From the May/June 1998 issue of Alert Diver

High-Pressure Opthamology
DAN Answers Divers' Most-Asked Questions About Their Eyes

While working with Divers Alert Network as a consultant in ophthalmology over the past three years, I have had the opportunity to respond to many questions from DAN members concerning the eye and diving. This article discusses some of the most frequently asked questions on the topic.

A recent review of this topic entitled "Diving and Hyperbaric Ophthalmology" was published by Butler in the medical journal Survey of Ophthalmology (March/April 1995) and serves as a good additional reference on the subject of the eye and diving.

By Frank K. Butler Jr., Captain, Medical Corps, United States Navy

 

 

The Eye and Diving

Our eyes normally exist in a world where the pressure around them is the result of the combined weight of all of the gases in the earth's atmosphere. Diving exposes the eyes to increased pressures. While most of the time this has little or no negative effects on the diver, increased eye pressure in scuba diving can result in ocular decompression sickness and other dysbaric disorders. It may also raise new questions about the management of common eye conditions in divers. The issues discussed here, for the most part, historically have not been well addressed in ophthalmology literature.

1. Is it safe to dive after radial keratotomy?

Radial keratotomy (RK for short) is a surgical procedure designed to cure myopia (nearsightedness). In this operation, the surgeon makes a small number of radially-oriented incisions in the cornea of the eye. These incisions cause a decrease in the strength of the cornea and may increase the risk of serious injury if the eye is subjected to subsequent trauma, including barotrauma such as a facemask squeeze. Despite this theoretical risk, there have been no reports of which I am aware involving a traumatic rupture of the cornea resulting from diving after RK.

Divers who have had this procedure should wait at least three months after the surgery before returning to diving and should be careful to avoid a facemask squeeze - it's important to avoid imposing the "Boyle's Law Stress Test" on these corneal incisions. (See the related article "Diving After Radial Keratotomy" March/April 1996.)

If you are a diver and considering having this procedure done, I would recommend that you also ask your eye surgeon to discuss the potential advantages of photorefractive keratectomy, the alternative refractive surgical procedure discussed below.

2. Is it safe to dive after having had the new laser refractive surgery (photorefractive keratectomy, or PRK)?

3. Diplopia (double vision)

Continued...