Pilot Physical Examination Guidelines

1. Ophthalmology

Each year, ophthalmologists assess pilots, with a significant proportion being disqualified due to inadequate vision. Hence, adequate attention must be given to vision. During vision tests, note that excessive stress can lead to vision loss; engage in light activities before the test to relax. Avoid factors that contribute to vision loss, such as fatigue and inadequate sleep. Apart from vision, refraction standards are strictly enforced; good vision exceeding these standards is still disqualifying. Latent squint examinations check for imbalances in extraocular muscles, with strict standards applied. The highest degree of squint among three tests is considered final, and no retests are conducted unless operational essentials are unmastered. During tests, subjects must focus on the light source ahead; once points and lines align, avoid further adjustments. If the distance between the rotated knob and the line increases, rotate in the opposite direction. Recent corrective vision methods like OK glasses, laser surgery, and corneal ring implantation are not recommended for pilots as surgically treated eyes cannot adapt to varying pressure environments. Consequently, corneal scars and history of refractive surgery disqualify individuals.

2. Otorhinolaryngology

Pilots with chronic rhinitis and sinusitis are disqualified due to these conditions causing nasal mucosa swelling, increased purulent mucus, and sinus ostium obstruction, impairing nasal ventilation and drainage. During flights, altitude changes drastically alter cabin and sinus cavity pressure, causing sinus blockage and severe headaches, known as aero-sinusitis.

3. Olfaction Examination

With eyes closed, the examinee presses their right nostril with their right index finger. The examiner then places a vial approximately 1.5 cm from the left nostril, allowing the examinee to inhale and identify the odor. This process is repeated with a different odor, then with the right nostril. If congested, blow the nose first or inform the examiner for a spray before the test.

4. Audiometry

In recent years, the disqualification rate due to hearing impairment has increased significantly. Proper earphone usage is advised; volume should be audible but not loud, with daily usage limited to 1 hour. Improper medication is another cause of hearing loss. Follow doctors' instructions when taking medication.

5. Laboratory Tests

Tests include blood, urine, stool routine, liver function, and Australia antigen (AusAg) screening. AusAg positivity indicates hepatitis B virus infection, not necessarily hepatitis B disease. Specimen collection typically occurs after waking up on the second day of the physical. Clean the urethral opening the night before to avoid contamination. Collect 20-30 ml of midstream urine, and 3-4 grams of fresh stool for analysis. Students undergoing standing exams should drink plenty of water to prevent dehydration. Avoid sugary or canned fruits the night before. If feeling dizzy during blood draw, sit down immediately to prevent injury.

6. Electrocardiogram and Cardiac Function Tests

These tests can be conducted separately or sequentially. ECG amplifies and records the heart's electrical activity for analysis. Avoid physical activity and medication to eliminate stress before the test. Lie supine, unbutton your jacket, relax, and breathe calmly. Cardiac function tests analyze post-exercise cardiac function, ischemia, and arrhythmias. During the test, wear a sphygmomanometer cuff on your right arm, inflate the cuff with your right hand, and move your arm up and down for 3 minutes to the beat of a metronome. Immediately afterward, lie down, measure your blood pressure 1 minute post-exercise, record a 2-minute ECG, and then measure your blood pressure again after 3 minutes. Remain relaxed and still during the ECG and follow the exercise rhythm precisely. Dress warmly after the test to avoid catching a cold.

7. X-ray Examination

Routine X-rays include chest fluoroscopy and radiography. Additional X-rays may be conducted based on specific requirements. X-ray doctors comprehensively analyze lung, heart, pleura, and diaphragm conditions. Certain pleural thickenings, adhesions affecting diaphragm movement, and excessive lung calcifications may disqualify individuals from flying but are acceptable for ground work.

8. B-mode Ultrasound

Ultrasound waves penetrate skin and reflect off internal organs, allowing for the examination of their position, size, texture, and new growths. During recruitment exams, the liver, gallbladder, spleen, and kidneys are