Cleared for Takeoff

Pilot is cleared to fly without glasses for the first time.

An airplane is fitted with numerous technical instruments the pilot must regularly operate for a flight to be successful. But the most critical instrument a pilot must operate is his eyes. No one knows this better than commercial pilot and flight instructor Guy Smith, PhD.

Photo by Nerissa Johnson.

Guy Smith, PhD

“Pilots treasure vision more than just about any other skill we have,” he stresses. “Our eyes are critical to us in terms of being able to not only read the information and instruments in the aircraft, but also to see other planes in the sky.”
Guy, 72, had worn glasses most of his life, and he was required to wear corrective lenses when he flew. To enhance safety, Guy invested in the highest-quality eyewear, and had his prescription updated regularly. Several years ago, however, he noticed he wasn’t seeing the entire picture.
“My peripheral vision seemed to be a problem when I was flying, primarily when I was looking outside for other airplanes. We call it looking for traffic,” explains Guy. “I felt my eyelids were drooping. Years ago, I flew with an eye doctor who told me about an operation to correct droopy lids, so I started looking for an eye surgeon with expertise in that field.
“I heard about Dr. Ge at Premier Eye Clinic, so I contacted the office and made an appointment. Dr. Ge did a test of my peripheral vision and confirmed that I did have a problem. She said she could solve it with a combined surgery called blepharoplasty and ptosis repair.”

“My clearer vision since surgery makes me a much safer pilot and much more comfortable with the work I’m doing.” – Guy

“At seventy-two, Guy is a very active senior,” describes board-certified ophthalmologist Q. Jocelyn Ge, MD, PhD of Premier Eye Clinic. “He is an instructor of pilots as well as a pilot himself, so he has a very high demand for clear vision.
“When he came in, he reported that part of his visual field was being obstructed by droopy eyelids, and a complete field of vision is needed to be a safe pilot. Droopy eyelids are mainly an age-related condition. Over time, gravity causes the lids and facial muscles to sag. That’s what was happening with Guy, so I recommended surgery.”
Eyelid bagginess afflicts both men and women. Although it is often hereditary, it typically becomes more pronounced with age. As the transition takes place, eyelids can change in ways that make people look tired, to the point where they almost feel tired as a result. Others may actually begin to appear sad or angry.
According to Dr. Ge, folds and bags of excess skin form when the connective tissue of the upper eyelids is no longer able to hold the protective layer of fat in place around the eye, allowing the tissue to bulge forward. As it loses its tone and elasticity, the excess skin of the upper eyelids protrudes into the visual field.

Photo by Nerissa Johnson.

Guy needs clear vision to read the instruments in an aircraft.

Dr. Ge examines all patients first to be sure that a surgical procedure is necessary.
“We test for droopy lids by performing what is called a visual field test,” says Dr. Ge. “Peripheral vision is first checked with the eyelid in its natural position. Next, the eyelid is taped up and the field of vision is rechecked. If there is a significant difference between the two tests, it is considered a functional problem.”
Blepharoplasty is a relatively minor procedure. The surgery is done on an outpatient basis under local anesthesia. During the surgery, an incision is made in the upper lid crease, and through that incision, the extra skin and fat are removed.
In addition to the blepharoplasty, Dr. Ge performed a second procedure for Guy called ptosis repair at the same time. During this procedure, she lifted the hard plate inside the eyelids to move them out of the way so they no longer obstruct vision.
“Some patients, like Guy, require a combined upper blepharoplasty and ptosis repair in order to not only remove the excess tissue but also tighten the deep ligament of the eyelid,” confirms Dr. Ge. “The surgery is performed on both eyes so the eyelid positions are checked during the surgery to ensure symmetry.”
“The difference in what I could see before the surgery and after was absolutely amazing,” offers Guy. “My vision was so much clearer. That really made me trust Dr. Ge.”

Connecting the Dots

As a result of the success of his eyelid surgery, Guy retained Dr. Ge as his regular eye doctor for routine examinations and eyeglass prescription updates. All went well until 2016, when Guy again began having issues seeing clearly.
“When I was driving, especially at night, I would see a glow around lights,” he reports. “I also had trouble reading signs, mostly those in the distance. It helped that I had very good glasses because Dr. Ge had been keeping my prescription current.”
Glare around lights wasn’t what worried Guy the most. He was more concerned about not seeing his best while he was working because he noticed the problem affected his vision in one particular situation.

Photo by Nerissa Johnson.

Guy is now cleared to fly without prescription glasses.

“Mostly, I couldn’t pick up the traffic when I was flying,” he notes. “When the traffic controllers tell us there’s traffic to look for at one o’clock, two miles, that means slightly right of your aircraft about two miles away. It’s not a huge thing out in the sky. It’s more like a dot in the sky. You’re looking for a relatively small, moving target.
“I noticed my students would say, Yes, I have the traffic, but I couldn’t say that. I didn’t see it. I discussed this with Dr. Ge, and she said I had cataracts that were growing, but they could be corrected.”
A cataract is the natural lens in the eye that has become cloudy over time. There are a few factors that can contribute to cataract formation, but they are primarily an age-related condition. Treatment for cataracts is surgery to remove the cloudy lens and replace it with a clear, artificial lens.
“Today, cataract surgery technology has progressed so that patients are often able to see both near and far after surgery,” observes Dr. Ge. “This way, they can avoid having to wear corrective lenses, which is a huge benefit.
“When Guy felt his vision had gotten worse, we moved forward with surgery. He had femtosecond laser-assisted cataract surgery in both eyes. He was interested in being without glasses after surgery, so he opted for premium lens implants that would allow him to see both far and near. He had a TRULIGN® lens in his right eye, and a Crystalens® in his left.”

A First in Life

Before his cataract surgery, Guy wore glasses 100 percent of the time. After surgery, he has 20/20 vision in both eyes and no longer needs glasses to see clearly.
“My results are excellent,” marvels Guy. “In one eye, Dr. Ge fine-tuned the lens for closer view, and in the other, she fine-tuned it for more distant view, which gives me full range of vision. I just completed my medical exam in October, and for the first time in my life, I’m cleared to fly without corrective lenses.
“The most remarkable thing is, with my new eyes, I can pick up traffic visually almost instantly, which to me is a miracle. I was never able to see traffic two or three miles away before. My clearer vision since surgery makes me a much safer pilot and much more comfortable with the work I’m doing.”
Clear vision is critical to aviators like Guy, but it’s also a huge asset to anyone who leads an active life. With all the advanced technologies now available to treat cataracts and drooping eyelids, individuals can more easily improve their vision and return fully to their activities. Guy stresses that Premier Eye Clinic is the best place to receive these services.
“One thing I really like about Dr. Ge is she has very delicate hands,” he says. “I’m a big guy with big hands, so I really appreciate a person with delicate, exact hands working around my eyes. I can hardly feel her touch because it’s so gentle.
“I absolutely recommend Dr. Ge and Premier Eye Clinic. In fact, I’ve already recommended them.”

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    • Premier Eye Clinic

      Premier Eye Clinic provides comprehensive eye examinations and treatment for patients of all ages. Their board-certified ophthalmologist is highly experienced in advanced cataract surgery using a "no injection, no stitch, no patch" tech... Read More

    • Q. Jocelyn Ge, MD, PhD

      Q. Jocelyn Ge, MD, PhD, received her medical degree from the Vanderbilt University School of Medicine and her PhD from the University of California. She completed her internship at the University of Tennessee Medical Center and her o... Read More