The Army's newest weapon: Killer eyesight that gives soldiers an edge
In December 2004, the then Defense Secretary Donald Rumsfeld told an Iraq-bound group of soldiers who had criticized the quality of their equipment that “you go to war with the Army you have, not the one you might want or wish to have at a later time.”
But today, thousands of soldiers are going to war armed with the eyes they always wanted.
Legions of servicemen in Iraq have undergone a medical procedure whereby their near-sighted corneas are shaped to perfection. This experiment is believed to be the first by any army anywhere to use irreversible surgery to enhance combat power.
“This is the single most important thing, second to maybe warfare training, that we need to do for our soldiers that are on the front lines,” said Major Nick Pefkaros, an Army ophthalmologist at Fort Riley, Kansas.
“If they lose their contacts or they lose their glasses in the middle of a fight,” said Pefkaros, “all of their training is equal to a 4-year-old with an AK-47.”
Since just before the start of the Iraq war, Army eye surgeons have corrected the vision of nearly 55,000 soldiers for free in a campaign to increase their battlefield ability. The cost to the Army is $300 to $500 a head-–far below what a civilian would pay.
The military’s laser vision correction effort began with a few test cases on Navy Seals in 1993 and spread to Navy and Air Force pilots a few years later. “It is sentinel,” said Dr. Steven Schallhorn, a retired Navy Captain who pioneered the research, development, and propagation of the procedure for U.S. forces and is renowned in the field. “This is the first time that a medical procedure has improved the combat power of a military.”
The Army began offering the surgery to Green Berets at Fort Bragg in June 2000, and since May 2002 the Warfighter Refractive Eye Surgery Program – as it came to be called – has sharpened the vision of soldiers using a technique called photorefractive keratectomy, or PRK. Microscopic lasers bombard the patient’s corneas in a reshaping process that normally takes less than two minutes per eye and makes them as good as new within months.
Unlike unpopular and compulsory medical rituals of the past – like Anthrax shots and Malaria pills – PRK is completely voluntary. Despite the discomforts of the healing process – a few days of acute pain and sensitivity to light as well as several weeks of blurry vision – soldiers are signing up.
“I had 20/50 vision before, but having 20/20 is amazing,” said Gary Graig, 28, who received the surgery in Landstuhl, Germany, in order to improve his marksmanship before his second Iraq deployment. “I know for those with horrible vision, it was a life-changing event.”
For some soldiers, looking good can be just as important as seeing well. Visually impaired recruits suffer the indignity of wearing bug-eyed Army-issue glasses dubbed BCGs – birth control goggles – for their unflattering appearance.
But with the Army’s offer of free PRK, soldiers can improve their image without paying the thousands of dollars that cosmetic-conscious civilians shell out for the surgery. “It gave me tremendous confidence,” said Brian Pugh, 29, a Shell Corporation project engineer in Houston who underwent the operation after returning from a tour in Iraq. “I feel better as well as see better. I never realized how much wearing glasses affected me until I no longer needed them.”
While two thirds of civilian patients choose Lasik – a more complicated procedure that carries greater risk but involves a shorter healing time – the Army almost exclusively uses the more predictable PRK.
Lasik patients leave the operating table with immediate 20/20 vision, the laser doing its work only after a “hinged flap” has been sliced off the cornea and opened like a front-loading washing machine. That delicate flap never completely heals, making some soldiers-–whose jobs include parachuting out of airplanes or enduring blasts in sandy areas-–particularly ill-fitted for the procedure.
But that could soon change, too, according to Dr. Schallhorn. A new procedure called femtosecond surgery, the Navy’s technique of choice, cuts a flap that withstands the kinds of rigorous conditions that soldiers regularly endure. “That is the rage right now,” said Schallhorn, who predicts it will take the Army another year to catch up with the Navy.
In the program’s early days, before PRK had shown undeniable success, only major U.S. Army hospitals like Walter Reed and Landstuhl in Germany performed the free operation. This denied bespectacled combat troops in far-flung locations the possibility of getting it.
Pefkaros wrote several letters to a general crying injustice, and the foot-stomping paid off. “We purchased our laser last year,” said Pefkaros, “and we’ve just been going crazy.” He has churned out more than 3,500 sharp-eyed soldiers at Fort Riley since then.
Skeptics question the practice of some civilian clinics of performing laser vision correction on a high volume of patients in a short period. The argument goes that as quantity increases, quality will suffer.
“There is more to manage and there is more litigation,” warned Dr. Richard Braunstein, Director of Refractive Surgery and Laser Vision at Columbia University’s Department of Ophthalmology. However, he added, “If people are trained right, then there is no reason not to.”
Pefkaros argued that the surgeons become better by doing more procedures. He predicted that more soldiers will opt for the surgery as the technology improves further.
“We will get to a point where people are joining the military and part of their training, like going to the dentist and getting their teeth filled, is getting eye surgery,” he said.