Contact lens wear by Royal Air Force aircrew in World War II

PurposeTo provide an overview of the use of contact lenses by RAF aircrew in World War II by identifying some of the fitters and wearers and appraising the clinical results that they achieved.MethodsA wide-ranging literature search was undertaken that encompassed peer-reviewed journals, non-refereed publications, books, official publications, newspapers and archived documents.ResultsThirty-one aircrew are known to have worn sealed scleral lenses in order to meet the required visual standards. Of these, only two were considered to be completely unsuccessful, one of whom was unilaterally aphakic. One additional case of undisclosed contact lens wear was found and the identity of this officer was established. Brief biographies of a few pilots establish the context of their contact lens wear.ConclusionOverall, the results of scleral lens wear were variable reflecting those achieved by civilian patients of the period. While three men complained of discomfort due to heat and glare, one pilot experienced no photophobia when flying above white clouds in brilliant sunshine and another found no difficulty caused by altitude or tropical climate. Wearing time ranged from about 2 h to 16, or more, hours. In about a third of the cases, wearing time was limited due to the onset of a form of contact lens induced-epithelial oedema known as Sattler's veil and effective solutions to this problem were not implemented until after the war.