thedrifter
06-20-06, 06:20 AM
Perfect Vision, via Surgery, Is Helping and Hurting Navy
By DAVID S. CLOUD
New York Times
Published June 20, 2006
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 surface of the cornea and then using a laser to reshape the cornea. But military doctors worry that the flap could come loose during combat, especially in a supersonic fighter.
So rather than slicing into the cornea covering, Navy doctors grind it away. The approach requires a longer recovery as the covering re-forms but leaves the eye more stable.
The Air Force also limits its pilots to PRK, but nonpilots can get either procedure; because most students admitted to the academy aspire to fly, and have already met strict vision standards, relatively few cadets have the surgery, compared with the number at the Naval Academy. Army personnel, including helicopter pilots and other aviators, are allowed to get either procedure.
One in every 200 midshipmen who has the surgery suffers initial complications, which can usually be corrected, Commander Pasternak said. A study by the Navy soon after the program began concluded that pilot trainees who had the surgery graduated from flight school at higher rates than other pilots, he added.
Now that most midshipmen meet the vision requirements, getting into pilot training is harder than ever, depending almost entirely on academic class rank, military performance while at the academy and other physical criteria.
Last year, 310 midshipmen competed for 272 flight training slots. Of those, 104 had undergone laser eye surgery.
"If we didn't have PRK, where would those 104 midshipmen have gone?" said Capt. Michael Jacobsen, of the Naval Academy's office of professional development. "Tough to say, but we know they wouldn't have gone into flight training."
Expanding the pool of potential pilots and members in the Navy Seals was the original goal of making the surgery available, Commander Pasternak said, but it has become increasingly popular with marines, who say it eliminates concerns that their glasses will be damaged or clouded in dust storms during combat in Iraq and Afghanistan.
"We get at least five times as many requests every year as we can keep up with," said Commander Pasternak, a 1984 Naval Academy graduate who said he nearly left the academy after learning his eyes were not good enough to allow him into flight training.
The growing number of aspiring pilots has also made it harder to find candidates to become "back-seaters," officers who serve as navigators and weapons officers on planes, Navy officials say.
The failure to produce enough submarine officers, though, is the source of greatest worry to academy officials and the Navy as a whole. This year the academy's quota was 120, but only 88 midshipmen chose to go into submarines, according to academy records.
Acknowledging the decline, Capt. John R. Daugherty, the chief of staff in the Commander Naval Submarine Forces, said in a statement, "There are many potential contributing factors."
The shortfall in the submarine quota is made up from officers joining the Navy who do not attend the academy.
While there are no plans to restrict the availability of the surgery, some Navy officials concede that the procedure contributes to the submarine service losing midshipmen at the top of their class, like Ensign Shaughnessy, a native of Rochester, Minn., who formerly could not have gone to flight school.
Going into submarines "requires a lot more school, and after the academy a lot of people aren't looking to go to a high-paced environment for a long period," Ensign Shaughnessy said. "And some people also might see submarines as a less glamorous service assignment."
In recent years, many of the midshipmen to choose submarines have come from lower in the class rankings than they did a decade ago, said a senior Navy official who declined to release specific data and who was granted anonymity so he would discuss internal Navy personnel matters.
And academy graduates have been washing out of nuclear power school, which they must complete before being commissioned as a submarine officer, at an increasing rate over the last five years, according to the Navy official and an outside expert who has studied the issue.
In response, the Navy has begun offering $15,000 bonuses and other incentives to get midshipmen with better grades to join the submarine program.
Ellie
By DAVID S. CLOUD
New York Times
Published June 20, 2006
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 surface of the cornea and then using a laser to reshape the cornea. But military doctors worry that the flap could come loose during combat, especially in a supersonic fighter.
So rather than slicing into the cornea covering, Navy doctors grind it away. The approach requires a longer recovery as the covering re-forms but leaves the eye more stable.
The Air Force also limits its pilots to PRK, but nonpilots can get either procedure; because most students admitted to the academy aspire to fly, and have already met strict vision standards, relatively few cadets have the surgery, compared with the number at the Naval Academy. Army personnel, including helicopter pilots and other aviators, are allowed to get either procedure.
One in every 200 midshipmen who has the surgery suffers initial complications, which can usually be corrected, Commander Pasternak said. A study by the Navy soon after the program began concluded that pilot trainees who had the surgery graduated from flight school at higher rates than other pilots, he added.
Now that most midshipmen meet the vision requirements, getting into pilot training is harder than ever, depending almost entirely on academic class rank, military performance while at the academy and other physical criteria.
Last year, 310 midshipmen competed for 272 flight training slots. Of those, 104 had undergone laser eye surgery.
"If we didn't have PRK, where would those 104 midshipmen have gone?" said Capt. Michael Jacobsen, of the Naval Academy's office of professional development. "Tough to say, but we know they wouldn't have gone into flight training."
Expanding the pool of potential pilots and members in the Navy Seals was the original goal of making the surgery available, Commander Pasternak said, but it has become increasingly popular with marines, who say it eliminates concerns that their glasses will be damaged or clouded in dust storms during combat in Iraq and Afghanistan.
"We get at least five times as many requests every year as we can keep up with," said Commander Pasternak, a 1984 Naval Academy graduate who said he nearly left the academy after learning his eyes were not good enough to allow him into flight training.
The growing number of aspiring pilots has also made it harder to find candidates to become "back-seaters," officers who serve as navigators and weapons officers on planes, Navy officials say.
The failure to produce enough submarine officers, though, is the source of greatest worry to academy officials and the Navy as a whole. This year the academy's quota was 120, but only 88 midshipmen chose to go into submarines, according to academy records.
Acknowledging the decline, Capt. John R. Daugherty, the chief of staff in the Commander Naval Submarine Forces, said in a statement, "There are many potential contributing factors."
The shortfall in the submarine quota is made up from officers joining the Navy who do not attend the academy.
While there are no plans to restrict the availability of the surgery, some Navy officials concede that the procedure contributes to the submarine service losing midshipmen at the top of their class, like Ensign Shaughnessy, a native of Rochester, Minn., who formerly could not have gone to flight school.
Going into submarines "requires a lot more school, and after the academy a lot of people aren't looking to go to a high-paced environment for a long period," Ensign Shaughnessy said. "And some people also might see submarines as a less glamorous service assignment."
In recent years, many of the midshipmen to choose submarines have come from lower in the class rankings than they did a decade ago, said a senior Navy official who declined to release specific data and who was granted anonymity so he would discuss internal Navy personnel matters.
And academy graduates have been washing out of nuclear power school, which they must complete before being commissioned as a submarine officer, at an increasing rate over the last five years, according to the Navy official and an outside expert who has studied the issue.
In response, the Navy has begun offering $15,000 bonuses and other incentives to get midshipmen with better grades to join the submarine program.
Ellie