Flying Blind: Aeromedical Certification and Undiagnosed Age-Related Macular Degeneration

Abstract : The love of flying seldom diminishes throughout a pilot's career. It is often the primary motivation for investing the time and expense necessary to attain and maintain a valid pilot license and medical certificate. However, a pilot's ability to meet the physical requirements for aeromedical certification may become compromised by advancing age or impairments. Individuals with physical limitations or the elderly in a number of states must pass a vision test to renew their driver's license. These individuals may resort to extraordinary measures to avoid losing the privilege of operating a motor vehicle and maintain a sense of independence. Similarly, pilots with physical limitations may attempt to circumvent the Federal Aviation Administration's aeromedical certification process to retain a valid medical certificate. In an investigation of a fatal accident, the National Transportation Safety Board (NTSB) concluded that the aviation medical examiner who issued an airman medical certificate to a visually impaired pilot failed to perform the appropriate procedures to verify the validity of medical information provided by the pilot. The airman subsequently crashed his aircraft, resulting in his death and the deaths of five others onboard. The NTSB report stated that the pilot's failure to maintain airplane control for an undetermined reason resulted in an inadvertent stall. The report also stated that either the pilot's macular degeneration or his unrecognized coronary artery disease could have contributed to his failure to maintain control of the airplane. The report discusses this case study in depth, including the details of the accident, the pilot's medical history, clinical signs and symptoms of macular degeneration, FAA vision standards for the Airman Medical Certificate by class of certificate, macular degeneration clinical sequelae and treatment, and clinical considerations of this accident.