Phakic intraocular lenses (PIOLs) are gaining popularity as an alternative to wearing spectacles for correction of myopia in patients who are not appropriate candidates for traditional corneal refractive surgery (CRS). Although the visual outcome of such a procedure is at least equivalent to traditional CRS (i.e., photorefractive keratectomy, laser-assisted in situ keratomileusis), the risks and complications are different. This risk profile must be considered when evaluating an airman with PIOLs for medical clearance. This case involves an otherwise healthy applicant for Class-3 medical certification who has had these lenses implanted for the correction of myopia.