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Presbyopia in the Cockpit

Can presbyopic patients be pilots?

April 11, 2023

There is probably no vocation, nor avocation for that matter, that requires better vision than aviation. Previously, any distance or near visual acuity worse than 20/20 was disqualifying for entry into the Air Force Academy and many commercial airline pilot programs. Both distance and near demands on the visual system during flight operations are critical. 

Technological advances in computer graphics using glass displays have resulted in the need for even different focal ranges in the cockpit, creating additional focal distances necessary to fly a plane.    

iPads Replace Paper, But Can Pilots See Them?
The introduction of mobile screen devices has had a huge impact on cockpit activities. In an interview with United Airlines pilot Ryan Pontious, he mentioned that the use of an iPad has enabled pilots to nearly completely move away from paper.  

Historically, a corporate pilot would receive a package weighing approximately 50 pounds of maps, charts, and other revisions from their airline every two weeks. This created a cumbersome task for pilots to digest and manage. Today’s corporate-issued iPads update constantly, enabling pilots to stay current with less time and effort. Plus, the ability to adjust the font size on the iPads is very helpful.  

The airlines have installed mounting brackets in the cockpit to hold the iPads. Each pilot has an iPad mounted approximately 18” from the seat. This additional distance causes new problems for presbyopic pilots. They now have to focus on an iPad 18” away, the instrument panel typically 22” to 24” away, and far away vision. 

More than One Lens to See the Control Panel
Pontious has been a mild hyperope most of his life and enjoyed excellent far and near vision until the past five or so years. When his near vision started to decline, he resorted to OTC single vision readers and, like most pilots, had several pairs in his flight bag. 

Douglas Devries, OD, a noted dry eye specialist and presbyopic pilot, stated that even with the newer glass instrument panels, which make near vision easier than the old-style panels, he still needs visual aids to see the smaller waypoints. Like so many pilots, he has trouble with progressive lenses and often resorts to half-eye readers. Pontious, however, stated that his optometrist has found the perfect prescription for his progressive lenses.  

Can Presbyopic Patients Become Pilots?
Patients often ask their ECPs if they can become a pilot if they wear glasses. The answer is yes, you can wear glasses and be a private or commercial pilot. Perfect uncorrected vision is no longer a requirement to be a pilot or an air traffic controller. Glasses, contact lenses, and refractive surgery are all (with certain limitations) acceptable ways to correct visual acuity problems. Commercial pilots must have 20/20 vision, corrected, in each eye. For our patients who wish to become a private pilot, their vision must be only 20/40 or better in each eye separately, with or without correction. (This is because private pilots need only a third class medical certificate, unlike commercial pilots who need a first class certificate). 

In the case of presbyopic patients, FAA regulations require near vision of 20/40 or better in each eye separately, with or without correction, as measured at 16”. Additionally, at age 50 and older, regulations require intermediate vision of 20/40 or better in each eye separately, with or without correction, as measured at 32 inches. 

When I was the squadron optometrist for the 129th Tactical Fighter Squadron, my commanding officer would insist that I frequently fly on missions to experience the visual needs of our pilots. Ready room discussions often centered around vision demands. Many Guard and Reserve pilots are also commercial airline pilots. During my time in uniform, LASIK was not allowed; however, that has changed in more recent years. 

Presbyopia will continue to be a challenge for pilots in the cockpit. Eyeglass lens manufacturers are designing newer progressive lens formulas that make flying, as well as other life activities, easier. 

Disclosure: Ryan Pontious is a full-time pilot for United Air Lines based in Denver, Colorado, and my son’s brother-in-law. I interviewed him for this article on December 22, 2022.


  • Kirk Smick, OD

    Dr. Smick is a retired Air Force Colonel and pilot. He has held several key leadership positions in optometry and has lectured both nationally and internationally. He is a past president of the Georgia Board of Optometric Examiners, the Georgia Optometric Association, and SECO International. Dr. Smick believes that post-graduate education is the key to best practices and therefore has dedicated much of his professional life to continuing education. He served as the chairman of continuing education for SECO International, the American Optometry Association’s Optometry’s Meeting, and the Vision Expo meetings. In total he has dedicated more than 30 years to continuing education, both as a facilitator and a lecturer. He was the first optometrist to be certified by the American Academy of Certified Procedural Coders and an original founder of the Omni Referral Center System. He continues to consult with several industry partners, including Allergan, Optical Connection, and ScienceBased Health. He views presbyopia as a unique opportunity for optometrists because of the new technologies available.

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