Paul Barney, OD, on caring for veterans, VA optometry scope

Paul Barney, OD, secretary-treasurer of the American Optometric Association (AOA) and center director at Pacific Cataract and Laser Institute began his career training in US Army and US Department of Veterans Affairs (VA) eye clinics. Now, he is a community care provider who frequently treats veterans. Barney spoke with Optometry Times about his experience in VA and active-duty care, as well as his 2023 congressional testimony advocating for a broad optometry scope of practice within the VA.

How did military and VA training shape Barney’s approach to care?

Barney trained at various facilities, including Tripler Army Medical Center in Honolulu, Hawaii, Schofield Barracks in Oahu, Hawaii, and a VA outpatient clinic in downtown Los Angeles, California. These experiences introduced him to the challenges veterans have in accessing eye care. “Many of them had…service-related injuries that compounded some of their visual problems, and that also compounded access to care for many of them,” he stated.

Glaucoma and cataracts are two of the most common eye conditions Barney saw in veterans. He also noted that trauma-related conditions are common, particularly traumatic brain injury-related eye problems.

What did Barney tell Congress about optometry in the VA?

In September 2023, Barney testified before the House Committee on Veterans’ Affairs Subcommittee on Health. The hearing examined the VA’s effort to establish national standards of practice for clinicians treating veterans, regardless of an individual state’s scope of practice laws. Barney advocated for a VA standard that reflects optometrists’ full education and training, including anterior segment laser and surgical procedures. In his testimony, he discussed patient’s limited access to ophthalmologists in their area, training standards for optometrists performing laser and surgical procedures, and malpractice rates.¹

“Currently, the national standard of practice for optometry in the VA system hasn’t been determined,” Barney told Optometry Times. “It’s a local decision by the local VA, and it would allow the maximum standard of practice for that state.” The community care program allows optometrists to perform anterior segment laser and surgical procedures in states that allow it. As a community care provider in Alaska, Barney performs anterior segment laser procedures for his patients who are veterans.

What should optometrists know about caring for veterans?

Barney provided advice for optometrists who see veterans, whether through community care or within the VA. He emphasized that, while veterans tend to be from an older demographic, caring for them is not unlike caring for any other patient. He urged optometrists to keep in mind that traumatic stress-related conditions and injuries from combat may affect vision. Barney continues to work with the AOA’s federal advocacy group on issues related to scope, reimbursement, and the VA. “If we're not careful, we could see scope privileges taken away from us. We could also see situations where we're not fairly reimbursed for the services that we provide,” he said.

References

1. VA’s federal supremacy initiative: Putting veterans first? Congress.gov. September 19, 2023. Accessed November 5, 2026. https://www.congress.gov/118/chrg/CHRG-118hhrg53767/generated/CHRG-118hhrg53767.htm