Jarett Mazzarella, OD, on his career as a VA optometrist

Jarett Mazzarella, OD, is the optometry service chief at the W.G. "Bill" Hefner VA Medical Center in Salisbury, North Carolina, which is part of the Salisbury VA Health Care System within the US Department of Veterans Affairs (VA). In this Q&A, Mazzarella discussed what drew him to VA optometry, the eye conditions he sees most often in veterans, challenges faced by patients and providers, and advice for optometrists interested in caring for this population.

Editor's note: This interview has been lightly edited for clarity and length.

What motivated you to pursue VA optometry?

Jarett Mazzarella, OD: Both of my grandfathers were veterans, and watching what they gave for their country taught me early what service means. Veterans are the heroes of our nation. Having the privilege of caring for their eyes gives my work a sense of purpose and fulfillment that I have not found anywhere else. It is an honor to provide the highest level of care possible to those who have served this country.

Can you discuss a defining early experience providing care within the VA health system?

Mazzarella: I was fortunate to complete my VA optometry residency at the Salisbury VA Health Care System, the same facility where I now serve as optometry service chief. That year shaped my career goals and led me to choose VA as my long-term path.

VA operates the largest optometry residency program in the country, and the experience I gained was unmatched. I was able to practice to my full potential while caring for some of the nation's most deserving Americans. I developed a strong sense of pride and community in being part of something larger than myself. To this day, nothing compares to seeing what better vision means for a veteran, whether it is making daily tasks easier or helping them return to a hobby they love. Optometrists can make a real difference in veterans' lives.

What are the most common eye conditions you see among your patient population? Are there conditions related to military service, such as traumatic brain injury, that optometrists should be aware of?

Mazzarella: Veterans can face a set of eye health challenges related to their service. Traumatic brain injury (TBI) is a major concern. Many veterans with TBI may experience blurred vision, double vision, light sensitivity, and difficulty reading. Blast-related injuries can damage the retina, optic nerve, and other structures of the eye, and some of that damage can be permanent.

Low vision and vision rehabilitation services help veterans improve their visual function and maintain their independence in daily life. According to VA Blind Rehabilitation Services, via the Office of Research and Development, approximately 130,000 veterans are legally blind, and a substantial number have low vision that affects daily living.¹ The veteran population is also aging, which raises the risk of macular degeneration, glaucoma, cataract, and diabetic retinopathy. These conditions can often be compounded by other service-connected health concerns, which is why the integrated care VA provides is so valuable to our veterans.

What does a routine eye exam look like for your veteran patients? Are there specific preventive screenings you prioritize for this population?

Mazzarella: A routine exam begins with a detailed history, including a conversation about the veteran's overall health, current medications, work and leisure activities, any eye concerns, and the impact of vision on daily activities. We then check visual acuity, eye movements, visual fields, and pupil function, and we evaluate refractive error to determine spectacle needs. The anterior segment is examined, intraocular pressure is measured, and the eyes are dilated for a thorough posterior segment evaluation.

Based on the findings and the veteran's history, we may use additional testing such as retinal photography, optical coherence tomography, and threshold visual field testing. These tests facilitate early detection of glaucoma and macular degeneration, identification of ocular side effects from high-risk medications, and diabetic eye examinations to detect diabetic retinopathy and diabetic macular edema, among other ocular conditions.

These practices follow American Optometric Association guidance for optometrists and VA clinical standards. Our eye clinic also prioritizes suicide risk screening and timely connection to resources to help prevent veteran suicide, partnering with other services to support a holistic approach to veteran care. VA also identifies veterans who may have been exposed to burn pits, airborne hazards, contaminated water, Agent Orange, radiation, and other toxic substances during their service with the PACT Act Toxic Exposure Screening. This screening helps connect the veteran with the appropriate health care and benefits related to their exposure.

What does access to eye care look like for veterans in your region, particularly those in rural areas?

Mazzarella: Veterans in our region can receive in-person eye care at VA medical centers, VA health care centers (HCCs), and community-based outpatient clinics (CBOCs) across the Southeast. For veterans in rural communities, telehealth offers another option, bringing care closer to home and reducing travel time and cost. Some VA facilities also operate mobile medical units that take care directly into communities. Where appropriate, based on the MISSION Act, VA partners with community providers so eligible veterans can receive care near where they live.

What challenges do your patients face when it comes to attending eye exams?

Mazzarella: Distance and transportation remain the most common barriers. Many veterans travel long distances to reach a clinic, and for some, the time and cost of travel make regular appointments difficult. VA continues to address these barriers through expanded telehealth, community care partnerships, and long-term facility planning.

How does the referral process to ophthalmology work? Are your patients typically referred within the VA system or through community care?

Mazzarella: Optometry and ophthalmology work together as a team to provide comprehensive eye care and address complex eye conditions. Within VA's integrated system, veterans receive both surgical and nonsurgical ophthalmology referrals. This collaboration is guided by Veterans Health Administration (VHA) Directive 1121(2), VHA Eye and Vision Care, which establishes national VA policy for the delivery of comprehensive, interdisciplinary eye and vision services, as well as preferred practice patterns and the American Optometric Association's clinical practice guidelines.

Many referrals remain within VA, while others are coordinated through community care when eligibility criteria are met. Under the MISSION Act, enrolled veterans may be eligible for community care when they meet one of several criteria, including wait time and drive time standards, the unavailability of a needed service, the absence of a full-service VA facility, quality standards, best medical interest, and grandfathered Choice Act eligibility.

What are the specific challenges you face as a VA optometrist that your colleagues should be aware of? What should optometrists outside VA know?

Mazzarella: Many veterans live with service-connected conditions, such as posttraumatic stress disorder and chronic toxic exposure, which can influence eye findings, including light sensitivity and dry eye. VA providers receive focused training to recognize these connections and to coordinate care across specialties. Veterans deserve care informed by their full health history and their service. Hearing their stories and helping them see clearly is among the most meaningful parts of our work as VA optometrists.

For optometrists considering a career path, VA is a rewarding place to practice. Approximately 1100 optometrists serve veterans nationwide, and VA offers one of the largest optometry training programs in the country, which supports VA's education mission to drive innovation, advance knowledge, and enhance collaboration. VA is also the largest integrated health care system in the nation, with opportunities for professional growth and advancement, a strong focus on work-life balance and wellness, competitive pay, loan repayment and forgiveness programs, comprehensive health insurance, and federal retirement benefits.

If you are looking for a career with a meaningful mission of serving those who served, guided by VA's core values of integrity, commitment, advocacy, respect, and excellence, I encourage you to consider VA.

Reference

1. Vision loss. US Department of Veterans Affairs Office of Research & Development. Accessed November 2, 2026. [INSERT DIRECT research.va.gov URL]