The pigmentary dispersion disorder in USAF aviators

The pigmentary dispersion syndrome (PDS) can have serious ocular consequences. Visual changes due to glaucoma and the treatment required can threaten the high level of visual function necessary in military aviation. We reviewed the records of 50 aviators with PDS who were evaluated at the Aeromedical Consultation Service (formerly the USAF School of Aerospace Medicine) over the past 10 years. At last evaluation, 48 were still qualified to fly. Only two aviators were permanently removed from flying duties due to glaucoma. Initial intraocular pressures, cup-to-disc ratios, and refractions were not statistically correlated with progression to glaucoma, but sample sizes were small. At final evaluation, 20 of the 34 aviators with follow-up had glaucoma and required medication. Thirteen eyes underwent laser trabeculoplasty. With appropriate management, the majority of aviators with PDS were able to safely continue their flying careers.