Introduction. The use of contact lenses to satisfy the distant visual acuity requirements for obtaining a civil airman medical certificate has been permitted since 1976. According to the Federal Aviation Administration's "Guide for Aviation Medical Examiners," the use of monovision contact lenses is not considered acceptable for aviation duties. An aviation accident involving the use of monovision contact lenses will be reviewed.Methods. A case report is presented utilizing information from a National Transportation Safety Board (NTSB) aircraft accident report (NTSB/AAR-97/03) of a nonfatal scheduled airline accident. Past studies that examined the use of contact lenses in the aviation environment are reviewed.Results. On October 19, 1996, a McDonnell Douglas MD-88 aircraft, Delta Airlines Flight 554, was substantially damaged in an undershoot approach while landing at LaGuardia Airport, Flushing, NY. Weather observations indicated a broken cloud layer at 800 feet, visibility between 1/2 and 1 mile in heavy rain and fog or mist, and easterly winds at 12 to 14 knots. The approach was over water to Runway 13 and the flight crew transitioned to visual references just above the decision height. As the airplane continued to descend, it struck an approach light structure and the end of the runway deck, shearing off the main landing gear and slid 2,700 feet down the runway. During an emergency evacuation, 3 passengers received minor injuries.Conclusion. The NTSB determined that the probable cause of this accident was the inability of the pilot to overcome his misperception of the airplane's position relative to the runway, due to the use of monovision contact lenses. The adverse effects of wearing contact lenses in the aviation environment are discussed. Research is recommended to better understand the effects of environmental conditions on monovision to validate the current policy on such corrections.
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