Open angle glaucoma

Considerations

The main aeromedical implications of glaucoma relate to the loss of visual fields. This is usually not realised by the affected individual until the loss is well advanced. It is a slow process that can be stopped by treatment following regular screening of intra ocular pressure and fundus assessment. In case of doubt Optical Computerised Tomography (OCT) can be performed to analyse the macula and the optic nerve. If glaucoma is suspected visual fields determination must be one.

Information to be provided

Applicants who first present with a history of glaucoma or whom the ME suspects may have glaucoma, should provide:

• A special eye report;
• An ophthalmologist report;
• The result of visual fields testing.

Applicants who subsequently present with a history of glaucoma should provide, at each subsequent application:

• Copy of all follow-up reports and any other reports at the intervals recommended by their by their treating ophthalmologist.
• The ME or Director may seek further reports.

Disposition in case of open angle glaucoma

• An applicant with untreated, or unstable glaucoma, or who has any bilateral deficit of the visual fields should be assessed as having a condition that is of aeromedical significance.

An applicant with open angle glaucoma that is effectively treated, stable, with normal intraocular pressures, and no more than a small unilateral visual field deficit, not overlapping the contralateral blind spot, may be considered as having a condition that is not of aeromedical significance if:

• The medication is well tolerated; and
• If beta-blocker eye drops are used, there are no respiratory, cardiac, or others side effects; and
• Regular ophthalmologist surveillance, including repeat visual fields determination as necessary, takes place, at least annually.