Recent letters from members of Congress and physician groups to Department of Veterans Affairs health officials highlight growing concerns that a potential new national standard of practice could allow VA-employed optometrists to perform laser eye surgery — significantly lowering the quality of surgical eye care in VA health facilities.
These latest actions reinforce previous messaging to the Department of Veterans Affairs that members of Congress and the physician community are concerned that the loosening of eye surgery standards could put veterans’ surgical eye care at risk.
In a Dec. 22 letter (PDF) to assistant Under Secretary for Health for Clinical Services Erica M. Scavella, MD, U.S. Reps. Mariannette Miller-Meeks, MD, R-Iowa, and Julia Brownley, D-Calif., expressed deep concern that a Nov. 6 memo suggested “optometrists may already be performing certain surgeries in VA Medical Centers and in contravention of VA policy.”
The Nov. 6 memo was an internal VA communication requesting all VA Medical Centers to report if the optometrists on staff are privileged to perform eye surgery by state licensure and mandated that all Department of Veteran Affairs optometrists “stop performing laser eye procedures at VA medical facilities” in accordance with long-standing VA policy. The Academy called on ophthalmology's congressional champions to seek more answers from the VA on what this memo means for the quality of surgical eye care that veterans are currently receiving in VA health facilities.
Dr. Miller-Meeks and Rep. Brownley are the chair and ranking member of a key committee with VA oversight. Academy CEO Stephen D. McLeod, MD, testified to the committee in September on the development of national standards of practice in VA health facilities.
Dr. Miller-Meeks and Brownley seek answers to how some VA-employed optometrists at some VA medical centers may have been allowed to perform surgery, contrary to current policy. They also expressed doubts that the VA could ensure its health facilities will adequately abide by any finalized standard of practice. The VA has until Jan. 19 to respond.
The American Academy of Dermatology Association, the American College of Radiology, and the American Society for Dermatologic Surgery Association have also expressed deep concerns for how any changes in VA policy could undermine access to high-quality surgical eyecare.
In a Jan. 8 letter (PDF) to Under Secretary of Health Shereef Elnahal, MD, these organizations said, “Allowing individuals who are not medical doctors or trained surgeons, such as optometrists, to perform such surgeries would undeniably place our veterans in elevated risk to injury resulting in the need for additional procedures or in a worst-case scenario loss of vision.”
They go on to outline that management of the many risks inherent to eye surgery, such as excessive eyelid bleeding, cannot be adequately grasped in a “16-hour mini course, which is the current standard of optometric training in incisional surgeries.”
The Academy anticipates the VA will issue more national standards this year, so we are pleased to see Congress exercising its oversight responsibilities of the VA.
Now is the time for all ophthalmologists to get engaged. You can join the Academy’s campaign to protect veterans’ access to high quality surgical eye care.
You can also donate to the Academy’s OPHTHPAC fund to ensure pro-ophthalmology candidates are elected to Congress this election year