Vision Conservation and Readiness

Local Vision Conservation and Readiness Program Guidance

Last Updated: April 22, 2019
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"An effective Army Vision Conservation and Readiness Program (VCRP) promotes and optimizes vision and optical readiness. The VCRP is essential to assure a safe and healthful working environment and applies to garrison, field training, and deployment environments. An effective VCRP is implemented and administered using the procedures, principles, and guidance provided in DA Pam 40–506 and 29 CFR 1910 and includes occupational vision, eye safety, and environmental vision components." (from DA PAM 40-11 Preventive Medicine External Link)

"The most effective method of preventing eye injury and promoting visual efficiency is by establishing an integrated installation/division level Vision Conservation and Readiness Team (VCRT). The VCRT should include a Vision Conservation and Readiness Officer (VCRO), a local occupational health (OH) professional/ technician, a worksite hazard evaluation coordinator, and a safety officer/technician..."  (as stated in DA PAM 40-506, The Army Vision Conservation and Readiness Program  External Link)

"Vision services include preventive eye care to reduce or eliminate conditions that may decrease personnel readiness in performing their mission and which could result in members being removed from their duty unit for treatment. Vision services also ensure the Service member has eye protection, decreasing the occurrence of sight-threatening injuries among military personnel. Service members should have all needed devices to protect their eyes to ensure they complete the mission and do not pose a logistical burden to their unit."  (from JP 4-02 Joint Health Services External Link )

Every site has some sort of vision conservation and vision readiness program already in place.  There are protocols for performing hazard assessments and the identification of processes that require the use personal protective equipment such as eye protection and policies to enforce compliance with of their use already in place.  Every site is required to do a health assessment including the assessment of their vision on all active duty personnel each year as well as requirements for medical surveillance for all workers performing certain tasks or working with certain agents. A  Vision Conservation and Readiness Program is simply a part of each of those programs.

The reality is that, without someone emphasizing occupational vision, it often becomes less important as other issues arise since there are not that many eye injuries being reported or investigated.  The VCRO should be the subject matter consultant and primary proponent of vision conservation and vision readiness at the local level. Their primary responsibilities are:

  1. To ensure that eye and vision safety and surveillance programs operate as necessary; and
  2. To monitor and review the incidences of eye injuries that occur at their site and recommend protocols, if needed, to reduce the number of injuries occurring. 

The VCRO should be simply making certain that those activities specific to vision and ocular health are being achieved through reviews of the existing programs and processes.  Having someone whose focus is vision conservation, occupational vision, and vision readiness provides those involved with Safety and Occupational Health at each site someone who has a focused perspective and, as a result, can be a valuable asset to their team.  For additional information:

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Primary Elements of a Local VCRP

Occupational Vision

  • Perform pre-placement, periodic, and termination vision screenings
  • Ensure required vision standards (e.g., Emergency vehicle operators) are being met
  • Determine the vision ready status of military and deployable DA civilians

Eye Safety

  • Perform in a timely fashion worksite hazard assessments and ensuring that appropriate risk controls are in place
  • Provide education/training about appropriate eye protection, PPE, and the benefits of vision conservation consistent with Occupational Safety and Health Administration (OSHA) requirements

Environmental Vision

  • Perform worksite analyses for evaluating levels of illumination to ensure optimum job performance
  • Promote appropriate ergonomics and visual environment assessments to ensure optimal visual performance for all workers including computer/digital devise users

Additional Elements of a Local VCRP

Advice, Education and Training

  • Provide advice, education/training on vision conservation and readiness to commanders, Local Medical Authority, supervisors, and employees

Medical Management

  • Assist in establishing local policies and protocols on work-related emergent/urgent vision/ocular health problems
  • Maintain a Vision Surveillance Program and ensure that all personnel required to be in the program are being assessed
  • Provide education about the management of occupational eye injuries and disease
  • Injury Surveillance
    • Monitor eye injury data – organization/installation
    • Develop/implement intervention strategies based on the surveillance data

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Planning a Local VCRP

While only the Army has a requirement for an actual VCR Program in writing, other sites at other Services should consider having a simplified program which may be as simple as identifying someone as the VCRO who will act as a subject matter expert on vision and eye related matters for the site.  However, the most effective way to prevent eye injuries, promote efficiency, and improve readiness is by executing an integrated program which will meet the specific needs of an organization or installation - there are more than one way to accomplish this.  Options include:

  • Forming a fully functional VCRT with all of the key members actively involved and meeting regularly; or
  • Having someone who is the VCRO who utilizes available resources when needed to monitor and evaluate vision related policies and eye injury trends.
  • Start by defining what is the ideal solution and what is the practical “local” solution - what can actually be achievable.
    • Ideal might be post-wide, integrated program
    • Practical might be a subset of institutions based on needs and priorities
    • Remember that the decision also will require command support, medical support, as well as support from the customers.

Steps in Planning a Local Program

  1. Identify the stakeholders - who should be part of the program.
    • A local VCRT should include representatives from Preventive Medicine, Occupational Health, Industrial Hygiene (Bioenvironmental Engineers), Safety, Optometry and/or Ophthalmology as well as other interested parties.
  2. These representatives should then meet to determine:
    • What elements of the program currently exist (such as the prescription safety glasses "program")?
    • What should be the scope of the local program?
    • What are the current needs and priorities for the program?
    • What are the roles of the individual members of the VCRT?
    • How often does the team need to meet?
      • This can  vary from place to place.  Initially meeting more often assists in the creation of the team.  Once established, meeting quarterly, semi-annually, as part of another meeting where vision is discussed such as the Safety and Occupational Health Council meetings and if something occurs which requires the team getting together to discuss the issue should suffice.

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Role of the Vision Conservation and Readiness Officer (VCRO)

As the local primary proponent of vision conservation and vision readiness - provides leadership to the VCRT

  • Defines priorities/needs/requirements for the local program
  • Develops and implements the local program emphasis
  • Develops and implements local protocols such as ensuring the effectiveness of current vision screening, vision or eye safety hazard and worksite assessment programs, referral criteria, emergency procedures and other items related to vision conservation and vision readiness
  • Monitors local eye injury and readiness trends as reported in the local surveillance process
  • Responsible for reporting requirements of the program

Roles of Key Members of the VCR Team

Even though local sites may not have a formal VCRT, there are still responsibilities according to current regulations.  These responsibilities include:

Safety and Occupational Health (SOH) Personnel

  1. Represent management
  2. Manage the Safety Program and ensure that all aspects of the program (including the requirement for a Vision Conservation Program for the Army) are being met.
  3. Provide or ensure that proper safety training (including eye safety) is being accomplished.
  4. Ensure hazard assessments are performed in a timely manner.
  5. Assist in the selection of personal protective equipment and other controls such as the installation of eyewash stations and emergency showers.
  6. Establish procedures for identifying hazards from the results of mishap investigations and injury and illness reports.
  7. Maintain  a current listing of all areas and processes that:
    1. Require eye protection; and
    2. Require eye wash or deluge shower facilities and their locations and ensure that the weekly and annual testing is being performed by someone.
  8. Usually will be the team member responsible for eye injury data.

Industrial Hygiene (IH) and Bioenvironmental Engineering (BE) Personnel

  1. Perform Occupational and Environmental Health (OEH) assessments for new processes or processes not previously assessed within 3 months of being identified or for before the process has been performed more than three times, whichever is longer and identify associated risks and hazards  (including eye hazards).
  2. Perform workplace surveys as scheduled through the master schedule (and other emergency or urgent situations as necessary) to ensure IH hazards are recognized and evaluated.  Works with SOH personnel to ensure that all sites are evaluated at least annually.
  3. Assess and document eye hazards, eye protection required and used, and proper illumination levels during workplace evaluations.
  4. Recommend engineering controls (to include illumination levels), administrative controls, and eye and face protection to eliminate or control eye hazards and assist in the evaluation of the effectiveness of those controls.
  5. Identify appropriate medical surveillance (including those requiring vision surveillance) recommendations from worksite evaluations.
  6. Enter survey and IH hazard data in the DOEHRS–IH including those selected for Vision/Sight Conservation surveillance programs.
  7. Notify OH program personnel when workers are recommended for medical surveillance - at least annually.
  8. Coordinate with the installation Occupational Safety office to ensure that the appropriate type PPE is selected and utilized and the workers are properly trained on their use.
  9. Coordinate with the installation Occupational Safety office to determine the appropriate type and location of Eyewash Stations and Emergency Showers.
  10. Usually will be the team member, along with the SOH member,  responsible for identifying new issues or procedures that need to be addressed by the team.

Occupational Health (OH) Personnel

  1. Medical surveillance program management including:
      1. Validation of personnel identified for vision surveillance as part of a medical surveillance programs based on industrial hygiene data.
    1. Medical surveillance examinations.
    2. Job certification examinations.
  2. Treatment and referral (if indicated) of work-related injuries and illnesses
  3. Occupational injury and illness case management to restore workers to optimal health and productivity.
  4. Worksite consultations when requested.
  5. Epidemiological assessments of available injury and illness data to assist with prevention efforts and reduction of lost work time.
  6. Recommend engineering controls, administrative controls, and eye protection to eliminate or control eye hazards.
  7. Usually will be the team member that notifies the team of sudden increases in eye injuries and issues with vision surveillance programs.

Optometrists, Ophthalmologists and other Eye Care Professionals

  1. Act as an SME for the team and those involved in occupational vision and vision readiness.
  2. Assist with policies and protocols on vision and vision performance issues.
  3. Provide consults when requested, such as:
    1. Failed vision screenings
    2. Use of special optical devices
    3. Assist with workplace accommodation recommendations for vision related matters
  4. Provide education on the management of occupational eye injuries and disease, protective eyewear, readiness, first aid for eye injuries... teaching those that do the vision testing how to properly do and score the vision screening tests... when requested.
  5. Provide care for work-related eye injuries when appropriate.

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Practical Considerations

  1. Identify and prioritize needs/requirements
    1. Address management or leadership concerns
    2. Review installation eye injury data such as DoD Eye Injury Data, Strategic Management System data, Safety, Workers Comp data...
    3. Review local contracts for their specific requirements - Situation can vary for both government union personnel and contractors
    4. Identify needed protocols and SOPs - Most likely the current process is not well defined
      1. Often, identification, tracking and screening of workers requiring vision surveillance requires a VCR Team coordination (e.g., IH and OH)
    5. Prioritize units/shops based on VCRT or management concerns, past inspection reports, injuries, readiness status...
  2. Add vision conservation to the post safety committee agenda (at small sites this may be all that is required).
  3. Consider performing education and training at various levels to increase VCR visibility
  4. "Publish your wins" in the installation newspaper, website, safety newsletter...
  5.  Periodically evaluate the VCR Program and its effectiveness
    1. Review required surveillance
      1. Vision/optical readiness - be familiar with requirements and support the units when necessary.
      2. Local prescription safety glasses program and the processes, turnaround times, choices and quality of the available products, contracts in place...
      3. Vision screening and the process of identifying, tracking and properly screening required workers.
      4. Eye injury surveillance - should be a part of the required medical surveillance reporting requirement - need to simply:
        1. Review the data for eyes as to the consistency between who is reporting the information.
        2. Monitor trends to identify issues and concerns that the command should be informed of.
      5. Review current protocols and SOPs - are they current and clear enough?
      6. Determine if the Program needs a shift in priorities and/or emphasis.

VCRP Reporting

Reporting to us once a year should normally be sufficient unless something occurs that warrants a more timely notification such as a new type of potential eye hazard, eye injuries due to a new procedure or type of equipment... 

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Still need more assistance?

The TSVCR team at APHC is here to help you establish and maintain an effective Vision Conservation and Readiness Program at your installation.  If you have any questions or comments, please do not hesitate to contact us by phone at 410-436-2464 or by email at:  

usarmy.apg.medcom-aphc.mbx.dcpm-tri-service-optometry@mail.mil

We are also available to provide Site Assistance Visits where we can come to your site and, if necessary, provide additional instruction.  To request that or other assistance, either contact us directly or go to the Mission Services Request Make certain to select "Vision Conservation and Readiness" as the Subject of Request.