1. Laser Exposure to Aircrew CAPT Matt Rings Aerospace Ophthalmology

2. Disclosure Statement
CAPT Rings has investments in the following companies who manufacture military laser systems:
General Dynamics
Northrup Grumman Corp
Coherent Inc.
II-VI inc.

3. Laser Threats Handheld Laser Pointers - (Red/Green/Blue)
CAS lasers (vis/IR)
Airborne lasers – targeting
and countermeasures (vis/IR)
Anti-personnel lasers (Green)

5. Laser Dazzle

7. Tahrir Square - Egypt

8. Laser Physical Effects
Glare “Dazzle”
Flash-blindness
Irritation
Photophobia
Headache & eye pain
Sub-clinical tissue damage
Visible retina and ocular damage
Retinal hemorrhage

9. Laser Aviation Effects
Surprise / Startle effect
Distraction
Inability to discern instruments and landing lights
Mission compromise or failure
Loss of aviator temporarily
or permanently to flight

10. Approach, Nov/Dec 2012

12. Ground Incidences “Friendly fire” from ground targeting lasers:
“Since November 2008, [we have] had 64 laser incidents reported in Iraq, resulting in 45 documented injuries to soldiers. Two of those injuries were permanent — one soldier is now legally blind in one eye, Hayes said.”
“Usually, the damage is temporary,” he said, “but they have to be evaluated by a retina specialist in the States.”
(Stars & Stripes, June 14, 2009)

13. 2012 DoD Aviation Incidences
79 Aviation Laser Incidents reported via Hotline
20 HAZREPS
Abnormal Eye Exams (~10% rate)

14. USN Aviation
Note: Multiple persons per incident is frequent

15. Commercial / Civil Aircraft
2004: 46 incidences
2008: 988 incidences
11% reported distraction, glare, afterimage, ops interference,
2% pain/injury
69% on final approach
92% green lasers, 5% red lasers
7PM to 11PM (70%)
The Illumination of Aircraft at Altitude by Laser Beams: A 5-Year Study Period ( FAA

16. Pre-Flight Crew Procedures
OPNAV 3710 : annual LEP / laser training
Review reports of any laser activity in the area reported to ATC (concerts, pireps, intel)
Consider Laser Eye Protection (LEP) based on theater threat intelligence
Discuss in-flight laser exposure procedures
Carry small Amsler grid (if significant threat)
LEP must be worn if “significant laser threat” exists (per OPNAV U)

17. In-Air Exposure Procedures
Look Away & shield eyes (don LEP if available)
DO NOT rub the eyes – increases irritation
Turn up instrument lights
Mark the position, time, and report to ATC
Unexposed co-pilot gets on instruments
Query other crew members for exposure
Self-examination using small print or Amsler grid (if available)
‘Self-triage’ vision
able to read small print,
check individual eyes,
check pocket Amsler grid, nav charts, HUD or MFD for any visual defects
Determine mission viability, if significant vision symptoms prevent safe continuance

18. Crew After-Landing Procedures
Notify Chain of Command
Notify Flight Surgeon & Laser Safety System Officer ( per OPNAVINST B)
Undergo eye exam by Flight Surgeon as soon as practicable
Complete HAZREP
Complete FAA laser exposure web report
Call DoD Laser Hotline (24/7)
Toll-free:

22. Laser Injury Guidebook
United States Air Force School of Aerospace Medicine Laser Injury Guidebook:
Appendix C: Laser Incident Questionnaire
Appendix D: Amsler grid

23. Flight Surgeon Procedures
Complete the ‘Laser Incident Questionnaire’ (Appendix C of Laser Injury Guidebook)
Obtain complete history of events
List ocular symptoms
Document LEP or eyewear worn (e.g. NVGs)

24. Flight Surgeon Physical Exam
Visual Acuity (with correction)
Amsler Grid test
Pupil exam
Stereopsis testing
Color Vision
Slit Lamp – corneal abrasions/burns, lens opacity, conjunctival injection.

25. Flight Surgeon Exam and Actions
Dilated Retinal Exam
Evaluate for retinal changes, blood, burns, white lesions

26. Ophthalmology Consultation
Does laser eye exam reveal significant visual or ocular findings? If yes, consult ASAP to ophthalmology or aerospace optometrist
Navy/USMC: OPNAV :
**ALL exposures get consult exam**
Make recommendation on Fitness for Aviation Duty or further medical management

27. Laser Exposure Aerospace Pearls
99%+ of exposures will not cause permanent injury– may return to flight if no persistent symptoms, normal vision testing and normal exam. Document follow-up in 1-3 days.
Actual injuries or persistent symptoms:
“Down” chit for flight pending further workup
Ophthalmology/Optometry consult (aerovac as needed)
Laser Hotline advice on ALL exposures

28. DoD Laser Injury Hotline & Info
HOTLINE Toll-free:
Comm:
USAFSAM Ophthalmology:
NAMI Ophthalmology:
Pubs (unclassified):