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Senior VA and DOD Representatives Confirm Development of Military Eye Trauma Center of Excellence and Registry

Legislative Update
April 14, 2008

Left to right:  Colonel Robert Mazzoli, M.D., F.A.C.S., Assistant Secretary of Defense S. Ward Cascells, M.D., AAO President-Elect Michael Brennan, M.D., and VA Secretary James Peake, M.D.
Left to right: Colonel Robert Mazzoli, M.D., F.A.C.S., Assistant Secretary of Defense S. Ward Cascells, M.D., AAO President-Elect Michael Brennan, M.D., and VA Secretary James Peake, M.D.
At an April 11 session entitled Ophthalmology on the Front Lines, held during the American Academy of Ophthalmology’s (AAO) Mid-Year Forum, James Peake, M.D. (Secretary of Veterans Affairs, Department of Veterans Affairs, VA) and S. Ward Casscells, M.D. (Assistant Secretary of Defense for Health Affairs, Department of Defense, DOD), announced that their departments were working jointly on establishing a Military Eye Trauma Center of Excellence ("Center") that would develop a Military Eye Injury Registry ("Registry"). The Center would address the prevention, diagnosis, mitigation, treatment, and rehabilitation of eye injuries, while the Registry would track the diagnosis, surgical intervention, and follow up for each significant case of eye injury incurred by a member of the Armed Forces while serving on active duty.

Left to right: AAO President David Parke II, M.D. (Dean McGee Eye Institute) and AAO Executive Vice President H. Dunbar Hoskins, Jr., M.D., chat with VA Secretary Dr. Peake and Dr. Brennan
Left to right: AAO President David Parke II, M.D. (Dean McGee Eye Institute) and AAO Executive Vice President H. Dunbar Hoskins, Jr., M.D., chat with VA Secretary Dr. Peake and Dr. Brennan
The creation of the Center and Registry within the DOD—but with close coordination with the VA—was contained in provisions of theMilitary Eye Trauma Treatment Act (METTA)that were included in the Fiscal Year (FY) 2008 National Defense Authorization Act, passed in late January 2008. Although authorized by the legislation, these programs were not funded. Dr. Peake and Dr. Casscells confirmed testimony that their staffs presented in an April 2 hearing on Traumatic Brain Injury (TBI)-related vision disorders by the Subcommittee on Oversight and Investigations of the House Veterans’ Affairs Committee that the programs were in an initial stage of development. Neither senior official provided a timeframe for the launch of these programs, citing the funding challenges.

Dr. Peake and Dr. Cascells were joined by James Orcutt, M.D., Ph.D. (VA National Program Director of Ophthalmology) and Colonel Robert Mazzoli, M.D., F.A.C.S. (Consultant in Ophthalmology to the Surgeon General of the Army) in providing their thoughts to the AAO attendees on how the Center and Registry should be constructed. Noting that he "talked with or emailed Dr. Orcutt just about every day" on issues relating to the programs, Dr. Mazzoli made three important points:

  • The Center should consist of a network of regional sites that can conduct services ranging from diagnosis to rehabilitation, with a centralized administrative office

  • The DOD should not duplicate the VA’s extensive network of vision rehabilitation centers, but focus on complementary efforts

  • Although the METTA-required Center and Registry are DOD programs, they must represent a coordinated effort between the DOD and VA
All of the speakers noted the DOD and VA challenges regarding combat-related eye injuries, including better understanding of and providing comprehensive care for eye trauma and visual disorders associated with TBI, as well as how to ensure portability of medical records that facilitates a seamless transition between the two departments.

Earlier in the week, AAO member James Chodosh, M.D., M.P.H. (Dean McGee Eye Institute/University of Oklahoma) joined NAEVR Executive Director James Jorkasky and Advocacy Manager David Epstein in visits with House and Senate champions for the continued eligibility of eye and vision research in the DOD’s Peer Reviewed Medical Research Program (PRMRP) in FY2009 defense appropriations. Eye and vision research has been eligible since FY2006 (in which vision research accounted for 12 percent of all grant awards), and the grant award mechanisms for the FY2008 cycle were announced in late March, with a pre-application deadline of June 4, 2008, and proposal deadline of July 2, 2008.

Randy Kardon, M.D., Ph.D. (University of Iowa Hospitals and Clinics and the VA) spoke about visual rehabilitation for soldiers with TBI-related disorders. Dr. Kardon is also a recipient of a DOD/PRMRP award from the FY2006 funding cycle, with research focusing on laser injuries.
Randy Kardon, M.D., Ph.D. (University of Iowa Hospitals and Clinics and the VA) spoke about visual rehabilitation for soldiers with TBI-related disorders. Dr. Kardon is also a recipient of a DOD/PRMRP award from the FY2006 funding cycle, with research focusing on laser injuries.
Earlier in the week, NAEVR’s James Jorkasky (left) and James Chodosh, M.D., M.P.H. (Dean McGee Eye Institute, right) met with Heath Bumgardner in the office of Cong. Jim Moran (D-VA), in whose district the Pentagon is located
Earlier in the week, NAEVR’s James Jorkasky (left) and James Chodosh, M.D., M.P.H. (Dean McGee Eye Institute, right) met with Heath Bumgardner in the office of Cong. Jim Moran (D-VA), in whose district the Pentagon is located