ATCO.MED.B.070 Visual system
Regulation (EU) 2015/340
(a) Examination:
(1) A comprehensive eye examination shall form part of the initial examination and be undertaken periodically depending on the refraction and the functional performance of the eye.
(2) A routine eye examination shall form part of all revalidation and renewal examinations.
(3) Applicants shall undergo tonometry at the first revalidation examination after the age of 40, on clinical indication and if indicated considering the family history.
(4) Applicants shall supply the AeMC or AME with an ophthalmic examination report in cases where:
(i) the functional performance shows significant changes
(ii) the distant visual standards can only be reached with corrective lenses.
(5) Applicants with a high refractive error shall be referred to the licensing authority.
(b) Distant visual acuity, with or without optimal correction, shall be 6/9 (0,7) or better in each eye separately, and visual acuity with both eyes shall be 6/6 (1,0) or better.
(c) Initial applicants having monocular or functional monocular vision, including eye muscle balance problems, shall be assessed as unfit. At revalidation or renewal examinations the applicant may be assessed as fit provided that an ophthalmological examination is satisfactory. The applicant shall be referred to the licensing authority.
(d) Initial applicants with acquired substandard vision in one eye shall be assessed as unfit. At revalidation or renewal examinations the applicant shall be referred to the licensing authority and may be assessed as fit provided that an ophthalmological examination is satisfactory.
(e) Applicants shall be able to read an N5 chart or equivalent at 30 – 50 cm and an N14 chart or equivalent at 60 – 100 cm distance, if necessary with the aid of correction.
(f) Applicants shall have normal fields of vision and normal binocular function.
(g) Applicants who have undergone eye surgery shall be assessed as unfit until full recovery of the visual function. A fit assessment may be considered by the licensing authority subject to satisfactory ophthalmic evaluation.
(h) Applicants with a clinical diagnosis of keratoconus shall be referred to the licensing authority and may be assessed as fit subject to a satisfactory examination by an ophthalmologist.
(i) Applicants with diplopia shall be assessed as unfit.
(j) Spectacles and contact lenses
(1) If satisfactory visual function for the rated duties is achieved only with the use of correction, the spectacles or contact lenses must provide optimal visual function, be well tolerated, and suitable for air traffic control purposes.
(2) No more than one pair of spectacles, when worn during the exercise of licensed privileges, shall be used to meet the visual requirements at all distances.
(3) A spare set of similarly correcting spectacles shall be readily available when exercising the privileges of the licence(s).
(4) Contact lenses, when are worn during the exercise of licensed privileges, shall be mono-focal, non-tinted and not orthokeratological. Monovision contact lenses shall not be used.
(5) Applicants with a large refractive error shall use contact lenses or high index spectacle lenses.
AMC1 ATCO.MED.B.070 Visual system
ED Decision 2015/010/R
(a) Eye examination
(1) At each aero-medical revalidation examination, the visual fitness should be assessed and the eyes should be examined with regard to possible pathology.
(2) All abnormal and doubtful cases should be referred to an ophthalmologist. Conditions which indicate ophthalmological examination include but are not limited to a substantial decrease in the uncorrected visual acuity, any decrease in best corrected visual acuity and/or the occurrence of eye disease, eye injury or eye surgery.
(3) Where ophthalmological examinations are required for any significant reason, this should be imposed as a limitation on the medical certificate.
(4) The effect of multiple eye conditions should be evaluated by an ophthalmologist with regard to possible cumulative effects. Functional testing in the working environment maybe necessary to consider a fit assessment.
(5) Visual acuity should be tested using Snellen charts, or equivalent, under appropriate illumination. Where clinical evidence suggests that Snellen may not be appropriate, Landolt ‘C’ may be used.
(b) Comprehensive eye examination
A comprehensive eye examination by an eye specialist is required at the initial examination. All abnormal and doubtful cases should be referred to an ophthalmologist. The examination should include:
(1) history;
(2) visual acuities — near, intermediate and distant vision; uncorrected and with best optical correction if needed;
(3) objective refraction — hyperopic initial applicants with a hyperopia of more than +2 dioptres and under the age of 25 in cycloplegia;
(4) ocular motility and binocular vision;
(5) colour vision;
(6) visual fields;
(7) tonometry;
(8) examination of the external eye, anatomy, media (slit lamp) and fundoscopy;
(9) assessment of contrast and glare sensitivity.
(c) Routine eye examination
At each revalidation or renewal examination, the visual fitness should be assessed, and the eyes should be examined with regard to possible pathology. All abnormal and doubtful cases should be referred to an ophthalmologist. This routine eye examination should include:
(1) history;
(2) visual acuities — near, intermediate and distant vision; uncorrected and with best optical correction if needed;
(3) morphology by ophthalmoscopy;
(4) further examination on clinical indication.
(d) Refractive error
(1) Applicants with a refractive error between +5.0/-6.0 dioptres may be assessed as fit provided optimal correction has been considered and no significant pathology is demonstrated. If the refractive error exceeds +3.0/-3.0 dioptres, a four-yearly follow-up by an eye specialist should be required.
(2) Applicants with:
(i) a refractive error exceeding -6 dioptres;
(ii) an astigmatic component exceeding 3 dioptres; or
(iii) anisometropia exceeding 3 dioptres; may be considered for a fit assessment if:
(A) no significant pathology can be demonstrated;
(B) optimal correction has been considered;
(C) visual acuity is at least 6/6 (1.0) in each eye separately with normal visual fields while wearing the optimal spectacle correction;
(D) two-yearly follow-up is undertaken by an eye specialist.
(3) Applicants with hypermetropia exceeding +5.0 dioptres may be assessed as fit subject to a satisfactory ophthalmological evaluation provided there are adequate fusional reserves, normal intraocular pressures and anterior angles and no significant pathology has been demonstrated. Corrected visual acuity in each eye shall be 6/6 or better.
(4) Applicants with a large refractive error shall use contact lenses or high-index spectacle lenses.
(e) Convergence
Applicants with convergence outside the normal range may be assessed as fit provided it does not interfere with near vision (30–50 cm) or intermediate vision (100 cm) with or without correction.
(f) Substandard vision
(1) Applicants with reduced central vision in one eye may be assessed as fit for a revalidation or renewal of a medical certificate if the binocular visual field is normal and the underlying pathology is acceptable according to ophthalmological evaluation. Testing should include functional testing in the appropriate working environment.
(2) Applicants with acquired substandard vision in one eye (monocularity, functional monocular vision including eye muscle imbalance) may be assessed as fit for revalidation or renewal if the ophthalmological examination confirms that:
(i) the better eye achieves distant visual acuity of 1.0 (6/6), corrected or uncorrected;
(ii) the better eye achieves intermediate and near visual acuity of 0.7 (6/9), corrected or uncorrected;
(iii) there is no significant ocular pathology;
(iv) a functional test in the working environment is satisfactory; and
(v) in the case of acute loss of vision in one eye, a period of adaptation time has passed from the known point of visual loss, during which the applicant is assessed as unfit.
(3) An applicant with a monocular visual field defect may be assessed as fit if the binocular visual fields are normal.
(g) Keratoconus
Applicants with keratoconus may be considered for a fit assessment if the visual requirements are met with the use of corrective lenses and periodic review is undertaken by an ophthalmologist.
(h) Heterophoria
Applicants with heterophoria (imbalance of the ocular muscles) exceeding when measured with optimal correction, if prescribed:
(1) at six metres:
— 2.0 prism dioptres in hyperphoria,
— 10.0 prism dioptres in esophoria,
— 8.0 prism dioptres in exophoria
— and
(2) at 33 centimetres:
— 1.0 prism dioptre in hyperphoria,
— 8.0 prism dioptres in esophoria,
— 12.0 prism dioptres in exophoria
may be assessed as fit provided that orthoptic evaluation demonstrates that the fusional reserves are sufficient to prevent asthenopia and diplopia. The Netherlands Optical Society (TNO) testing or equivalent should be carried out to demonstrate fusion.
(i) Eye surgery
(1) After refractive surgery or surgery of the cornea including cross linking, a fit assessment may be considered, provided:
(i) Satisfactory stability of refraction has been achieved (less than 0.75 dioptres variation diurnally);
(ii) examination of the eye shows no post-operative complications;
(iii) glare sensitivity is normal;
(iv) mesopic contrast sensitivity is not impaired;
(v) evaluation is undertaken by an ophthalmologist.
(2) Cataract surgery
Following intraocular lens surgery, including cataract surgery, a fit assessment may be considered once recovery is complete and the visual requirements are met with or without correction. Intraocular lenses should be monofocal and should not impair colour vision.
(3) Retinal surgery/retinal laser therapy
(i) After successful retinal surgery, applicants may be assessed as fit once the recovery is complete. Annual ophthalmological follow-up may be necessary. Longer periods may be acceptable after two years on recommendation of the ophthalmologist.
(ii) After successful retinal laser therapy, applicants may be assessed as fit provided an ophthalmological evaluation shows stability.
(4) Glaucoma surgery
A fit assessment may be considered six months after successful glaucoma surgery, or earlier if recovery is complete. Six-monthly ophthalmological examinations to follow up secondary complications caused by the glaucoma may be necessary.
(5) Extraocular muscle surgery
A fit assessment may be considered not less than six months after surgery and after a satisfactory ophthalmological evaluation.
(j) Visual correction
Spectacles should permit the license holder to meet the visual requirements at all distances.
GM1 ATCO.MED.B.070 Visual system
ED Decision 2015/010/R
COMPARISON OF DIFFERENT READING CHARTS (APPROXIMATE FIGURES)
(a) Test distance: 40 cm
|
Decimal
|
Nieden
|
Jäger
|
Snellen
|
N
|
Parinaud
|
|
1,0
|
1
|
2
|
1,5
|
3
|
2
|
|
0,8
|
2
|
3
|
2
|
4
|
3
|
|
0,7
|
3
|
4
|
2,5
|
|
|
|
0,6
|
4
|
5
|
3
|
5
|
4
|
|
0,5
|
5
|
5
|
|
6
|
5
|
|
0,4
|
7
|
9
|
4
|
8
|
6
|
|
0,35
|
8
|
10
|
4,5
|
|
8
|
|
0,32
|
9
|
12
|
5,5
|
10
|
10
|
|
0,3
|
9
|
12
|
|
12
|
|
|
0,25
|
9
|
12
|
|
14
|
|
|
0,2
|
10
|
14
|
7,5
|
16
|
14
|
|
0,16
|
11
|
14
|
12
|
20
|
|
(b) Test distance: 80 cm
Decimal
|
Nieden
|
Jäger
|
Snellen
|
N
|
Parinaud
|
|
1,2
|
4
|
5
|
3
|
5
|
4
|
|
1,0
|
5
|
5
|
|
6
|
5
|
|
0,8
|
7
|
9
|
4
|
8
|
6
|
|
0,7
|
8
|
10
|
4,5
|
|
8
|
|
0,63
|
9
|
12
|
5,5
|
10
|
10
|
|
0,6
|
9
|
12
|
|
12
|
10
|
|
0,5
|
9
|
12
|
|
14
|
10
|
|
0,4
|
10
|
14
|
7,5
|
16
|
14
|
|
0,32
|
11
|
14
|
12
|
20
|
14
|