This part of the Medical Manual provides guidelines to Medical Examiners (MEs) in relation to a number of medical conditions that may be of Aeromedical significance. This manual must be used in conjunction with any applicable legislation: Civil Aviation Act 2023, Civil Aviation Rule Part 67 and General Directions.
Where any doubt or contradiction exists, the legislation provisions, inclusive of the General Directions, take precedence. Guidelines should be applied using judgement. Departure from them is acceptable when medical evidence justifies. Such justification should be fully explained in the documentation provided to the Central Medical Unit.
This document is not intended to be a textbook in Aviation Medicine. It is intended to be a living document. Medical Examiners (MEs) wishing to print this manual should check regularly on the Civil Aviation Authority (CAA) website that they are using a current version. Suggestions for improvements are welcome.
The CAA website provides a number of links. Medical Examiners need to be aware however that local legislation, or CAA policies and opinion, may be different from overseas policies.
ICAO Medical Manual(external link) - Manual of Civil Aviation Medicine
CASA Medical Manual(external link) - Designated Aviation Medical Examiner's Handbook
* Developed in collaboration with CASA Medical.
Adrenal gland disorder – Addison Disease
Alcohol and other drugs (AOD) - interim guidelines
Asthma *
Atrial and ventricular premature beats
Atrial fibrillation (AF) and atrial flutter
Atrio-ventricular block (AV block)
Attention-deficit/hyperactivity disorder (ADHD) *
Cardiovascular risk assessment *
Cataract *
Cerebrovascular diseases / accidents
Chronic Obstructive Pulmonary Disease (COPD)
Consciousness loss (non-traumatic)
Demyelinating disease & optic neuritis
Functional and true monocularity
Glaucoma and ocular hypertension *
GLP-1 medication (weight loss) *
HIV - Post-Exposure Prophylaxis (PEP) *
HIV - Pre-Exposure Prophylaxis (PrEP) *
Implantable collamer lenses (ICLs)
Implantable devices - Pacemaker
Inner ear disease and vestibulo-cochlear nerve
Left anterior and left posterior hemi-block
Left Bundle Branch Block (LBBB)
Loss of consciousness (non-traumatic)
Non-spontaneous (secondary) Pneumothorax
Pneumothorax (primary - spontaneous)
Pneumothorax (secondary - non-spontaneous)
Recurrent tonsillitis, tonsillectomy
Right Bundle Branch Block (RBBB)
Sinus node arrest and sinoatrial block
Spontaneous (primary) Pneumothorax
Tympanic membrane and middle ear disease
Tricuspid and pulmonary valve disease
If you have any questions about this topic, use our contact form, or email med@caa.govt.nz.
