyes |
| ANY evidence of defect or reported Unreliable Visual FieldsAcceptable visual field tests: Humphrey 24-2 or 30-2 (either SITA or full threshold), Octopus (either TOP or full threshold). Other formal visual field testing may be acceptable but you must call for approval. Confrontation or screening visual field testing is not acceptable. | [ ] No |
AME MUST NOTE in Block 60 one of the following:
[ ] CACI qualified glaucoma. (Documents do not need to be submitted to the FAA.)
[ ] Has current OR previous SI/AASI but now CACI qualified glaucoma.
[ ] NOT CACI qualified glaucoma. I have deferred. (Submit supporting documents.)
LATTICE DEGENERATION
All Classes
(Updated 06/26/2024)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. History of Lattice Degeneration(Reported by the individual or seen on progress notes.) | If the AME can determine the individual has no symptoms that would interfere with flight or safety related duties including:• Flashes;• Floaters;• Decreased vision; and/or• Blurry visionANDThe individual meets the vision standards for class applied: |  ISSUEAnnotate this information in Block 60. |
| B. All othersSymptomsORDoes not meet vision standardsORQuality of vision affectedORTreated with laser surgery | Submit the following for FAA review:1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating ophthalmologist or optometrist no more than 90 days before the AME exam. It must include:• A detailed summary of the history of the condition;• Current medications, dosage, and side effects (if any);• Ophthalmological exam findings;• Results of any testing performed;• Diagnosis;• Assessment and plan;• Prognosis; and Follow-up.2. The Clinical Progress note must specifically include the best corrected visual acuity for distant and near vision (intermediate - if age 50 or older and First or Second Class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.3. Copies of any testing performed (visual fields, etc.) |  DEFERSubmit the information to the FAA for a possible Special IssuanceAnnotate (elements or findings) in Block 60. |
OPTIC NEURITIS
All Classes
(Updated 08/27/2025)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Any history of optic neuritis(single or multiple episodes; resolved or currently being treated) | Submit the following for FAA review:3. A current, detailed Clinical Progress Note generated from a clinic visit with the treating ophthalmologist or retinal specialist (preferred) no more than 90 days prior to the AME exam. It must include:• A detailed summary of the history of the condition;• Current medications, dosage, and side effects (if any);• Physical exam findings;• Results of any testing performed;• Diagnosis;• Assessment and plan;• Prognosis; and Follow-up.2. It must specifically include:• Date treatment completed or if any ongoing treatment or surveillance recommended;• If the condition has resolved;• Underlying cause if identified;• Is the presentation consistent with typical or atypical;• Are there any symptoms, current problems, or remaining abnormalities which could interfere with flight or ATCS duties3. The Clinical Progress Note must specifically include the best corrected visual acuity for distant and near vision (intermediate - if age 50 or older and First or Second Class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.4. Visual field testing (30-2 or 24-2) performed no more than 90 days prior to the AME exam.5. MRI of the brain and orbits with and without contrast for demyelinating disease.6. A current, detailed neurological evaluation that meets FAA Specifications for |  DEFER Submit the information to the FAA for a possible Special IssuanceAnnotate (elements or findings) in Block 60. |
| Neurologic Evaluation generated from a clinic visit with the treating neurologist no more than 90 days before the AME exam.7. Color vision testing must be performed for each eye separately using an FAA acceptable computer-based color vision test, within 90 days prior to the AME exam. Pay particular attention to red desaturation. One-time screening is not sufficient; repeated testing is required, as optic neuritis can affect color vision over time.8. Copies of any testing performed (visual fields, etc.) |
- Retinal Dystrophies (Cone, Rod, Retinitis Pigmentosa)
- All Classes
- (Updated 03/25/2026)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Any history ofNote: In most cases, retinal dystrophies (e.g. Cone, Rod, Rod-Cone, Cone-Rod, Retinitis Pigmentosa) are incompatible with medical certification/clearance. | Submit the following for FAA review:1. A current, detailed Clinical Progress Note* generated from a clinic visit with a board-certified Retinal Specialist (subspecialty of ophthalmology), no more than 90 days prior to the AME exam. An FAA 8500-7 or 8500-14 are NOT acceptable. The progress note must include:• A detailed summary of the history of the condition;• Current medications, dosage, and side effects (if any);• Physical exam findings;• results of any testing performed;• diagnosis;• assessment and plan;• prognosis; and follow-up.2. It must specifically include:• The eye specialist’s interpretation of any testing performed.• Whether the dystrophy is associated with any medical syndrome.• Any treatments.3. Copies of the most recent testing already performed for this condition such as:• Reliable threshold visual fields.• Electroretinography (ERG);• Optical Coherence Tomography (OCT);• Fundus imaging and autofluorescence;• Any other testing already performed.4. Visual acuity testing no more than 90 days prior to the AME exam.*NOTE: Submission of 8500-7 or 8500-14 instead of actual clinical progress notes is NOT acceptable. |  DEFERSubmit the information to the FAA. |
RETINOSCHISIS
All Classes
(Updated 08/26/2026)
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| A. Any history(Reported by the individual or seen on progress notes.) | Submit the following for FAA review:5. A current, detailed Clinical Progress Note generated from a clinic visit with their treating retina specialist (ophthalmologist) no more than 90 days before the AME exam.It should include a summary of the history of the condition or diagnosis; current medications, dosages, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.6. Visual acuity: The best corrected visual acuity for distant and near vision (intermediate if age 50 or older and 1st or 2nd class). If vision standards are not met, that should be discussed. Include if the visual acuity is expected to change.7. Visual field testing (30-2) performed no more than 90 days prior to the AME exam.8. Copies of any testing already performed such as electroretinogram (ERG) and optical coherence tomography (OCT). |  DEFERSubmit the information to the FAA for a possible Special Issuance.Summarize findings in Item 60. |
| B. Due to a neurological condition | If due to a neurological condition, see corresponding page. |
ITEM 33. Pupils
PUPILS
All Classes
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| Disparity in size or reaction to light (afferent pupillary defect) requires clarification and/or further evaluation | Submit all pertinent medical information and current status report | Requires FAA Decision |
| Nonreaction to light in either eye acute or chronic | Submit all pertinent medical information and current status report | Requires FAA Decision |
| Nystagmus¹ | Submit all pertinent medical information and current status report | Requires FAA Decision |
| Synechiae, anterior or posterior | Submit all pertinent medical information and current status report | Requires FAA Decision |
ITEM 34. Ocular Motility
- OCULAR MOTILITY
- All Classes
| DISEASE/CONDITION | EVALUATION DATA | DISPOSITION |
|---|---|---|
| Absence of conjugate alignment in any quadrant | Submit all pertinent medical information and current status report | Requires FAA Decision |
| Inability to converge on a near object | Submit all pertinent medical information and current status report | Requires FAA Decision |
| Paralysis with loss of ocular motion in any direction | Submit all pertinent medical information and current status report | Requires FAA Decision |
1 Nystagmus of recent onset is cause to deny or defer certificate issuance. Any recent neurological or other evaluations available to the Examiner should be submitted to the AMCD. If nystagmus has been present for a number of years and has not recently worsened, it is usually necessary to consider only the impact that the nystagmus has upon visual acuity. The Examiner should be aware of how nystagmus may be aggravated by the forces of acceleration commonly encountered in aviation and by poor illumination.