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National Standards of Practice: What the VA is Doing

The U.S. Department of Veterans Affairs (VA) oversees America’s largest integrated health care system, providing care at 1,255 health care facilities and serving 9 million enrolled veterans each year. 


In 2021, the VA launched a project to establish national standards of practice for 50 categories of health professionals. The purpose is to create continuity and consistency across all VA facilities so the VA can deploy health care professionals quickly across the country to care for veterans and other beneficiaries without hindrance from state licensure, registration, certification or other state requirements. These standards could override state laws governing scope of practice and health professional licensure.   

Why You Should Be Concerned

As part of its national standards project, the VA is taking steps to allow optometrists to perform eye surgery on veterans.  


Optometrists are valued members of the eye care team who serve an important role, but they are not medical doctors or trained surgeons. Optometrists don’t have the medical education, surgical training, or clinical experience to perform eye surgery.  


That means if a veteran requires laser or other surgical eye care, there’s a possibility a provider who is not a trained surgeon would perform that surgery. 


Eye surgery is delicate and requires the skill and judgement only a highly trained and experienced surgeon can provide. A poor surgical outcome can be impossible to fix and result in vision loss or blindness. 

A standard of care that allows optometrists to perform eye surgery puts veteran patients’ health, safety, and vision at risk.
Military Medal


The VA’s long-standing standard of surgical eye care allows only ophthalmologists to perform laser surgical eye procedures on veterans, which is consistent with the standard of medical care in the overwhelming majority of states. This policy ensures that there is a system-wide quality standard for laser surgical eye care and that all veterans – regardless of where they live – have access to the eye care provider with the appropriate education, training and professional experience needed to perform their eye surgery.

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