San Diego’s large military community will continue to benefit from a growing Department of Defense-funded program that provides free refractive surgery to medically eligible, active-duty servicemen and women.
While most near- or farsighted individuals struggle with contacts in front of the mirror, military personnel deployed to Iraq often battle 120-degree temperatures, gusting winds, sand storms and spartan accommodations. Similarly challenging, glasses interrupt the seal of protective gas masks, become scratched and trap dust and dirt.
“Those are just a fraction of the issues that face our active duty forces,” said Capt. Steve Schallhorn, ophthalmologist at the Naval Medical Center San Diego. “By reducing dependence on glasses and contact lenses, people who have to go into harm’s way are better off.”
Schallhorn pioneered and currently directs the Navy Refractive Surgery Program and continues to free patients from the burdens associated with poor eyesight at no cost. Active-duty personnel from all military branches and the coast guard are eligible. Once a candidate is approved for the surgery by their eye doctor, the individual’s commanding officer submits a request and designates a priority. The applicant’s need and job duties determine whether the wait time is weeks or years.
The program has treated 100,000 service members to date, while Navy facilities perform roughly 15,000 procedures annually. The number keeps rising as the benefits eclipse the risks and the technology improves.
“As we treat more and more people, more and more people want it,” Schallhorn said. “The fleet, the line, the operational forces have come to appreciate what it can do for them.”
Maj. Michael Rohlfs underwent photorefractive keratectomy (PRK) at the Naval Training Center’s Primary Care Center in Point Loma during April of 2005 after returning from a five-month stint in Iraq. Rohlfs, a Marine stationed out of Marine Corps Air Station Miramar, took advantage of a clinical trial two weeks after his first inquiry. He no longer wears glasses and looks forward to the luxury his new eyesight will afford during his second tour of duty in Iraq this coming August.
“It’s made a difference in this portion of my life, but especially when I come down here to the field,” Rohlfs said while training in Yuma, Ariz. “It’s just so much easier out here not worrying about fooling around with glasses.”
The actual application of the laser to the eye lasts between 10 seconds and one minute, depending on the patient’s vision. The time-consuming work is prepping each patient beforehand. Side effects range from minor eye irritation, such as dry eyes, to serious visual impairment.
“There are risks,” Schallhorn said. “We have learned how to manage the risks, mitigate against the risks, know what patients may be at greater risks and try to maximize the safety of the surgery in that context.”
Recovery time varies with the type of surgery from days to months. PRK is a surface procedure that requires true convalescence afterward and a longer visual recovery than laser-assisted in situ keratomileusis (LASIK) eye surgery. Rohlfs was unable to drive and had difficulty with bright lights for five days after his procedure.
“After the five days, my eyes were healed and I had no more pain and no need for glasses,” he said. “Over the next couple of months, my eyesight continued to improve. Today I see better than 20/20.”
In the early 1990s, the head of Navy special forces catalyzed the program and secured funding after identifying problems with contacts experienced by SEALs (Sea, Air, Land), a highly skilled and mobile unit trained to operate strategically and tactically.
In 1993, the Naval Medical Center San Diego stepped forward as the first facility to offer clinical trials evaluating the safety of refractive surgery among military members. Letters and calls poured in to Schallhorn detailing the difficulty of performing military duties while wearing glasses or contacts. At that time, the procedure was not commercially practiced, as the lasers used had yet to receive Federal Drug Administration (FDA) approval. Following the FDA’s endorsement of two excimer lasers in October of 1995, the military program expanded and patients were able to receive the surgery without taking part in a study.
The Navy’s initiative caught on and the Army and Air Force started their own programs. There are now more than 20 military laser vision correction centers nationwide, seven of which are Navy. The San Diego facility accepts patients from as far as El Centro and Yuma, in addition to servicing greater San Diego County. Recently, a clinic opened at Camp Pendleton for Marines, shortening the wait time for San Diegans.
Schallhorn argues that there is more to gain from refractive surgery than improved eyesight.
“Enhanced quality of life and moral, while secondary “¦ shouldn’t be overlooked in the overall context of the benefit we provide,” he said.
For information, contact the Naval Medical Center San Diego by visiting www.nmcsd.med.navy.mil or calling (619) 532-6400.