Special Eye Report

Guidance for Applicants and Examiners

IMPORTANT: Please refer to the General Directions (GDs) for instructions regarding the timing and nature of the tests. The comments below are intended to provide practical advice to ensure that the report is completed satisfactorily and provides the information necessary for an aeromedical assessment.

Purpose of Form

  • Must be used for Special Vision Examination (as detailed in GD/Gen/02/04 Part 8 & 9.) and completed by registered Ophthalmologist or a CAA credentialed optometrist.
  • Should be used for examination following replacement of glasses. Use Sections 8 - 10 as template for all optometrists, credentialed optometrists and ophthalmologists (other sections only as clinically indicated).

Applicant Notes

  • The Applicant should fill in Sections 1 - 5.
  • The Applicant should sign the form in front of the Examiner.
  • The following MUST be taken to the examination:
    • Photographic ID as specified in the GD. (For example Passport, Firearm Licence, Driving Licence.)
    • Glasses and/or contact lenses, and any stand-by correction which are or may be used when flying.
  • Applicants should be aware that the examination may require dilatation of the pupil with eyedrops. This causes blurring of vision and renders the applicant unable to drive (or fly) for several hours afterwards. It is important to check with the examiner how long the effect might last.

Examiner Notes

  • Please check ID and witness the signature (or get Applicant to re-sign if already signed).
  • Advise Applicant of effects of pupillary dilatation (if applicable).
  • Testing should show the results with correction actually used. Likewise, Section 9,  the "Prescription" should record refraction actually in use.
  • Specify type of main and standby correction used (ie lookover, bifocal, varifocal, etc) on the form.
  • Even if a different prescription might improve vision, the Report must state results for correction that is used. Any change of prescription requires retesting.
  • Applicants with distance Visual Acuity of less than 6/24 uncorrected must carry standby glasses. These too must be tested.
  • Please ensure "Normal" findings are recorded with a tick. If there are significant findings on examination (eg on fundoscopy), please use a continuation sheet if needed.
  • Please ensure that the examiner's name and contact details are legible too.
  • 24067-211 Special Eye Report Form (PDF)
  • Printer friendly advice for Special Eye Report (PDF) (as above)