Use this forum to flag up examples of red tape and gold plate
#1282102
I've been a contact lens wearer now for 35 years. Been through various types and technologies, and my optometrist is always keen on trying new products out on me as he always gets a lot of useful feedback because I've been round the block so many times on various makes/types.

Currently running single vision for distance but due to my age, the curse of presbyopia (age related near-focus problem) I have to wear reading specs for any closeup work.

So my optometrist suggested I try one of the newer multi-focus contact lenses (they have been out for a while but the technology is improving all the time) - boy what a revelation. It's like time has been shifted backwards and I can now happily read even the smallest text at normal reading distance, and my overall vision right up to infinity is improved, so they work like varifocal specs, without the issues associated (which I'll mention in a bit).

So thinking this was the way forward, I was about to pull the trigger on changing over, but coincidentally my Class 2 renewal is due, so booked that with my AME. Something else came up regarding this as I had it in mind that ECG was every 2 years so checked with the CAA docs on Part-MED and whilst looking through the docs on line, came across the stuff about vision and specifically Contact Lenses. This is where the surprise and annoyance came in.

Part-MED/CAA specifically state that Contact Lenses are for DISTANCE VISION ONLY. They explicitly prohibit the use of multi-focus contact lenses, citing some obscure reasons about lack of visual acuity and contrast.

They are quite happy to accept the wearing of spectacles of all types, including the use of Varifocals. Now, I know just how problematic varifocals can be after trying them as my 'resting' spectacles (for the odd day off when I don't have my lenses in) and the weeks of issues my Mrs had with hers, having to go back to get them adjusted and almost giving up on them. The CAA also acknowledge that spectacles have issues due to the frames blocking vision, and the aberrations caused (like lines appearing warped etc) - something that they also acknowledge that contact lenses don't cause.

My optometrist confirms that I can see as well if not better with the multi-focus lenses than with the fixed distance-only lenses. It is much less hassle in the cockpit to not have to wear readers (I have a set of bi-focal glasses with readers in the bottom and plano on top or the same as sunglasses). You can even get multi-focus contacts now in Toric to correct astigmatism too.

So my issue/question here is, why do the CAA wish to prohibit the use of a 'better' contact lens for wearers who are over 40 and who are suffering from presbyopia? Surely in the same way that they allow your AME to make the best call over your general health based on their examination of you, they should allow your optometrist to make the best call on whether a particular lens technology works for you? After all, those of us who wear contact lenses would see their optometrist at least every 12 months (by law relating to the prescription of contact lenses) whereas someone who wears spectacles may only go to see their optometrist once in a blue moon when perhaps they notice vision issues or when their specs break.

The CAA are happy (ish?) to allow someone to have a laser carve bits out of their cornea which can cause all sorts of issues not necessarily immediately apparent, they are happy to allow spectacles which have the potential to block and distort vision, but prohibit something that actually can improve the overall visual acuity of the wearer.

CAA ... please get into the 21st century.

Oh, and my AME was not aware of the restriction as I had a brief discussion with her about this ... her comment was "use them and just change to single focus to go flying :wink: " which is what I'll probably do, as the improvement in my daily life not having to wear (and keep losing) reading specs will far outweigh the annoyance that the CAA over-regulation will impose.
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By Flyin'Dutch'
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#1282218
trapdoor wrote:So my issue/question here is, why do the CAA wish to prohibit the use of a 'better' contact lens for wearers who are over 40 and who are suffering from presbyopia? Surely in the same way that they allow your AME to make the best call over your general health based on their examination of you, they should allow your optometrist to make the best call on whether a particular lens technology works for you? After all, those of us who wear contact lenses would see their optometrist at least every 12 months (by law relating to the prescription of contact lenses) whereas someone who wears spectacles may only go to see their optometrist once in a blue moon when perhaps they notice vision issues or when their specs break.



Substitute CAA with EASA and understand that the Part-MED is the outcome of compromises of 27 odd countries' view on what the medical requirements should look like.
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By Flyin'Dutch'
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#1282227
Irv Lee wrote:Are single distance lenses only manufactured in France or Germany by any chance?


Tres cynical, mein Freund!
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By trapdoor
#1282277
Flyin'Dutch' wrote:Substitute CAA with EASA and understand that the Part-MED is the outcome of compromises of 27 odd countries' view on what the medical requirements should look like.


Yes, but no, but ....

I've not established whether it is wholly a Part-MED EASA requirement or just a CAA 'interpretation' or gold-plating. I doubt it was any different before Part-MED. Because we now all come under the Part-MED medicals (assume even if you decide not to convert the poo-brown to the tiny-blue license it's still a Part-MED medical - according to my AME it is) I could believe that the CAA would just ensure that any restrictions imposed before Part-MED were continued regardless. Is there a generic Part-MED that can be compared to what the CAA have implemented (in 'level 6 English' and not level 6 French or German :lol: )? Not that it matters one jot as the CAA have implemented what the CAA have implemented, and it's quite well accepted the CAA will try and gold-plate everything including the bog chain if given a free hand.

Unfortunately Irv, your 'theory' doesn't hold water as they all make the multi-focus lenses, be it B&L, Ciba etc... nice try though 8)

I do get it that for some patients, multi-focus lenses are not compatible (in the same way that Varifocal specs aren't), but a good optometrist will quickly discover this and its not in their interest to make your vision worse. As a slight side note, my optometrist (who I've been seeing since I was in my 20's) claimed that two of his patients who were commercial pilots used and raved about them ... go figure :shock:
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By Keef
#1282316
That's the concept of "Thou shalt not be found out", sometimes rendered as "It's easier to ask forgiveness than permission".
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By Flyin'Dutch'
FLYER Club Member  FLYER Club Member
#1282372
trapdoor wrote:
Flyin'Dutch' wrote:Substitute CAA with EASA and understand that the Part-MED is the outcome of compromises of 27 odd countries' view on what the medical requirements should look like.


Yes, but no, but ....

I've not established whether it is wholly a Part-MED EASA requirement or just a CAA 'interpretation' or gold-plating. I doubt it was any different before Part-MED. Because we now all come under the Part-MED medicals (assume even if you decide not to convert the poo-brown to the tiny-blue license it's still a Part-MED medical - according to my AME it is) I could believe that the CAA would just ensure that any restrictions imposed before Part-MED were continued regardless. Is there a generic Part-MED that can be compared to what the CAA have implemented (in 'level 6 English' and not level 6 French or German :lol: )? Not that it matters one jot as the CAA have implemented what the CAA have implemented, and it's quite well accepted the CAA will try and gold-plate everything including the bog chain if given a free hand.

Unfortunately Irv, your 'theory' doesn't hold water as they all make the multi-focus lenses, be it B&L, Ciba etc... nice try though 8)

I do get it that for some patients, multi-focus lenses are not compatible (in the same way that Varifocal specs aren't), but a good optometrist will quickly discover this and its not in their interest to make your vision worse. As a slight side note, my optometrist (who I've been seeing since I was in my 20's) claimed that two of his patients who were commercial pilots used and raved about them ... go figure :shock:


Being a funny continental I speak to pilots from several countries about their medical certification processes and experiencing and whilst it may seem attractive to consider that everything the CAA does is subject to gold-plating I can assure you that the Medical Department does not suffer from that affliction.
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By Flyin'Dutch'
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#1282386
Irv Lee wrote:Are you going to mention what it does suffer from?


Too much work for too few people at present.

:D

Irv you know that anyone in a capacity where at times decisions are taken which are not to the person's liking is only as good as their last positive decision; be it an examiner, a pilot or a medical examiner.

I bet that flight examiners get few complaints from those candidates who have been successful in their flight test.

One of the observations I made when I was working at the CAA in Aviation House was that there were a good few non Brits who elected to move their licences and medicals over to the UK when their home based regulatory had decided that the outcome of their assessment was nee, nein, non, or its 27 EU equivalent of no.

And while the wearing of reading glasses is extremely annoying, it is not a show stopper which can not be remedied and endured. No doubt the diabetic pilots who can now achieve certification again will probably be grateful that the CAA directed its resources to getting them flying again rather than in determining whether varifocal contact lenses were compatible with safe flying.

I don't know enough about them to make a reasonable judgement about them, I suspect they will be fine, but it may take some time before that issue has permeated to the top of the pile of things that need sorting out.

:D
By Bathman
#1282406
For once I agree with the CAA on this one.

Visual acuity is USUALLY not as good in multifocal or monovision contact lenses. And contrast sensitivity is always worse.

As for how they dream up the cut of points for sphere and cyl in class one and class two medicals I have no idea. And I also suspect they have no evidence but it but for multifocal contact lenses my above statement is well know industry wide.