BETHESDA, Md. -- As a U.S. Naval Academy midshipman in the early 1980s, Dr. Joseph Pasternak missed his chance to fly by a single line on the eye chart. He could see well with glasses, but the rule then was more unforgiving than it is now: U.S. Navy pilots needed to see 20/20 without them.
“I was off by a letter or two in one eye. That was it. If you weren’t 20/20 uncorrected, you could be a naval navigator but not a pilot,” he said.
Today, Pasternak, a retired U.S. Navy Captain and a cornea specialist, is the director of Walter Reed National Military Medical Center’s Refractive Surgery Center, where a small team of surgeons and technicians uses advanced laser technology to help warfighters meet vision standards without the aid of glasses or contact lenses.
The clinic performs LASIK and PRK to correct common vision problems, including nearsightedness, farsightedness and astigmatism. Both procedures use specialized lasers to reshape the cornea, but LASIK involves creating a surgical flap while PRK does not. Providers at Walter Reed choose between them largely based on how much correction a patient needs, with LASIK more common in higher-correction cases.
Pasternak said thousands of Naval Academy graduates have passed through the center while working to meet the vision standards for their chosen careers.
Midshipman 2nd Class Christian Basulto, a junior at the academy, came to Walter Reed hoping to turn a childhood dream of flying into a real possibility.
“It’s definitely a childhood dream to fly, and if service assignment was tomorrow, I would put Marine Corps pilot first, Navy pilot second,” he said. “I’m definitely sure that’s what I want to do.”
Basulto, who got his first pair of glasses in fifth grade and switched to contact lenses in eighth grade, said doctors at Walter Reed recommended PRK to correct his vision, clearing a major obstacle on his path to earning pilot wings.
“Even before I came to the academy, I knew PRK was a thing,” he said. “It’s something I’ve been looking forward to since [Induction Day]. I’m grateful this is hopefully the last step toward realizing that dream.”
On surgery day at Walter Reed, Basulto expected his nerves to catch up with him. They never did.
“I’m not somebody who’s necessarily calm about stuff like this, and I really wasn’t worried at all,” he acknowledged. “Even in the waiting room I thought maybe I’d start getting nervous, but it didn’t happen. At that point, I was kind of excited because it felt like that last step.”
Basulto said the detailed pre-surgery briefings made it much easier to relax.
“I mean the brief, even the virtual brief, really helped,” he said. “They walked us through all the steps, the possible complications, even the stats on how high the success rate is. It made it a lot easier to stay comfortable.”
Before patients step into the laser suite, they meet with optometrist Dr. Shayesteh Izaddoost, who handles pre- and post-operative visits and walks them through what the surgery does, how long it lasts and what to expect in the hours and days afterward. She said she focuses on setting clear expectations and practical instructions — down to what to bring on surgery day — because many midshipmen are away from home and navigating the process on their own.
“For our patients, it’s never just about getting rid of glasses,” Izaddoost said. “There’s a lot more at stake when you’re taking care of warfighters who need to see in the dark, underwater, in the desert — wherever they’re sent.”
Walking out of the laser room, Basulto said he could see clearly without glasses for the first time since childhood. “I was looking around, and even now it feels like I have glasses on,” he said. “I thought, ‘Wow, I’m not wearing glasses right now.’”
Doctors said his vision was still expected to fluctuate in the days following PRK, but the immediate clarity marked a dramatic change from what he had known for most of his life.
At his six-day follow-up, Basulto reflected on the early days of his recovery.
“Tuesday, I had the surgery. I got back and honestly was feeling, at first, almost deceitfully well.”
He said the discomfort peaked over the next couple of days. “It kind of feels like you have soap in your eyes, but you can’t rub them. But that’s a small thing compared to the long-term impact, so definitely worth it.”
Doctors at the center said that pattern is typical for PRK patients. After several days of irritation while the surface cells heal, vision can fluctuate before gradually sharpening over the following weeks.
At six days, Basulto was seeing 20/30, already better than his pre‑operative unaided vision of 20/60, roughly twice as sharp, with further improvement expected over the next month.
LASIK patients often experience a faster initial recovery, with noticeable improvement within the first day. However, both procedures are designed to achieve the same long-term visual outcome.
Basulto acknowledged the surgery doesn’t guarantee him a seat in the cockpit, but it ensures that an eye chart won’t keep him from getting a shot at it.
His experience reflects the readiness mission behind the refractive surgery program.
In a forward-deployed environment, service members are not permitted to wear contact lenses, yet many still do. Pasternak said he has seen as many troops sidelined by contact-lens-related corneal infections as by combat eye injuries. He said every option carries some risk — even glasses can steam up or fall off at the worst moment — but significant problems after refractive surgery are uncommon, affecting roughly one eye in a thousand, and are usually treatable.
In 2025, surgeons at Walter Reed’s Refractive Surgery Center completed roughly 1,850 laser eye procedures, reflecting steady demand from across the force. About 45% of patients were students at the U.S. Naval Academy, but the center also treats active-duty service members from all branches, cadets from West Point and the Coast Guard Academy, as well as students from the Uniformed Services University of the Health Sciences. All must receive command approval, with time-in-service requirements varying by branch.
“Our goal is for all warfighters to have access to this,” Pasternak said. “It’s a proven, safe and predictable surgery that’s been around for 25 years, and it’s only gotten better.”
If you are an active-duty service member and interested in more information or to apply for refractive surgery, visit walterreed.tricare.mil/lasereyesurgery.