Optic Nerve Drusen?

[dochances94]

I cleared MEPS and have been accepted for the AF HPSP, but I do have somewhat of an eye condition that I did not think to disclose (I don't think it's directly asked about really). When I was 18, my optometrist said that I appeared to have a swollen optic nerve (pseudopapilledema).I remember she asked a bunch of questions about symptoms like headaches, blurry vision, etc. - none of which I had, and I had to stay for hours and do tests. Just to be safe I had an MRI done which found no cause of inter cranial pressure, and I remember my optometrist was telling me she believed drusen was the culprit and causing the appearance of swelling. 6 years later and although my vision is poor in general (passed MEPS but still), I have no symptoms from drusen like visual field loss or anything (that I know of). It doesn't really get mentioned at eye appointments anymore although they always want to dilate me.

My concerns are:

1) Is this something that could get me sent home from officer training? I know a thorough eye exam is performed there to fit you for glasses. I would hate to be a year or more into the HPSP program when I go and get sent home and be stuck trying to pay year(s) worth of tuition and stipend back.

2) Would this DQ me from flight surgery? I do have interest in flight surgery and I feel like this could definitely at least be DQ here if not for military service in general

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[j4pac]

1) as long as you get through your initial physical and get commissioned, assuming no new issues arise, it’d be unlikely

2) Google search NAMI waiver guide. Flip to section 12.10 (Optic Disc Drusen).

 

[Cooperd0g]

1) as long as you get through your initial physical and get commissioned, assuming no new issues arise, it’d be unlikely

2) Google search NAMI waiver guide. Flip to section 12.10 (Optic Disc Drusen).

Bro, I know you have been out for a bit now, but NAMI doesn’t apply for Air Force.

 

[j4pac]

Bro, I know you have been out for a bit now, but NAMI doesn’t apply for Air Force.

Lol. Yeah, OP disregard everything I’ve said. But I’m sure there is some level of overlap with NAMI and AF policies.

 

[dochances94]

Lol. Yeah, OP disregard everything I’ve said. But I’m sure there is some level of overlap with NAMI and AF policies.

But I should still most likely be okay provided I’ve already passed MEPS? I’ll be commissioning in the next month or so.

 

[j4pac]

But I should still most likely be okay provided I’ve already passed MEPS? I’ll be commissioning in the next month or so.

Yes...there aren’t any major medical checkpoints between initial screening and residency. The next checkpoint would be specialty training such as flight/dive.

 

[dochances94]

I see, thanks! I was just worried it might come up when they fit me for glasses on my eye exam. Hopefully it won’t be a big deal since I don’t have symptoms. If anyone has any other info on the AF policy I’d appreciate it. I found a case study where a marine was dismissed for drusen, but he seemed to be having some visual field loss and night blindness.

 

[cubsrule4e]

I see, thanks! I was just worried it might come up when they fit me for glasses on my eye exam. Hopefully it won’t be a big deal since I don’t have symptoms. If anyone has any other info on the AF policy I’d appreciate it. I found a case study where a marine was dismissed for drusen, but he seemed to be having some visual field loss and night blindness.

From the medical standpoint (I dont know any military requirements) but disc drusen are generally an asymptomatic finding and sounds like youve already been thoroughly worked up in the past. As long as your visual fields are normal (if anything, disc drusen would only cause an enlarged blind spot) this would not disqualify you from any kind of corrective surgery and should not impact your vision in any meaningful way.

 

[orbitsurgMD]

I cleared MEPS and have been accepted for the AF HPSP, but I do have somewhat of an eye condition that I did not think to disclose (I don't think it's directly asked about really). When I was 18, my optometrist said that I appeared to have a swollen optic nerve (pseudopapilledema).I remember she asked a bunch of questions about symptoms like headaches, blurry vision, etc. - none of which I had, and I had to stay for hours and do tests. Just to be safe I had an MRI done which found no cause of inter cranial pressure, and I remember my optometrist was telling me she believed drusen was the culprit and causing the appearance of swelling. 6 years later and although my vision is poor in general (passed MEPS but still), I have no symptoms from drusen like visual field loss or anything (that I know of). It doesn't really get mentioned at eye appointments anymore although they always want to dilate me.

My concerns are:

1) Is this something that could get me sent home from officer training? I know a thorough eye exam is performed there to fit you for glasses. I would hate to be a year or more into the HPSP program when I go and get sent home and be stuck trying to pay year(s) worth of tuition and stipend back.

2) Would this DQ me from flight surgery? I do have interest in flight surgery and I feel like this could definitely at least be DQ here if not for military service in general

You might expect to be referred for an ophthalmology evaluation. Superficial nerve drusen are fairly easily identified on ophthalmoscopy with the exception of buried drusen which may create elevation of the optic nerve and the appearance of nerve margin edema. (That is where the headache, tinnitus and vision change history has relevance.) Some drusen may cause visual field defects, but many don't. There are different ways to document stability of disc drusen, mainly by retinal photographs and serial visual fields done over a reasonable span of time, ideally many months or years. B-mode ultrasonography is useful to show patterns of increased echogenicity of drusen-containing nerve heads. CT with fine cuts through the optic nerve can show calcific densities.

If you have vision disturbance or progressive field loss or headache, then you will (or should, anyway) have a full papilledema workup: MRI of the brain and optic nerves without and with gad, MR venogram of your cerebral vasculature and an LP with CSF opening pressure manometry, and CSF collection for studies.

If you can obtain any of your old exam studies, like a Humphrey visual field and optic disc photos, do so. Those would be very helpful to any ophthalmologist asked to evaluate you.

 

[dochances94]

@orbitsurgMD I appreciate the in-depth reply. Could you speak to the likelihood that I might have to undergo an ophthalmology workup? And under what circumstances it might be grounds for dismissal? I have not had any noticeable symptoms ever other than being told I have drusen. I will ask my optometrist about records when I go to my next exam. I would hate to make this commitment and then be booted for something that literally doesn't affect me at all.

 

[TheEarDoc]

I cleared MEPS and have been accepted for the AF HPSP, but I do have somewhat of an eye condition that I did not think to disclose (I don't think it's directly asked about really). When I was 18, my optometrist said that I appeared to have a swollen optic nerve (pseudopapilledema).I remember she asked a bunch of questions about symptoms like headaches, blurry vision, etc. - none of which I had, and I had to stay for hours and do tests. Just to be safe I had an MRI done which found no cause of inter cranial pressure, and I remember my optometrist was telling me she believed drusen was the culprit and causing the appearance of swelling. 6 years later and although my vision is poor in general (passed MEPS but still), I have no symptoms from drusen like visual field loss or anything (that I know of). It doesn't really get mentioned at eye appointments anymore although they always want to dilate me.

My concerns are:

1) Is this something that could get me sent home from officer training? I know a thorough eye exam is performed there to fit you for glasses. I would hate to be a year or more into the HPSP program when I go and get sent home and be stuck trying to pay year(s) worth of tuition and stipend back.

2) Would this DQ me from flight surgery? I do have interest in flight surgery and I feel like this could definitely at least be DQ here if not for military service in general

I am surprised you didn't get sent for optho consult if you had poor vision at MEPS. I had astigmatism slightly over the limit and had to have a full optho work up to rule out keratoconus even though I had no vision loss, just the astigmatism.

 

[dochances94]

I am surprised you didn't get sent for optho consult if you had poor vision at MEPS. I had astigmatism slightly over the limit and had to have a full optho work up to rule out keratoconus even though I had no vision loss, just the astigmatism.

He said my vision is poor but passable

 

[TheEarDoc]

He said my vision is poor but passable

Ah cool. Well good luck with it. From the responses above it sounds like it comes up you have the documentation to prove you're good to go.