TP 13312

•	Foreword
•	Section 1
•	Section 2
•	Neurology
•	Cardiovascular
•	Diabetes
•	Asthma
•	Other Policies
•	Contacts
•	Alternate Formats

• Requirements for Medical Certification Following Refractive Surgery
• Photorefractive Keratectomy (PRK) and Laser Assisted in Situ Keratomeulesis (LASIK)
• Radial Keratotomy (RK)
• Aeronautics Act (1985) Medical and Optometric Information

Ear, Nose and Throat

1. Hearing: 
     
   Audiogram if doubt raised by screening examination. Acceptable limits:
     
   35 db at 500 Hz
   1000 Hz
   2000 Hz
   50 db at 3000 Hz
    
   If hearing doesn’t meet standard on audiogram the applicant will likely need Practical Hearing Test.
     
2. Drum Perforation: 
     
   A single dry perforation is acceptable. An acute perforation will result in being unfit until hearing and the tympanic membrane recovers.
     
3. Otitis media: 
     
   Unfit until recovered 
     
4. Sinusitis: 
     
   Unfit until recovered. 
     
5. Menière’s Disease: 
     
   Disqualifying. ENT consult will be needed to confirm diagnosis.
     
6. Labyrinthitis:
     
   Unfit while acute. ENT consult will be needed in non-infective vestibular disorders.

Ophthalmology

1. Myopia:
     
   Initial medical Category 1,2 or 3 - need glasses prescription if uncorrected visual acuity is 6/60 (20/200) or worse.
     
2. Cataracts:
     
   Unfit when vision in affected eye no longer meets standard.
     
3. Intraocular Lenses:
     
   Unfit for 6 weeks following surgery. Full report from attending ophthalmolgist. 
     
4. Colour Vision Deficiency:
     
   If applicant fails pseudoisochromatic plate test, he will be given restricted medical certificate (Daylight only, 2 way radio required at controlled airports). Those who fail plate test may try a colour lantern test or Farnsworth D-15.
     
5. Contact Lenses:
     
   Can be approved for all categories: 
     
6. Refractive Surgery:
     
   (See guidelines on Page OP–3)

Respiratory

1. Pneumonia:
     
   Unfit until fully recovered.
     
2. COPD / Emphysema:
     
   Usually disqualifying if it requires active treatment. Pulmonary function tests and arterial blood gases or oxymetry usually required. Consultation with a respirologist or internist is usually required.
     
3. Asthma:
     
   (See guidelines on Page A–1.)

Gastrointestinal Disease

1. Acid Peptic Disease:
     
   Dyspepsia or esophagitis treated with antacids alone is acceptable. Long term maintenance with H2 antagonists is acceptable if there are no significant side - effects. 
     
2. Gastric / Duodenal Ulcer: 
     
   Disqualifying while ulcer is present and under active treatment. Long term maintenance with H2 antagonists is acceptable if no significant side - effects.
      
3. Hernia: 
     
   Significant hernias are disqualifying until the hernia is repaired. If there is any question about the significance of a hernia a surgical consultation is required.
     
4. Cholelithiasis / Cholecystitis:
     
   Cholecystitis is disqualifying. Presence of stones with a history of symptoms is disqualifying. Asymptomatic cholelithiasis as an incidental finding may be acceptable.

Genitourinary Disease

1. Renal Calculi: 
     
   Single episodes my be acceptable after recovery if IVP or ultrasound shows no stones present, and a metabolic work-up is normal. Repeated episodes will need a full work-up and individual assessment.
     
2. Cancer of the Prostate: 
    
   May be acceptable after treatment. Will need full report from urologist or oncologist. Follow-up reports including PSA will likely be required. 

Metabolic Disease

1. Diabetes Mellitus: (See Section D1 -D10.)
      
2. Thyroid Disorders:
     
   Hypothyroidism is acceptable if adequately treated and stabilized. Hyperthyroidism requires full report from internist or endocrinologist and treatment stabilization prior to assessment. 

Musculoskeletal Disease

1. Locomotor Dysfunction: 
     
   Includes all amputations, malformation, arthritis and loss of function. All will be assessed on an individual basis. Full description is required. Practical Flight Test may be required.

Psychiatric Disease

1. Anxiety Disorder:
     
   Disqualifying if requiring active treatment with tranquilizers. Will likely require a psychiatric consultation.
     
2. Depression:
     
   Ongoing depression is disqualifying condition. May be recertified after full recovery and cessation of treatment. Waiting period prior to recertification will be individually assessed. Report from attending physician or psychiatrist likely required. 
     
   Note: Applicants who have been treated for a depressive illness and who are on maintenance or prophylactic therapy with non-sedating selective serotonin reuptake inhibitors (SSRIs) may be considered for medical certification on an individual basis after review by the CAM Aviation Medicine Review Board.
     
3. Substance Abuse / Dependence:
     
   Disqualifying. Once “recovering”, an individual assessment to assess risk of relapse. Restricted category may be recommended. Continued abstinence is the key to medical recertification.

Malignancy

1. Malignancy: 
     
   Each case assessed individually. Active chemotherapy is disqualifying. Will need: pathology report and report from oncologist to include staging, treatment, prognosis and follow - up plans.

HIV /AIDS

1. Applicants who are HIV seropositive may be considered for medical certification on an individual basis. The major concern is the development of HIV related psychiatric or neurological complications. CD-4 cell counts and “viral load” measurements will be taken into account. For further information contact your RAMO.