Another win for VA doctors of optometry

The U.S. Department of Veterans Affairs (VA) published new regulations implementing physician-level recognition for VA doctors of optometry, placing them alongside physicians, dentists and podiatrists, in a major win for the profession. 

Posted to the Federal Register on Oct. 24, the VA notice specifically calls attention to optometry’s placement in the annual pay table to “enhance the flexibility of the Department to recruit, develop and retain the most highly qualified optometrists to serve our nation’s veterans and maintain a standard of excellence in the VA health care system.”  

The changes, taking effect on Dec. 28, 2025, ensure VA doctors of optometry are added to the same clinical compensation structure as other VA physicians, dentists and podiatrists.   

“Doctors of optometry practicing and serving patients at the VA will now be recognized for the significance that optometry brings to the VA system,” says Deanna Alexander, O.D., chair of the AOA Federal Relations and Advocacy Action Committee. “This is a win for all of optometry to have our expertise valued and compensated fairly.” 

AFOS and AOA advocacy spurs change 

This achievement is the direct result of persistent advocacy and collaboration by dedicated volunteers and leaders from the Association of Armed Forces and Federal Optometric Services (AFOS) and the AOA, says Adam Preston, O.D., AFOS president. 

“Their continued engagement—including recent in-person meetings with congressional leaders in Washington, D.C.—helped generate the visibility and support necessary to move this long-delayed process forward,” he says. 

On Jan. 2, former President Joe Biden signed into law the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. The reform bill included a sweeping list of VA policies, such as adding optometry to the physician pay scale and giving the department the latitude to offer increased pay awards, bonuses and annual evaluations. 

Vision and eye health care is the third-most requested service by veterans—behind only primary care and mental health care—with VA doctors of optometry providing roughly 70% of essential primary and medical eye care services. Often the only licensed independent eye care practitioner available at their site, VA optometrists:  

• Practice at 95% of VA sites where eye care is offered. 
• Provide 73% of the 2.5 million selected ophthalmic procedures. 
• Provide 99% of services in low-vision clinics and blind rehabilitation centers.  

Yet despite the key role that optometry plays in the delivery of VA health care nationwide, VA optometrists were included in the general schedule (GS) pay scale, which has gone largely unchanged since 1976.   

When 2004 legislation created a new pay scale for allopathic and osteopathic physicians to remain competitive with private-sector opportunities, dentists, podiatrists and optometrists were initially left out. Over time, dentists and podiatrists were added to the physician pay scale, but optometry remained in the GS pay scale with a pay cap far below that of the private sector in many regions. The unfortunate consequence meant numerous vacant optometry positions at VA facilities went unfilled, a problem magnified by the fact that over 20% of the VA optometry workforce is at or near retirement with many having reached the legislative pay cap. 

This latest change marks a significant milestone in the VA’s recognition of the essential role doctors of optometry play in providing critical eye and vision care to veterans, says Lindsay Wright, O.D., AFOS executive director.  

“While additional work remains to ensure consistent and equitable implementation across all VA facilities, this progress represents a major step forward,” Dr. Wright says.