Refractive Surgery

The Refractive Surgery Center is staffed by specially trained physicians and technicians who use state-of-the-art procedures and equipment to perform PRK (photorefractive keratectomy), LASIK (laser in-situ keratomileusis) and SMILE (small incision lenticule extraction).

What is PRK?

PRK (photorefractive keratectomy) is a surgical procedure that changes the surface curvature of the cornea by shaping it with an ultraviolet (cold) laser. The new curvature of the cornea corrects the refractive error and improves the patient’s vision.

What is LASIK?

LASIK is a surgical procedure that uses a femtosecond laser to create a surgical flap on the front of the cornea. Following the lifting of the flap, the underlying surface of the cornea is sculpted with an ultraviolet (cold) laser in order to change the surface curvature of the cornea to correct the patient’s refractive error. The flap is then repositioned over the sculpted corneal tissue and it secures itself over the next days and weeks.

What is SMILE?

SMILE (small incision lenticule extraction) is a surgical procedure that changes the curvature of the cornea by removal of a disc shaped piece of tissue from just below the corneal surface.  It is considered as a LASIK variant for purposes of policy and waiver recommendations. 

Who is eligible for refractive surgery

All active-duty members (Army, Navy, Air Force, Marines or Coast Guard) with 12 months remaining on active duty orders are eligible for refractive surgery if they meet the following criteria:

• Approval by Commanding Officer (rank of O-3 or above)
• Active duty service members must have at least 12 month remaining on active duty at the time of enrollment (or in conjunction with an executed reenlistment action)
• National Guard and Reserve Soldiers are NOT eligible for treatment unless they have been activated and have at least 12 months on current Active duty orders at the time of enrollment.
• No adverse/Flagged personnel actions pending.
• At least 21 years of age
• Ability to meet all pre-operative and post-operative appointments

How can I be considered for the surgery?

This program is only available to active duty service members. Each service member must have his or her commanding officer’s approval, be deemed medically eligible, and have a minimum time remaining on active duty.

Applications are accepted from active duty service members in the Army, Navy, Air Force (non-aviators), Marines and Coast Guard. Reserve and Guard Forces may be eligible for surgery when on extended active duty and meet the administrative and medical requirements. Reserve and Guard Forces must include a copy of their orders with their applications.

Medical eligibility (candidacy) will be determined by a team of ophthalmologists and optometrists. An eligible member’s unit commander must endorse the request and select a level of priority. Once a command-endorsed request is received, and the patient is examined on site, the Refractive Surgery Center staff will make the final determination of clinical appropriateness for PRK/LASIK/SMILE or non-candidacy for surgery.

Refractive Surgery Consult Form

1. Download and print the form https://sandiego.tricare.mil/Portals/124/NMCSD-Optometry-RS_ConsultForm_RefractiveSurgery_121222.pdf
2. Completely fill out all information in Part 1 of the form.
3. Commanding Officer fills out Part 3 of the form.
4. Schedule a routine optometry appointment at your nearest Military Treatment Facility or Branch Clinic. Take the form and your health record to the appointment; the doctor will complete Part 2 of the form. The refractive surgery consult must be completed and signed off by an MTF vision care provider. As a military sponsored program, civilian eye exams & signatures are not authorized.
5. Email form to usn.san-diego.navmedcensanca.list.nmcsd-nrsc-consult-group@health.mil
6. You should receive an email shortly after confirming receipt of the email. If you do not get a return email within 24 hours please check to ensure email is entered correctly.
7. You will be contacted with further information when your name comes to the top of our database. To contact our staff or to report changes in the contact information on your application: usn.san-diego.navmedcensanca.list.nmcsd-nrsc-consult-group@health.mil

Refractive Surgery Waiting List Information

We recognize that most applicants are very anxious to have surgery, but we cannot provide accurate individual estimates of waiting times.  The wait time from application to surgery is variable, based on the number of applications and their assigned priority. 

Please do not contact us for status updates. We are doing everything possible to expedite the process and will consider your application as soon as possible.
 
usn.san-diego.navmedcensanca.list.nmcsd-nrsc-consult-group@health.mil is available to answer questions about refractive surgery in general. We look forward to assisting you in the future.
 Before Surgery, Surgery, Follow-Up, and Deployment
It is crucial for members & authorizing commanders to be aware of the requirements surrounding refractive surgery in order to plan for training & deployment.
Before refractive eye surgery, you must have:

• A signed command authorization form (not the original consult) permitting you to have refractive eye surgery.
• Eyeglasses (or prescriptions) that are at least one year old.
• Pre-operative evaluation with complete dilated eye exam by our optometrist (~2 hours).
• Group & individual counseling with an ophthalmologist that reviews your chart. This appointment generally lasts the entire morning or afternoon. Additional or repeat tests may be performed to ensure safe surgery.

Surgery:

• PRK, LASIK, or SMILE generally lasts 10-20 minutes per patient, but you may be in the clinic the entire morning or afternoon, depending on the number of patients being treated that day. 

After surgery you must make:

• Post-op appointments one day, one week, one month & three months after LASIK or SMILE.
• Post-op appointments one week, one month & three months after PRK.
• After LASIK or SMILE you will be nondeployable for one month.
• After PRK you will be nondeployable for three months.

Nondeployable time after surgery is given to optimize healing & minimize injury to the eyes after surgery. We expect units to adhere to these restrictions. For 30 days after surgery, members should not work in dusty or windy environments, do organized PT, swim, or wear face paint. Also, when in sunny or bright environs, service members should be allowed to wear sunglasses at all times for 90 days after surgery to minimize the risk of corneal scarring & hazy vision.
Deployment:

• After PRK, members require 90 days of follow-up prior to deployment.
• After LASIK or SMILE, members require 30 days of follow-up prior to deployment.
• The post-op appointments are necessary to ensure refractive stability & prevent deploying service members who are having rare complications. Again, most patients heal by the time the profile expires, but commanders must understand rare complications or slow healers exist; these outliers may require more frequent or longer follow-up.