Age-related vision problems in commuter and air taxi pilots: A study of 3019 pilots, 1987-1997

Introduction: Vision problems have become an increasingly important health and safety concern for pilots due to the aging of the pilot population. This paper examines the incidence of age-related vision problems in a birth cohort of commuter air carrier and air taxi pilots. Methods: A cohort of 3019 male pilots ages 45-54 yr at baseline and holding Class I medical certificates in 1987 were retrospectively studied from 1987 to 1997 through the medical certification system of the Federal Aviation Administration. Poisson regression modeling based on generalized estimation equations was used to assess the associations of pilot characteristics with risk of developing vision problems. Results: The study period accumulated 419 incident cases of vision problems, yielding an incidence of 20.3 per 1000 person-years. For pilots ages 45-49, 50-54, 55-59, and 60-64, the incidence of vision problems was 17, 20, 24, and 39 per 1000 person-years, respectively. A baseline history of eye problems and older age were each significantly associated with an increased incidence of vision problems. The adjusted relative risks of vision problems for pilot age were 1.0 (45-49 yr), 1.2 (50-54 yr), 1.4 (55-59 yr), and 3.0 (60-64 yr). The three most prevalent types of visual problems were corneal problems (16%), glaucoma (15%), and cataracts (7%). Conclusion: Identifying and preventing pathological changes that alter visual performance among pilots is an important component of aviation safety. With the increasing maturity of the pilot population, it is essential that appropriate visual screening and correction be emphasized for specific age-related ophthalmic conditions.