[Glaucoma and aircraft pilot fitness].

Two completely different questions arise when considering glaucoma and fitness to fly: Firstly, what is the risk for a passenger with glaucoma? Secondly, what is the flight safety risk connected with pilots suffering from glaucoma? National requirements and international standards pay little regard to this disease. This is astonishing, given that the perception of flight information in the peripheral visual field is of great importance in the cockpit. On one hand, diagnostic glaucoma examinations for pilots are mainly insufficient, and on the other, progressive visual field deficiencies may go undetected because of long intervals between examinations. Intraocular pressure may increase while flying in aircraft, e.g. in the case of negative g-load. Frequent flights at high altitudes without pressurized cabin air and with decreased oxygen supply, and therefore decreased tissue oxygen saturation, may represent a risk, especially for patients with progressive nerve fibre loss.