Working as an optometrist in the setting of a Veterans Affairs Medical Center is a unique and rewarding opportunity. I had the pleasure of rotating through two VAMC externship sites while a student at the SUNY College of Optometry then completing my residency at the Northport VAMC in Primary Eye Care, Vision Therapy and Low Vision Rehabilitation. I have now been on staff at the Northport VAMC for three years, and I am very grateful and proud to be a part of this national organization.
This article will give you a glimpse into what a typical workday at the Northport Veterans Affairs Medical Center entails and how this setting is special because of its patient population and involvement with optometric education/academia.
One thing I love about working in the VA eye clinic is that each day is different. The schedule includes a combination of direct patient care and teaching student interns and resident doctors. The day is broken down into morning and afternoon sessions, and each staff doctor is given an assignment per session; sessions usually differ from morning to afternoon and across days of the week. For example, I may have my own schedule of patients for direct patient care in the morning, and then supervise up to three student interns for afternoon clinics.
Specialty clinics, such as vision therapy and low vision, are also running a few days a week and these are mostly covered by the four resident doctors on a rotating schedule. This is all while our busy clinic is co-managing with the hospital’s ophthalmology department, incorporating whole-health practices, integrating with other medical services, and tailoring our optometric care to a very special population of veteran patients.
Working with veterans
VA optometry is unique and very rewarding. We serve a special population of deserving individuals and must hold ourselves to high standards of cultural competence. Since patients may have experienced physical or emotional trauma, the VA onboarding process requires extensive training and annual refreshers in the areas of sensitivity, non-discrimination, suicide prevention and more. This helps staff to recognize a veteran in need of assistance and how to coordinate the proper services to obtain help. It also allows the staff to understand what hesitations or concerns patients may have when seeking care at the VA, how to quell them, and how to help veterans feel most comfortable in this setting.
“The core values instilled in all VA employees are integrity, commitment, advocacy, respect, and excellence.”
Showing gratitude and compassion are musts when working at any VA hospital. One of the most important parts of any exam at the VA hospital is thanking the veteran patients for their service.
Working with this population in an optometry setting may necessitate some modifications to a typical eye exam. For example, there are additional history considerations to investigate, one of which is inquiring about head or eye injuries while in the service. Traumatic brain injury (TBI) from blast injuries or trauma can lead to visual symptoms, photosensitivity, headaches, balance issues and more. If this is the case, we may perform with a TBI symptom survey to investigate the specifics and guide our exam.
Working with interns and residents
Our clinic has the pleasure of hosting three to five student interns on quarterly rotations along with four resident doctors. The Optometry Residency at Northport VAMC is accredited by the Accreditation Council on Education (ACOE) and affiliated with the SUNY College of Optometry.
Each day begins with an educational lecture by either an attending doctor, student, or resident on an assigned topic. After a 1-hour lecture, clinic commences. Student interns spend most of their time in primary care/ocular disease clinic, while residents rotate through primary care/ocular disease and the specialty clinics of low vision/vision rehabilitation and vision therapy.
At the Northport VAMC we are fortunate to have a vision therapy clinic and low vision clinic. Much of the vision therapy performed centers around vision disorders resulting from TBI due to the patient population. Patients may be treated for conditions ranging from binocular vision disorders and oculomotor dysfunction to visual processing issues to visual scanning techniques status-post a new visual field defect. Weekly in-person therapy sessions and virtual sessions are available for veterans.
The Center of Balance is a sister clinic to the vision therapy clinic and involves a multidisciplinary exam by optometry, audiology, and physical therapy for patients who have complaints of dizziness or disequilibrium. The three services together form a treatment plan for the patient.
Low vision clinic evaluates veterans with reduced vision even despite best optical correction with typical glasses. Veterans can be fit with magnifiers, telescopes, and other helpful devices to assist with their activities of daily living. For example, check or document signing guides or a talking wrist watch may be dispensed if a veteran is having trouble with these tasks.
The Visual Impairment Center to Optimize Remaining Sight (VICTORS) takes these services one step further. Veterans with severe vision impairment are offered a more in-depth evaluation and assistance with higher powered magnifying devices, electronic magnifying devices, and the opportunity to work with a low vision rehabilitation therapist. This may be paired with orientation and mobility evaluation and training and an evaluation of the veteran’s home to ensure a safe environment.
An important part of VA Optometry is coordinating with other VA medical services. We frequently co-manage, refer to, and receive referrals from, our in-house ophthalmology service. Beyond that, we regularly coordinate with primary care, endocrinology, neurology, dermatology (and more) to ensure all members of the patient’s care team are on the same page.
An advantage of our electronic record system is the ability to access a patient’s clinical notes from other services and even other VA hospitals. This is especially helpful for blood work, A1c readings, and blood pressure reading.
Some additional professional opportunities that come along with VA Optometry are scholarships, student loan forgiveness and continuing education programs.
The Education Student Debt Reduction program is offered as an incentive to recruit qualified doctors to work in geographic areas that are in need. If this incentive is being offered, it will be listed in the optometry vacancy posting. If you are hired for the position, this is something you would discuss with HR to incorporate into your initial contract. As a federal employee you also become eligible for the Public Service Loan Forgiveness program.
If you are interested in pursuing higher education as a VA employee there are options to obtain monetary support. This includes the Employee Incentive Scholarship which can potentially cover all tuition for a graduate school program in exchange for service time working at the VA. The VA hospital also offers smaller scholarships ($1,000-1,500 per semester) for full-time employees pursuing further education related to their current job. In addition, the VA has many programs for career development and leadership training.
VA Optometry offers free COPE-approved continuing education courses (given by VA optometrists from all over the country) roughly once per month. While some courses are live and require registration, others are available through the learning portal to review and complete a final quiz on your own schedule.
For students, new grad ODs, and seasoned optometrists alike, practicing in a VA can offer immense academic and professional opportunities while also providing a much needed service to those who served us.
Interested in learning more?
Veterans Affairs optometry job openings can be found at the USAJobs website, and you can view the VA’s dedicated site to find Veterans Affairs optometry residency program information and updated listing of sites.