Mild PPA in left eye, military enlistment

[isu152]

I am in the military enlistment process. Due to myopia I was sent to an eye consult. The ophthalmologist have a non disclosure agreement, so I only asked if there were any diseases, or if I would have to worry about anything. He said no to both and said that I should pass. Later I got a notification that I would be tdq'ed and the diagnosis given was optic disk atrophy and exophoria (the latter is no condition that disqualifies). I was a bit surprised, but knew I had to act, as either the diagnosis is wrong or there is something and I need to get treatment.

So I scheduled another comprehensive exam with visual field testing. Which came back normal (no defect). My corrected vision is 20/15 in both eyes (I have myopia, but within military standards), color and depth vision are perfect, corrected vision is not blurry. Mild PPA and a tilted disk in the left eye were found. I think what might have happened is when a case worker copied the data, they turned the peripapillary atrophy into an optic disk atrophy through mistake. Alignment of the eyes was also perfect, no heterophoria was found.

The dilated exam gave those results:

Vitreous: clear OU
c/d ratio: 0.35 OU
optic disc tilt: OS
Macula: good foveal reflex, no edema, no heme OU
Vessels: WNL OU
Periphery: WNL OU

Findings: PPA OS

They found blepharitis, but I usually don't have dry eyes. I had a short night due to preparation for the hurricane and I woke up early due to a robot caller (forgot to turn off phone) and the exam was in the morning. Maybe this played into it?

I wonder if any of those findings would be in the way of a military career? I planned to go into laboratory, maintenance or civil engineering job fields. I am in my 30s. Anything else in my medical was perfect. I am aware that civil and military sectors have different requirements, but the diagnosis used for the temporary disqualification couldn't be confirmed, nor was there any sign of disease or traumatic injury.

[JohnHaganMD]

If it is possible the most important thing would be to get the original copy of the exam given by the ophthalmologist retained by the military (I did eye exams for the US Navy/Marine aviation programs for about 10 years).   If in fact that ophthalmologist saw "optic atrophy" he would have had to ethically and legally tell you about it and that you need follow up with a neuro-ophthalmologist, blood work and MRIs.  Optic atrophy is ultra serious in a person your age and needs an extensive and expensive work up.

Peripapillary atrophy  (PPA) is normally a harmless incidental finding in the eye that if mild I don't usually tell people about.  Where it can be significant is in ocular histoplasmosis.  In and of itself it is highly unusual for it to affect vision or cause a problem.  It would not have disqualified a person when i was doing exams for Navy/Marines.

So you would want to get the original and if in error as you suspect get your records changed.  You never mentioned what your glasses RX is. That could make a difference if you wanted to be a military pilot.  However the US military now allow refractive surgery such as lasik and PRK.    Dry eyes and blepharitis are not deal breakers.  I would suggest you follow your dreams but I suspect you are going to be fighting a tough bureaucracy in getting the change made.  

[isu152]

Thank you, Sir. Indeed my first step should have been to contact the consult. Instead I went to get an appointment to get my eyes checked out, worried about the possibilities such a diagnosis could imply. My prescription for 16 years was -6.5 -0.75 left and -6.0 -0.75 right. During initial Meps I still wore those glasses for a 20/20 corrected vision. But they broke a few weeks later and my optometrist, after an exam prescribed me a -6.75 -1.00 left and -6.25 -1.00 right for 20/15 vision. But it was not my aim to become a pilot.

And yes, my biggest worry now is that it may be hard to get that diagnosis changed. A copy of the original exam was given to me in an envelope for my recruiter, while another went to Meps. I will contact both the opthalmologist and my recruiter as soon as possible. Again, thanks a lot.

[JohnHaganMD]

The person that will probably be able to help you the most is the recruiter especially if he/she thinks you are a good candidate. I loved my time in the USAF, a great organization of dedicated women and men.

[isu152]

This is what I heard everywhere. I will definitely try my everything. Again, thanks! I am a bit late to comment, as we lost power/mobile on the weekend.

[JohnHaganMD]

Sorry.    Hope you make a complete recovery soon from the power outage.

[isu152]

Today I finally got the news. The SG just went by the diagnosis of the CMO and PDQ'ed me. The recruiter told me back then to just wait for the answer and do nothing. He now says there is nothing that can be done. But he also gave me the diagnosis of the Meps eye consult which was myopia and astigmatism, plus exophoria. No mention of optic atrophy. It just seems absurd that both the CMO and the SG office never wavered in their decision when this diagnosis contrasts so much with the fact I have a 20/15 corrected vision in both eyes, no visual field defect, full color vision. It's mindboggling...

[JohnHaganMD]

=

[JohnHaganMD]

Might have to try different service branch.