Defense vision center planning on track after delays
April 19, 2009
WASHINGTON — The head of the Defense Vision Center of Excellence says planning and operations for the new program are now on track, after more than a year of delays and inattention from Pentagon officials.
Dr. (Col.) Donald Gagliano, executive director of the center, said creation of a new eye injury registry is under way, with staff under contract to begin coordinating the basic data needed to track different patients, wounds and types of treatment. The first system to share information with service and VA doctors could be ready next year.
"From just a month ago, we’ve made huge leaps," he said. "The Defense Department is taking this seriously now."
Last month, lawmakers criticized defense health officials for slow progress on the new center, designed to coordinate research and treatment options for troops with serious eye injuries. Gagliano admits that most of his time on the job so far has been spent focused on funding instead of patients and clinical data.
Legislation creating the vision center along with another for psychological health and traumatic brain injury was signed into law in January 2008. But while work on the TBI center began almost immediately, the vision project was largely ignored.
Gagliano wasn’t appointed director until last November, and $3 million in funding wasn’t set aside until after he began work. Only $7,000 was actually spent between November and March, and the center still lacks any permanent office space or support staff.
Last month Dr. Jack Smith, acting deputy assistant secretary of defense for clinical policy, told lawmakers funding was delayed because Congress did not allocate enough money for both the vision and TBI centers.
Dr. Thomas Zampieri, director of government relations for the Blinded Veterans of America, disputed that. He notes that more than $60 million was set aside for the TBI center, $10 million more than planned, while the $5 million vision project was left to languish.
"This is not the way you manage people with eye wounds," he said. "You don’t just ignore them."
Zampieri believes the problem was a lack of appreciation among defense officials for the scope of vision problems among returning troops. While post-traumatic stress disorder and brain injuries have garnered headlines, more common injuries such as vision and hearing problems have struggled for attention and funding.
In November, the Armed Forces Health Surveillance Center reported that active-duty troops suffered more than 60,000 cases of serious eye injuries between 1998 and 2007. A large percentage of those, including nearly all of the 5,000 penetrating eye wounds recorded, were suffered in Iraq and Afghanistan.
And those figures are just direct injuries; the Defense Veterans Brain Injury Center notes that about 70 percent of TBI patients also suffer indirect but potentially crippling vision problems.
"We’re talking about serious numbers here," Zampieri said.
Gagliano said officials with the Department of Veterans Affairs have been very cooperative in the effort, setting aside funds early and working closely with him on setup for the registry.
"What we haven’t had until now is the Defense Department stepping up to the plate," he said.
Members of the House Veterans Affairs Committee in March called the lack of progress embarrassing and unacceptable, telling Smith the program needs to be a top priority for the DOD. Since then, Gagliano said, more money has been released and he has been able to spend more time on actual vision care issues.
Zampieri said he’s still concerned that the center does not yet have permanent office space, even though a potential home has been identified inside the new Walter Reed National Military Medical Center.
He plans on resuming lobbying on Capitol Hill this week for money for offices, computers and more staff, and for pressure from Congress for the Pentagon to follow through on those necessities.
"It’s frustrating," he said. "This is a horror story. But now we have a chance to make something right with this project."