The U.S. Navy's Doctrine of Laser Eye Surgery

The New York Times reports that laser eye surgery — now performed on nearly a third of every new class of midshipmen — is transforming Naval careers. Navy doctors are performing these operations with "assembly-line efficiency," allowing older pilots to continue flying, and those who might otherwise have been disqualified to pursue flight school. The number of procedures has reportedly climbed from 50 to 349 over the past five years. The Navy uses a different procedure than that used on civilians — grinding the cornea rather than cutting a flap — out of fears that the flap could come loose in supersonic combat.

Grinding your eyeball?

[OverlordQ (264228)]

I've had glasses since I was 11 months old, and as much as I'd like to get rid of them, getting flaps cut or 'ground down' just dont sound very appealing to me.

Re:Grinding your eyeball?

[no_pets (881013)]

I agree. I mainly dislike wearing glasses when it's raining or if I begin to sweat. I clean my glasses nearly every day and it's a pain. But at the end of the day I know that I can see - with my glasses.

Sure, eye surgery can solve these problems and it's not very likely that the surgery will "backfire". But that just is not a risk I would like to take with my eyesight.

Re:Grinding your eyeball?

[planetmn (724378)]

I agree. I mainly dislike wearing glasses when it's raining or if I begin to sweat. I clean my glasses nearly every day and it's a pain. But at the end of the day I know that I can see - with my glasses. Sure, eye surgery can solve these problems and it's not very likely that the surgery will "backfire". But that just is not a risk I would like to take with my eyesight.

Can't the same be said about every medical condition/procedure?

Sure, the remedies aren't going to be 100%, but if we waited for them to be perfect, we'd still have extremely short life expectancies.

-dave

Re:Grinding your eyeball?

[no_pets (881013)]

True. Nothing is 100%. Each person just has to weigh the pros/cons of each procedure. IMHO eye surgery in most cases is more like plastic surgery than a real medical procedure. It doesn't have to be done to correct eyesight.

Re:Grinding your eyeball?

[GigG (887839)]

It doesn't have to be done to correct eyesight.

It does if you want to fly fighters which is what TFA is talking about.

Re:Grinding your eyeball?

[spicyjeff (6305)]

Sure, but some risks are bigger thatn others. And like the granparent post said, I too would rather keep wearing corrective lens (contacts in my case) rather than risk loosing site for life. Even if that risk is small. The potential loss is huge. If given such a horrible choice I would much rather loose appendages or other sensory organs/sensations than my vision.

Re:Grinding your eyeball?

[hoggoth (414195)]

> rather than risk loosing site for life
> I would much rather loose appendages or other sensory organs

It looks like it's too late to save your spelling organ.

Re:Grinding your eyeball?

[hoggoth (414195)]

> And if only you could find someone to remove your nitpicking, superiority complex...

Thanks, I'll try not to loose site of my humility.

Re:Grinding your eyeball?

[HardCase (14757)]

Whoosh!!!!!

Re:Grinding your eyeball?

[hoggoth (414195)]

> You should leave out the "basically", unless you are writing about PH.

You shouldn't capitalize the 'p' in pH.

.
.
.

ball's in your court...

Re:Grinding your eyeball?

[MindStalker (22827)]

I too would rather keep wearing corrective lens (contacts in my case) rather than risk loosing site for life.

You do realize that statistically over the course of your life contacts are a greater risk to your eyes than one quick surgery.

Re:Grinding your eyeball?

[Intron (870560)]

From the article you cite: 12,000 ulcers / 24 million wearers = 1 per 2000

Lasik has several risks [fda.gov], but just counting flap complication rates [diamondvision.org] = (0.1-0.5%) = 1 per 200-1000, which doesn't include some of the other side effects mentioned by the FDA.

Re:Grinding your eyeball?

[Greyfox (87712)]

Oddly, when I was wearing contacts I'd wear 'em all day every day (Taking them out at night to sleep.) Then during one eye exam my doctor told me that my eyes weren't getting enough oxygen and that was causing an overabundance of blood vessels to grow in my eyes. He told me to cut back on my contact-lens wearing or bad things would happen. He was kind of vague on what kind of bad things, I assume my eyeballs would fall out of my head or something like that.

I had lasik a couple of years ago. Now here's the thing I can't understand about people who get lasik... You're taking a risk with your eyesight. You would think that you would take care to make sure you get a good surgeon. I did a lot of research on the internet, found a surgeon with an eyeball tracking laser and made sure he was doing the right tests and executing due dilligence prior to the surgery. I also dropped 2 grand an eyeball to have it done. Now the thing is, when you're doing something like this, why would anyone even consider "Bob's Discount Lasik -- Buy one Eye, Get one Free!" Or going to Thailand to have lasik done? Sure you might shop around on a car or a sofa, but when your body's involved the first point of consideration should NOT be the price of the procedure.

Anyway I did the research and decided the risk was worth it and now have perfect vision in one eye and better than perfect vision in the other. I'd do it again in a heartbeat. It was hardly uncomfortable at all, too -- I just had to take tylenol for a slight headache. I hear PRK is rather less comfortable and has a longer recovery period but I think I'd still have gone that route if I hadn't been able to have lasik for any reason.

Re:Grinding your eyeball?

[cagle_.25 (715952)]

Well, exactly. My aunt was one of the patients in the FDA trials of LASIK. Prior to surgery, she had 20/800 vision, wore "bottle-glass" glasses, and had constant migraines. Now, she still wears glasses, but of the normal lens variety, and the migraines are gone. For her, LASIK was a significant improvement to her quality of life and worth the risk, even at a time when the procedure was really risky.

I, on the other hand, get by reasonably comfortably with glasses. LASIK would be entirely elective for me, and I don't really want to spend the money or undergo the risk for it. The expected value of the improvement to my life is lower than the expected cost of the risks.

Re:Grinding your eyeball?

[swillden (191260)]

Sure, eye surgery can solve these problems and it's not very likely that the surgery will "backfire". But that just is not a risk I would like to take with my eyesight.

Like lots of things, I think it's a risk/reward question. In my case, I wear glasses and will continue to wear glasses, but my vision isn't that bad so the reward I'd get from eye surgery isn't all that great. The glasses sharpen my vision and make it easier for me to read road signs, but I can actually get along just find without them.

My wife, on the other hand, was blind as a bat without her glasses, to the point that she had to carefully place her glasses in the same place next to the bed each evening, because she had to find them by touch in the morning. She could not see them. She got Lasik about three years ago, and it has significantly improved her life. Before the surgery, for example, she didn't dare participate in any sort of water sports because losing her contacts or glasses would leave her completely blind. Now she SCUBA dives and I expect to get her up on water skis this summer. Even more important is the sense of freedom she has, being able to see without assistance. After the surgery, her sight was 20/20, but has gradually declined to where she is contemplating getting glasses again to sharpen her vision a bit. She could have the surgery re-done (for free, even, since a followup was included in the original price) instead of getting glasses, but it's no longer worth the pain or the risk.

I know others with similar stories, and I can definitely see how someone who'd like to fly military jets would perceive the risk/reward tradeoff as a good deal. Heck, I'd get the surgery if it meant someone would let me fly an F-14.

Re:Grinding your eyeball?

[jimhill (7277)]

"My wife, on the other hand, was blind as a bat without her glasses..."

ObCliffClavin:

It's a little-known fact that bats actually have very good eyesight. The echolocation isn't compensatory.

Re:Grinding your eyeball?

[COMON$ (806135)]

I had PRK done earlier this year. I had been wearing glasses since I was very young, like 5-6 years old. I was an athlete and contacts just didnt cut it in contact sports, and glasses were a nuisance but I lived with it all through my college sport years. Now I am without either and as much as RK surgery sucked (the bandages dried to my eyes 2 days after the surgery). I would not go back. I may have to wear glasses again when I am 45 but to have 20 years or so being able to see my wife in the morning, not having to worry about cuts in my contacts, or having my glasses break at inopportune times, is all very much worth the 3K to do it.

Re:Grinding your eyeball?

[AuMatar (183847)]

http://www.telegraph.co.uk/news/main.jhtml;$sessio nid$N24ETIUZ3QYIPQFIQMGCFFOAVCBQUIV0?xml=/news/200 3/05/04/neye04.xml&sSheet=/news/2003/05/04/ixhome. html [telegraph.co.uk]

Apparently a 10% failure rate of the surgery. The blinding rate is far lower than that, probably not the 1/20 I quoted (I must have had the 2 mixed up in my head). But there's a spectrum here- of the 10% that fail, a portion will have no negative effect (discounting temporary pain), a portion will have low negative effects, a portion will become blind. When the alternative is just needing to wear glasses, even a 1% worsening my vision at all is too much. I'd happily take risky surgery if it was that or lifelong debilitation/death, but these are just glasses.

Re:Grinding your eyeball?

[by Anonymous Coward]

As a 37y/o that had been wearing glasses and contacts since I was 6, I had many of the same concerns listed in this thread. But this past February I took the plunge and had Intralase Lasik. It is the best money I have ever spent. The worst part of the procedure is the Intralase that creates the corneal flap. The actual Lasik part was really fast, only a couple of seconds per eye. You just have to be very careful for the first couple of weeks after the procedure to give your flaps time to heal. I just had my 3 month check up, and I was able to see 20/10 - 2, which means I could get 2 of the letters on the 20/10 line. This is utterly amazing to me, since my eyesight was so poor.

It is a big step to take though, and I can truly understand the uneasiness some feel about this procedure, but I am a complete convert now. It is the best money I have ever spent. If you live in Houston Tx I would seriously go the Mann Eye institute and at least take advantage of the free evaluation. Hell get evaluated by 2 or 3 doctors.

Re:Grinding your eyeball?

[UttBuggly (871776)]

Well boys and girls, I had my "eyes done" at age 40, which was 10 years ago. I had terrible myopia and astigmatism so bad, I couldn't wear contacts of any kind.

I was in the Air Force in the 70's and tried to fly; no dice with 20/400 vision.

It was never vanity, but practical reasons that caused me to take a chance on eye surgery. I've always been involved in sports and martial arts. I've had a zillion cuts and bruises on my face (nose especially) from that. Then in 1995, I started fighting full contact with some serious folks. Now, I always fought WITHOUT glasses because I only had to see the shape in front of me, right?

Nope. A circular technique like a roundkick didn't "show up" in my field of vision until too late to block or duck effectively. After two concussions and some broken bones, I went under the knife on both eyes. Today, I'm still 20/20 in both eyes and love it.

I retired from fighting about a year ago but my last fight was in a small ring with 3 opponents at least 10 years younger than me. We went about 20 minutes non-stop and as one of them commented later "we never got a clean shot in even once!"

Yeah...I'm real unhappy with eye surgery...NOT!

Seriously, do a lot of research and shopping for a good doctor. Check with his patients who are 1, 2, 5 and 10 years out from their work. See what they say. Then, do it!

Hell, it was worth it not to have permanent furrows on either side of my nose anymore from the weight of the coke bottle bottom glasses I had to wear from age 5 on. :o)

the flap?

[oni (41625)]

the flap could come loose in supersonic combat.

there's a circumsicion joke there somewhere

Re:the flap?

[deblau (68023)]

"Slashdot: where meta-jokes get modded (+5, Funny)."

Dammit

[by Anonymous Coward]

I thought this article was about laser-eye surgery, as opposed to laser eye surgery. Meaning I could FINALLY get surgery allowing me to shoot lasers out of my eyes. Like Superman. I've never been so disappointed in my life.

Misleading summary

[Mindwarp (15738)]

I think the phrase 'ground down' used in the summary is a little misleading. It's not an abrasive process which is used to reshape the cornea; rather a laser is used to ablate it.

Not that the word 'ablate' is any more paletable than 'grind' when it's coupled with the word 'cornea.'

Re:Misleading summary

[mooingyak (720677)]

Not that the word 'ablate' is any more paletable than 'grind' when it's coupled with the word 'cornea.'

That depends entirely on how good your vocabulary is.

Full Article Text

[rehtonAesoohC (954490)]

BETHESDA, Md., June 17 -- Almost every Thursday during the academic year, a bus carrying a dozen or so Naval Academy midshipmen leaves Annapolis for the 45-minute drive to Bethesda, where Navy doctors perform laser eye surgery on them, one after another, with assembly-line efficiency.

Nearly a third of every 1,000-member Naval Academy class now undergoes the procedure, part of a booming trend among military personnel with poor vision. Unlike in the civilian world, where eye surgery is still largely done for convenience or vanity, the procedure's popularity in the armed forces is transforming career choices and daily life in subtle but far-reaching ways.

Aging fighter pilots can now remain in the cockpit longer, reducing annual recruiting needs. And recruits whose bad vision once would have disqualified them from the special forces are now eligible, making the competition for these coveted slots even tougher.

But the surgery is also causing the military some unexpected difficulties. By shrinking the pool of people who used to be routinely available for jobs that do not require perfect eyesight, it has made it harder to fill some of those assignments with top-notch personnel, officers say.

When Ensign Michael Shaughnessy had the surgery in his junior year at the Naval Academy, his new 20-20 vision qualified him for flight school. And that is where he decided to go after graduating last month ranked in the top 10 percent of his class, rather than pursuing a career as a submarine officer.

"The cramped environment in submarines is something that turned me off," Ensign Shaughnessy, 22, said.

For generations, Academy graduates with high grades and bad eyes were funneled into the submarine service. But in the five years since the Naval Academy began offering free eye surgery to all midshipmen, it has missed its annual quota for supplying the Navy with submarine officers every year.

Officers involved say the failure to meet the quota is due to many factors, including the perception that submarines no longer play as vital a national security role as they once did. But the availability of eye surgery to any midshipman who wants it is also routinely cited.

"Some of the guys with glasses who would have gone to submarines or become navigators are getting the chance to do something they'd rather do, and the communities that are losing the people are not as happy about it as the aviation community, which is gaining better candidates," said Cmdr. Joseph Pasternak, the ophthalmologist who oversees the program at the National Naval Medical Center in Bethesda.

In the Naval Academy's class of 2006, 349 of the 993 midshipmen had the surgery, up from 50 five years ago, according to Naval Academy records. Fewer than 30 percent of the academy students whose eyes qualify for the surgery choose not to get it, and the number of holdouts is dropping every year, Commander Pasternak said.

Last week, a little after 10:40 a.m., Colin Carroll, a 21-year-old midshipman from Olney, Md., put anesthetic drops in his eyes and lay down under the laser as Capt. Kerry Hunt, a Navy doctor, and two assistants prepared to begin. "We're locking the laser on now," Captain Hunt told him.

Midshipman Carroll had originally hoped to enter flight school but discovered not only that his eyes were not good enough, but also that he was prone to kidney stones, ruling him out of aviation entirely. He said he was "resigned" to entering the Marine Corps or becoming an officer on a surface ship, neither an assignment requiring perfect vision.

But he decided to get the surgery anyway.

By 10:49, both eyes were done, though extremely bloodshot, and Mr. Carroll walked out wearing sunglasses, declaring he could already see better.

The procedure used by the Navy, photorefractive keratectomy, or PRK, is different from the one used on most civilians. That approach, known as laser-in situ keratomileusis, or Lasik, requires cutting a flap in the surfa

PRK

[SuperSanta (843034)]

The method the Navy uses has been available to civilians for years now. I should know - I had it. In LASIK SURGERY the potential for the flap to come apart exists because only the outer edge of where the cut is made heals. You recover in 3 - 5 days instead of 5 - 8 with PRK. But with PRK you don't have the heebie geebie factor of eye flaps busting loose. In fact most eye doctors will recommend PRK to those under 30 with any kind of an active lifestyle for sports, scuba diving, etc.

While taking a week or more off work is tough for some - YOU'RE PUTTING FRIKKIN' LASERS IN YOUR EYES in either way. Why not take the more permanent / durable approach? Don't chose 'Hi Dr. Nick' budget solution either. That's just stupid.

They've been doing this in the Army for a while...

[cavtroop (859432)]

...also.

I got out quite a few years ago, before this was possible. My cousin however is still in, and he got the surgery done, for free. They offer it to everyone, and encourage you to do it. It makes all aspects of being a soldier - particularly an infantryman, much easier. Now you can wear off the shelf eye protection, no longer are gas masks a pain in the ass to put on, nightvision goggle, scopes, sights in a tank, are all easier to use.

I think it's a great idea, myself.

Aging pilots

[Rob T Firefly (844560)]

Aging fighter pilots can now remain in the cockpit longer, reducing annual recruiting needs.

Is this really that good an idea? My late grandmother, whose cruising speed topped off at around 25 MPH, once had a blinker light going for three whole Presidential administrations.

Re:Aging pilots

[TheGratefulNet (143330)]

once had a blinker light going for three whole Presidential administrations.

that's nothing.

we currently have a president who has the lights on, but it appears no one is home...

PRK Experience

[Icepick_ (25751)]

I had PRK done in Jan-05, and have been extrodinarily happy with the results.

The only drawback was the day of "oh-my-god-what-have-I-done-get-these-icepicks-out -of-my-eyes" pain, and 3 days of "damn my eyes itch" iritation. Not for the faint of heart.

Best money I ever spent, and I'd do it again in a heartbeat.

Re:PRK Experience

[Icepick_ (25751)]

Followup to my own post. Here's a copy of my journals regarding my PRK experience:

Exam notes:

It was intresting. I had filled out the eye history sheet before I went
in. They gave me a quick eye exam, but it wasn't like a normal one.
First up was the typical Big E projected on the wall (no glasses!)
"Nope, can't see it."

Next up they took two pictures of each eye. It was a weird device, it
was cone shapped, and I was looking into the big end of it. The inside
was black, with many concentric circles of purple light, with a lens at
the center. It made a topographical map of my corneas.

Next up was a device that measured my perscription. I had to stare at
a little picture while it zoomed in and out of focus. Apparently this
determines my exact perscription, none of that "Is this better, or that"
lens swapping. I wonder why eye doctors don't use this all the time.

Last of the inital measurements was another corenal mapper. Nothing to
see, just a red light.

Then I got a 10 minute vides summerizing LASIK. I knew all that stuff
already from my research.

Then I got to speak with the doctor. She did a few more measurements,
including measuring the thickness of my corenas. Then we got down to
the nitty gritty.

I am NOT a good canidate for LASIK. The corena mappings reveal that
they're buldging on the lower sides, kinda pear shapped. LASIK can be
done, but by pealing back the flap, my corenas loose some of their long
term strength, and I risk having them thin so much I may need a corena
transplant in the years to come.

However....I am an exceptional canidate for PRK, which is basicly LASIK,
but with no flap, they just burn off the extra portions of the cornea.
The recovery time is a bit more involved, and would likely be unable to do
much of anything for a couple of days. I'd have to wear contacts as
bandages while the areas where tissue was removed healed.

Lots of questions with the doctor, but generally very optimistic about
my final result being 20/40 or better. Like 95%+

Then I was off to the office manager for the bottom line. $3700, for
both eyes, all the pre and post care (7 appointments!), and any
additional corrections for life. This about what I expected. And
that's with 15% off from my insurance. I asked, normally they'd give a
cash discount, but I can't combine it with my insurance. Then she gave
me several consent forms and whatnot to review.

4 hours post op:

Well, I did it, and I'm not blind.

It went very smoothly. Arrived, filled out a couple (more) consent forms, one last cornea mapping, and had a last minute chat with the doc. Got a perscription for some vicoden, and got my final post-op instructions. Paid the nice lady, and she gave me some Advil and a valium. Back to the waiting room for 10 minutes.

The proceedure itself I can't really describe, as most of the time I was staring at a bright light 6" from my face. But, they gave me a stylish hair net, and ploped me in a dentist like chair. Leaned me back, and it slid me under the light/laser/camera.

They gave me a half dozen eye drops in each eye and let me sit for a few minutes. I know one of them was an anastetic, hence the wait. They put a plastic shield over my left eye, and taped it in place. Then they tapped my eyelashs/eyelids open on the right eye. They put in the thingy that holds my eye open, which wasn't as uncomfortable as I thought it would be. Few more drops, and then they (according to C) put a little white disk over my cornea. I couldn't see anything, but after they lifted it, I could see the q-tip removing the outer layer of my cornea. Then, he used what looked to be a ice scrapper, I swear. Couple more drops, and then "Don't move, stare at the light" Then they fired up the laser, it made a clicking noise for about 40 seconds. The light went from really blurry to mostly blury, and then they popped in a "bandage" contact, and removed the thingy and left ey

PRK is most popular in Europe

[xutopia (469129)]

There are less side effects and the results are almost always better with PRK. It also is easier to do touch ups as needed. The reason why it isn't as popular in the states is that it requires people to take a few days off so their eyes recover. I could afford a week off in countries where you can get more than 2 weeks of vacation. ;-P Brought to you by the Vacation for everyone lobby.

Long Term Effects of Lasik

[Don853 (978535)]

My parents are both MDs, so I always go to them with medical questions before paying anyone for advice.
Last time I asked (I'm around -4.5 in both eyes), they were worried about the long terms of removing part of the lens in either eye. Apparently, part of the lens is also removed as a treatment for cataracts, and they had some worry that
a) Laser eye surgery could remove enough of the lens to make cataract treatment later in life difficult or impossible, and, also
b) There weren't any large scale long term (20+ yrs) studies on the rusults of the surgery.

As I said, this is secondhand... perhaps if there's a MD or a Optometrist on these boards they could comfirm/deny/just explain better?

How many eye doctors do this do themselves?

[Clueless Moron (548336)]

I have been to two different opthalmologists over the past few years, and both of them wear regular glasses. They don't even use contact lenses.

Their explanation in both cases was the same: we really don't know the long-term effects of PRK/LASIK/LASEK. It could have side effects (triggering glaucoma, etc) that would render you near blind in 30 years. Is it really worth that risk?

So I'm sticking with glasses. For one thing, I'm over 40 and while I'm still nearsighted, normal age-related presbyopia is setting in. I can deal with it by simply removing my glasses to look at things that are up close. If I had LASIK, I'd need to carry reading glasses with me all the time, so there's not much of a win.

Actually, it's mostly in subsonic combat

[mnemonic_ (164550)]

out of fears that the flap could come loose in supersonic combat.

Actually, LASIK concerns relate to high-g combat which is mostly subsonic. That's where pilots experience the highest inertial forces which could (theoretically) tear open a LASIK-cut cornea and eyeball. For every aircraft the optimum (quickest turn rate) turning speed is subsonic, and the ability to change the aircraft's attitude is paramount in tactical engagements.

Correcting some innacuracies.

[guidryp (702488)]

The Navy is doing PRK. This was the first procedure done widely on civilians. Lasik was introduced later. The primary Lasik advantage is the patients have usable vision sooner and are pain free sooner. PRK is the better treatment, but in our quick fix society, Lasik is more popular. It is also pushed by many docs as there is less negative feedback from customers, less followups during the shorter initial healing cycle.

Lasik, cuts a flap into the stroma, this is not the same flap that is removed for PRK as some folks have been characterizing. Alarmingly this flap never full seems to heal. It has been lifted YEARS after the original surgery. Lasik permanently weakens the cornea.

PRK is essentially moving or removing the epithelium. A thin surface layer that will grow back, not the deeper flap cut in the above. Variant (LASEK or epi-Lasik) attempt to preseve the epithelial layer and use it as a sort of bandage during healing. This helps speed the healing and lower pain, but it is still not as good as traditional Lasik.

Bottom Line:
PRK and variants, better/slower/more painful. Laskik has more issues/complications, but is more comfortable/faster.

The navy is making the right choice here.

Re:Let's get it out of the way.

[Shadow Wrought (586631)]

"Plenty to see here. Cleared for takeoff."

Eye-eye, sir!

Re:Navy?

[robertjw (728654)]

I never understood, why is it that the US have such a concentration of pilots in the Navy rather than the air force?

Because we rarely attack Canada and Mexico. Everyplace else is easier to reach by aircraft carrier.

Re:Let a military doc operate on my eye?

[planetmn (724378)]

Well, considering how expensive medical school is, one option is to have the military pay for it. You come out without all of the debt, you do your 5 years (I think it's 5) of service, and when you are discharged you have your education, no debt, and 5 years of experience as a doctor. Looks pretty good to me (if I were interested in becoming a doctor).

Also, the doctors who treat the President are from the Navy, and Bethesda Naval and Walter Reed are known to be very good medical centers. So I think your post is basically quoting people who have some slant against the military.

-dave

Re:Let a military doc operate on my eye?

[Brooklynoid (656617)]

I'm not qualified to comment on the skills of Navy docs in general, but if I were going to get laser eye surgery, I'd feel pretty comfortable knowing that the doc who's going to be doing it has done literally thousands of that same procedure before, and has turned out results good enough for their patients to qualify as fighter pilots.

Just my $0.02

Re:Let a military doc operate on my eye?

[Daniel Dvorkin (106857)]

Either you were in many, many moons ago, or you've fallen for the propaganda. I was a USAF medic 1989-1997, then worked as a civilian EMT and ER tech for a couple of years after getting out, and I feel very confident in saying that the standard of care in the military (at least the AF) is as good as or better than the standard on the civilian side. Doctors, nurses, medics, specialty technicians (e.g. lab and x-ray tech) all got away with sloppiness in the civilian medical world that I found shocking, and which would never have been tolerated in the service.

Re:Let a military doc operate on my eye?

[winkydink (650484)]

Earlier than that. Almost Vietnam Era, but not quite. I still have a scar from where a doc at Keesler AFB decided to treat a rather angry boil with antibiotics rather than lancing it. It burst on its own the next day. What fun!

Re:Let a military doc operate on my eye?

[brjndr (313083)]

Military pay is also better than what a medical resident makes. So you graduate med school with no debt, AND you get paid better for the next 3-5 years while you train. Then go find a nice job when you get out.

My friend is a Army dentist in Germany. The army picked up his 3 years of dental school, which cost around $200,000. He owes them 3 years now. He gets paid less than the average dentist, but he's stationed in Germany and since he left he's travled to the Olympics and the World Cup, not to mention all around Europe.

Also, the Army eye surgery isn't LASIK. It's PRK, which is a different procedure. They don't cut a flap in your eye for this one. My brother, a LT in the army, had it done. He had to use eye drops to treat dry eyes about 6 months.

Re:Let a military doc operate on my eye?

[faloi (738831)]

When I was in, 10 years ago, the actual doctors (officers) were top-notch. A lot of them were reservists that had a private practice and were spending their two weeks helping out as a way to help cut the costs of college. Now...the enlisted people that you have to shuffle through to get to talk to a real doctor were another story. I had bronchitis in a bad way for three weeks before they decided the standard "cold pack" wasn't cutting it and maybe I should get to see a real physician.

Re:Let a military doc operate on my eye?

[Just Some Guy (3352)]

Or maybe they've improved a lot since I was in many moons ago.

They must have, if your opinion was ever valid in the first place. I was an operating room tech (Surgeon: "Scalpel." Me: Passes scalpel) at Naval Hospital San Diego in the mid '90s, and the surgery they were doing was absolutely first class. We had lots of famous visitors - a friend of mine got to scrub in on a chest case with Dr. DeBakey [wikipedia.org] - and we performed a lot of routine operations that you're only now seeing in the civilian world.

I won't say that there aren't any bad doctors in the military, but there are plenty of brilliant ones to bring up the average. I wouldn't have thought twice about getting medical care for me or my family from the Navy.

Re:Let a military doc operate on my eye?

[LurkerXXX (667952)]

I've got to agree with the others posting here. I've known and worked with many MD's who were going to the military after finishing med school to help pay off those huge Med School bills. And this is from top-tier med schools (with top-tier med school bills). The military gets a lot of top-notch MD's right out of med school/internships. Some of them might like the military and decide to stay. By no means are all the military docs bottom of the barrel.

Re:Let a military doc operate on my eye?

[swillden (191260)]

The commonly held belief back then was these docs (and dentists... don't get me going on this one...) were only in the military because they couldn't hack private practice.

More like because they couldn't afford medical school another way.

My experience with military docs is that they're reasonably good physicians, but that the health care system in the military lacks continuity, and that causes problems. Also, because most of the doctors leave the military after they complete their obligation, the active duty doctors all tend to be young and somewhat inexperienced. The best thing to do, if you can, is to get one of the doctors who is a reservist.

My anecdote: The Army doctors at Fort Hood nearly killed my younger sister because she had condition (pyloric stenosis [wikipedia.org]) that is rare in girls, so each doctor wanted to exhaust all other possibilities first, and didn't really trust that the other doctors had done their job. In desperation because my baby sister was dying of dehydration and malnutrition, my parents eventually took her to a nearby civilian hospital, where they operated and corrected the problem within a few hours. To the Army's credit, they admitted their error and the correctness of my parents' actions, and covered the civilian medical bills.

In contrast, my parents now get all of their medical care through the nearby Air Force base hospital, which is generally staffed by a rotating group of reserve physicians who seem to be uniformly excellent doctors. The docs recognize the need for continuity of care and make heavy use of referral to local civilian docs for any condition that requires the sort of continuity they can't provide. They also try to arrange so that each patient sees the same doctor for routine physicals, etc.

Re:Eye surgery... gah!

[Ignignot (782335)]

I've had it done myself after some extensive shopping around and research. If the doctor suggested there was a high (10%) possibility of halos or other effects, I did not do it. Finally I found one who was getting some new equipment in half a year which would increase the treatment area and he felt would produce good results. I have had no trouble with my eyesight since then and that was 4 years ago.

But to respond to your worries, they do give you drugs to calm you down if you want them (I would recommend it) although they do not put you under you have to stare at a light while the laser goes to work on your eye. The actual worst part is when they cut the flap - they had to wait a few minutes while my eyes dialated, so for a little while had a flap cut in my eye and was just sitting in a chair in a dark room. But altogether it took only half an hour and it was time extremely well spent.

Re:Grinding? PRK is available to consumers.

[fahrbot-bot (874524)]

IANAP, but my wife was evaluated for PRK and here's what I learned...

Photorefractive Keratectomy (PRK) is available to consumers and is actually a better procedure than LASIK, but is more expensive, requires a longer healing period and fewer physicians are trained to perform it (takes longer to get certified, LASIK certs can be obtained via short, vendor classes).

In PRK, the outer surface of the cornea is ablated by the laser (on an lower power) and then reshaped at a higher power. A protective contact lens is applied to patient and remains on for about 5 days, then is removed by the doctor. The patient applies drops to the eye several times a day for about a month while the outer cornea heals.

The benefits of PRK are the lack of any "flap" problems (incorrect cut, complete cut [ouch], misalignment, dislodgment, halo effects, etc...) and ability to correct some visioin situations not correctable via LASIK.

While my wife wasn't a good candidate for the procedure and didn't have it performed, I highly recommend the physician who evaluated her, Dr. Bruce Bodner [vec2020.com] Associate Professor of Ophthalmology at EVMS [evms.edu].