Jordan Winegar, MD
If your glasses fail at the wrong moment, the consequence is not inconvenience—it can be death.
That reality shaped my understanding of refractive surgery as an active-duty Army ophthalmologist. Glasses and contact lenses are not benign. They are prosthetic devices—a crutch used to compensate for a malfunctioning optical system. In many settings, they work well. In austere, deployed, or combat environments, they introduce risk. In some situations, as in the case of some pilots, they absolutely cannot be used.
During my time in uniform, I performed refractive surgery on pilots, Special Forces personnel, infantry, artillery, explosive ordnance disposal specialists, physicians, other eye doctors, and service members across the Army, Air Force, Space Force, Navy, and Marine Corps. Their missions differed, but their vulnerability was the same: without their corrective lenses, many could not perform their jobs at their best.
Glasses fog, break, scratch, and get lost. Contact lenses require supplies, hygiene, clean water, and controlled conditions, which do not exist in the field. Military data show that contact lens wear in deployed environments increases the risk of sight-threatening infection more than thirteen-fold, driven by poor hygiene, environmental contamination, and limited access to care (Cope JR et al., MMWR, 2016; DeLoss KS et al., Cornea, 2013).
In civilian life, losing glasses is frustrating. In the military, it can turn a trained operator into a liability—unable to identify a threat, read instruments, operate equipment, drive, or protect others. Soldiers told me directly that this risk mattered to them. Death from malfunctioning prosthetic devices at a critical moment, while unlikely, is a real consequence they considered when they opted for surgery.
There is also a strategic reality. Dependence on external optical correction creates an obvious weakness. If a service member is captured or separated from equipment, removing their glasses is one of the simplest ways to disable them.
Refractive surgery is not a lifestyle upgrade in this context. It is a readiness tool. It removes a point of failure.
Importantly, the military has not adopted refractive surgery based on theory alone. It has studied outcomes extensively in extreme and operational environments and found refractive surgery to be a safe option. Performance on critical military tasks—such as shooting, driving, night ops and flying—is most often equivalent to performance with glasses or contact lenses, and in many cases, better (Schallhorn SC et al., Ophthalmology, 2003; Schallhorn SC et al., J Cataract Refract Surg, 2006; Tanzer DJ et al., Ophthalmology, 2013; Hammond MD et al., Mil Med, 2015). These findings reinforce that refractive surgery does not compromise function; it often enhances it.
Few medical interventions offer this kind of functional change. Surgery cannot make a person stronger, faster, smarter or able to hear better. With a simple 10-20 minute procedure, refractive surgery removes dependence on a prosthetic device and allows a person to function with their own visual system. It converts a limitation into independence.
This is not an argument against glasses or contact lenses. They are effective, appropriate and sometimes the best option for some patients. But their risks are treated differently. Surgical complications are discussed in detail and documented. The risks of lifelong dependence on external correction—breakage, loss, infection, supply failure, and functional incapacity, not to mention how much they cost—are rarely emphasized. As a result, surgical risk is highly visible, while nonsurgical risk is often ignored.
The same principles apply beyond the US military. Military members in all nations operate in environments where vision determines success or failure. Civilians face situations where dependence on glasses or contacts becomes consequential. Losing glasses can end a trip, prevent driving, or force dependence on others. In emergencies—fires, floods, evacuations—independence matters.
One of the greatest advantages I had in the military was the absence of financial incentive, and thus freedom from one of the largest perceived sources of bias: money. I had no reason to favor one procedure over another—or to recommend surgery at all. I performed all refractive surgeries, including LASIK, PRK, SMILE, implantable collamer lenses, refractive lens exchange, and combinations of these procedures based solely on patient anatomy, visual demands, and mission requirements. I also treated abnormal corneas with cross-linking, cross-linking combined with PRK, and corneal tissue addition keratoplasty.
That experience reinforced a simple point: refractive surgery is not a single procedure. It is a discipline focused on reducing optical disability and improving function.
Military refractive surgery highlights the broader value of our field. We are not just helping patients avoid glasses. We are removing dependence on a prosthetic device and restoring autonomy.
For some patients, that means convenience. For others, it means capability when it matters most.
That distinction is real—and it is a story we should tell clearly.
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