From beach lifeguard to astronaut: occupational vision standards and the implications of refractive surgery

Abstract

Minimum vision standards for employees are used in manufacturing,[1]transport industries,[2, 3]the emergency[4] and armed services1.[5]Traditionally, these have applied to colour vision, visual acuity and refractive error, with the later addition of visual fields for driving.[6]Vision standards are often historic and differ between countries, and their validity may be questioned as technological advances obviate some visual tasks.[7]Furthermore, entry standards applied to uncorrected acuity are being bypassed by advances in refractive surgery. This is of special significance in the armed services, where operational constraints must be taken into account. Our understanding of the interplay between visual demands at work and the effects of refractive surgery is evolving. Vision standards and official policies on refractive surgery should be understood in relation to the work environment, by both surgeons and patients. Performance-based and parametric tests are helping to define vision standards in a variety of occupations. Surgical correction of refractive errors can in many cases allow previously ineligible candidates to pursue their chosen occupation.