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Honorable Jeff Denham

Honorable Jeff Denham, U.S. House of Representatives, 10th Congressional District, California

Testimony of Rep. Jeff Denham

Despite making improvements in the backlog of veterans’ care in the VA via the CHOICE Act, there remains long wait times for patients to be seen within the VA. Eye care clinics staffed by VA doctors of optometry, including residents, are among the busiest primary care settings in the veterans’ health care system. As you know, lengthy wait times can make it more difficult and even discourage veterans from seeking care they need. H.R. 1688 is aimed at improving access to primary eye care in the VA by making a modest increase in the number of optometry residency positions in the VA. My bill seeks to amend the Choice Act by designating 20 of the 1,500 new graduate medical education residency positions to the field of optometry.

Although, VA optometrists provided comprehensive eye exams and other essential care to more than 1.2 million veterans last year, the need for eye health and vision care is expected to grow further in the coming years. Serious eye trauma is the second most common injury among those who served in Iraq and Afghanistan, with 16 percent of all wounded service members experiencing problems ranging from distorted vision to blindness (according to the Armed Forces Health Surveillance Center). Additionally, the joint Department of Defense / Department of Veterans Affairs Vision Center of Excellence has reported that up to 75 percent of all traumatic brain injury patients experience vision problems.

The VA is the largest integrated health care provider in the country and plays a leadership role in defining the education of future doctors of optometry. Through its partnerships with affiliated academic institutions, the VA optometry residency program has grown to be the largest clinical optometry training program and accounts for 50% of the profession’s residency training. Optometry residents are valuable members of the health care team; they can provide early diagnosis and treatment for such vision threatening conditions as diabetic eye disease and neurological disorders, preventing costly procedures and rehabilitation later. Also, optometry residents, as members of the primary care team of medical providers, screen and refer veterans for untreated hypertension, diabetes and other systemic diseases.

These much needed primary health services are not available at all VA medical facilities and the demand outpaces the supply. Increasing the number of optometry residents at the VA is one way to enhance the VA’s ability to address chronic patient care backlogs as well as train doctors of optometry in advanced practices.  VA officials recently recognized the importance of eye exams in keeping veterans healthy and active in a March 2015 advisory they issued stating, “The eye is the only place in the human body that a functioning nerve, arteries and veins can be viewed without cutting the body open. These are all evaluated during the eye examination and reveal a lot about a person’s general health. Early signs of diabetes, hypertension, atherosclerosis and carotid artery stenosis are often detected with an ocular health exam, and lead to diagnosis and management of these life threatening conditions.”

Since the VA established its first optometry residency in the 1970s, the program has proven to be an especially cost-effective force-multiplier to boost the eye care team and make veterans healthier and more engaged in their own care. I would appreciate your support on H.R. 1688 to improve access to this important care for our veterans by adding 20 additional optometry residents to the VA over the next 10 years.