Wildland firefighters whose OF-178 exam or screening shows a vision deficit take this four-page template to their eye care provider. It records diagnosis, stability, medications, recent distant and near acuity, temporal peripheral vision and eye surgeries, plus concerns about smoke, low light and driving, so a Forest Service Medical Officer can decide clearance or a waiver.
The employee completes Part A with fitness level and identifying details, which authorizes release to the program's Medical Officers. The ophthalmologist, optometrist or treating provider completes Part B as applicable and signs with credentials and an office stamp.
Download the current version from the source each time; forms change without notice.
USDA Forest Service: Fire Medical Qualifications Program - Vision
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The vision template states that Arduous positions require temporal peripheral vision of 85 degrees or greater, and Light or Moderate positions require 70 degrees or greater. The provider records each eye's measurement, taken since the employee's last OF-178 exam.
Visual acuity must have been performed since the last OF-178 exam or within the last six months, and peripheral vision since the last OF-178. Older results do not meet the form's instructions, so a current measurement may be needed before completing Part B.