Open-angle glaucoma is a CACI condition for all certificate classes — meaning many pilots can be certified by their AME without FAA referral. The outcome depends on IOP control, visual field status, and medication choice.
Informational Use Only. The information on this page reflects our understanding of current FAA medical certification requirements and is provided for general educational purposes only. FAA policies and the AME Guide are updated frequently. The FAA AME Guide is the authoritative source in all cases. Always verify with your AME and at faa.gov/ame_guide.
Open-Angle Glaucoma is a CACI Condition
For all three classes, qualifying glaucoma can use Conditions AMEs Can Issue (CACI) only when every worksheet criterion is met: diagnosis at age 40 or older, pressure ≤23 mmHg in both eyes, no documented nerve damage or trabeculectomy, and no field defect or unreliable fields. Stable angle-closure glaucoma treated by iridotomy or iridectomy can also qualify. The current medication table distinguishes CACI medications, oral drugs requiring SI, and unacceptable medications.
Glaucoma type, IOP control, medication type, and visual field status all determine your certification pathway.
Ocular hypertension or glaucoma suspect — monitored, stable and all worksheet criteria met
Stable open-angle glaucoma — diagnosis at age 40 or older, IOP ≤23 mmHg in both eyes, no nerve damage, trabeculectomy, field defect or unreliable fields; all remaining criteria met
Trabeculectomy (filtration surgery) or documented nerve damage — not CACI eligible
Pilocarpine or other cholinergic agonists, or cycloplegics such as atropine
Active or unstable angle-closure glaucoma — acute incapacitation risk
Angle-closure glaucoma treated by iridotomy or iridectomy, now stable and meeting every CACI criterion
Any visual field defect or unreliable fields — not CACI eligible
The FAA treats these two types of glaucoma very differently. Understanding which type you have is critical.
The most common type. Increased IOP gradually damages the optic nerve over years. Peripheral visual field loss occurs slowly — often not noticed by the patient until advanced.
FAA approach: CACI requires diagnosis at age 40 or older, IOP ≤23 mmHg in both eyes, no nerve damage or trabeculectomy, no field defect or unreliable fields, and all other worksheet criteria. Accept FAA Form 8500-14 or an equivalent treating-physician report.
Primary concern: Progressive field loss over time — must be monitored and documented at each renewal.
Risk of acute angle-closure attack causing severe, sudden incapacitation: extreme eye pain, nausea, blurred vision, halos, and potentially catastrophic vision loss. This is an acute flight safety emergency.
FAA approach: Stable angle-closure glaucoma treated by surgical or laser iridotomy/iridectomy can qualify for CACI if every worksheet criterion is met. Untreated or unstable disease requires FAA review; the diagnosis alone is not a blanket denial.
Secondary glaucoma: Caused by known pathology (uveitis, trauma). Eligibility depends largely on the underlying condition — if resolved and the other eye is normal, certification may be possible.
For open-angle glaucoma, the FAA performs a structured evaluation through the ophthalmologist's report and CACI worksheet.
CACI requires IOP of 23 mmHg or less in both eyes, diagnosis at age 40 or older, and a stable regimen with no treatment changes recommended.
No field defect and no reported unreliable fields are permitted for CACI. Use acceptable formal visual field testing; confrontation or screening fields are insufficient.
Vision must meet FAA acuity standards (with correction if needed). Glaucoma that has progressed to reduce central acuity below standard is a disqualifying finding.
The current Guide table lists beta blockers, carbonic anhydrase inhibitors, alpha2 agonists, rho kinase inhibitors, prostaglandins and listed combinations for CACI when criteria are met. Oral drugs such as acetazolamide require SI. Cycloplegics (atropine) and cholinergic agonists (pilocarpine) are unacceptable. Verify the exact drug and route.
Documented nerve damage or trabeculectomy excludes CACI. Stable angle-closure disease treated by iridotomy or iridectomy can qualify if every criterion is met; other procedures need case-specific review.
FAA Form 8500-14 OR an equivalent treating-physician report is acceptable. The AME reviews a detailed clinical evaluation within 90 days of the exam addressing every worksheet criterion.
Missing FAA Form 8500-14 or an equivalent treating-physician report addressing all worksheet criteria
Assuming pilocarpine is routinely acceptable through SI — the current medication table lists it as unacceptable
Submitting unreliable or screening visual fields, or overlooking even minimal field loss — these do not satisfy CACI
Significant field loss not disclosed — the ophthalmologist's report will reveal it anyway; proactive disclosure is always better
Not disclosing glaucoma on Form 8500-8 — required disclosure for any diagnosed eye condition
Narrow-angle glaucoma without iridectomy — do NOT attempt to fly; acute angle-closure risk is a genuine incapacitation hazard
Official FAA sources used in developing this guide.