Department of Veterans Affairs PG-18-9: Space Planning Criteria

Veterans Health Administration December 2008

Washington, DC 20420 Revised: October 03, 2016

CHAPTER 233: EYE CLINIC

1 PURPOSE AND SCOPE ...........................................................................................233-2

2 DEFINITIONS ............................................................................................................233-2
3 OPERATING RATIONALE AND BASIS OF CRITERIA ............................................233-4
4 INPUT DATA STATEMENTS ....................................................................................233-5
5 SPACE CRITERIA .....................................................................................................233-6
6 PLANNING AND DESIGN CONSIDERATIONS ......................................................233-12
7 FUNCTIONAL RELATIONSHIPS ............................................................................233-13
8 FUNCTIONAL DIAGRAM ........................................................................................233-14

Chapter 233: Eye Clinic - Page 1 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

1 PURPOSE AND SCOPE

This document outlines Space Planning Criteria for Chapter 233: Eye Clinic. It applies to
all medical facilities at the Department of Veterans Affairs (VA).
2 DEFINITIONS
Accessible: A site, building, facility, or portion thereof that complies with provisions
outlined in the Architectural Barriers Act of 1968 (ABA).
Architectural Barriers Act (ABA): A set of standards developed to insure that all buildings
financed with federal funds are designed and constructed to be fully accessible to
everyone. This law requires all construction, renovation, or leasing of sites, facilities,
buildings, and other elements, financed with federal funds, to comply with the
Architectural Barriers Act Accessibility Standards (ABAAS). The ABAAS replaces the
Uniform Federal Accessibility Standards (UFAS).
Affiliated: An arrangement whereby a school of medicine or optometry agrees to staff a
VA facility with faculty physicians (ophthalmologists), optometrists, residents and interns /
externs. In return, the VA provides the medical or optometry school with a venue to train
new physicians / optometrists. In this arrangement, the VA retains responsibility for the
care of its patients while the school of medicine or optometry retains responsibility for all
graduate level education and training.
Clinic Stop: A clinic stop is one encounter of a patient with a healthcare provider. Per
these criteria, the clinic stop is the workload unit of measure for space planning. One
individual patient can have multiple clinic stops in a single visit or in one day.
Eye Care Provider: An Optometrist or Ophthalmologist who examines, diagnoses, treats,
prescribes medication, and manages the care of patients within his or her clinical
privileges as established by the governing body of a healthcare organization.
Full-Time Equivalent (FTE): A staffing parameter equal to the amount of time assigned to
one full time employee. It may be composed of several part-time employees whose total
time commitment equals that of a full-time employee. One FTE equals a 40 hours per
week.
Functional Area: The grouping of rooms and spaces based on their function within a
clinical service. Typical Functional Areas are Reception Areas, Patient Areas, Support
Areas, Staff and Administrative Areas, Residency and / or Internship / Externship
Program Areas.
Input Data Statement: A set of questions designed to elicit information about the
healthcare project in order to create a Program for Design (PFD) based on the criteria
parameters set forth in this document. Input Data Statements could be Mission related,
based in the project’s Concept of Operations; and Workload or Staffing related, based on
projections and data provided by the VHA or the VISN about the estimated model of
operation. This information is processed through mathematical and logical operations in
VA-SEPS.
Low Vision: Vision considered being inferior to normal vision, as represented by accepted
standards of acuity, field of vision, or motility, and uncorrectable by conventional lenses,
or the branch of visual care identified with its correction or rehabilitation by special aids or
techniques.
Low Vision Training: Training an individual with low vision to use his or her residual
vision. This may also include training in the use of low vision and other aids in everyday

Chapter 233: Eye Clinic - Page 2 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

situations and activities of daily living. Low Vision Services including Basic, Intermediate,
Poly-trauma Facility, Advanced, Visual Impairment Center to Optimize Remaining Sight
(VICTORS), Poly-trauma Rehabilitation Network Site, as well as Poly-trauma
Rehabilitation Center which may include Low Vision Services have separate staffing,
space, and workload requirements based upon the level and intensity of vision
rehabilitation care provided.
Ophthalmologist: An ophthalmologist is a physician who specializes in the
comprehensive care of the eyes and visual system. An ophthalmologist is medically
trained and qualified to diagnose and treat all eye and visual system problems. An
ophthalmologist can deliver total eye care as well as diagnose general diseases of the
body. An ophthalmologist has completed 4 years of college premedical training, 4 or
more years of medical school, 1 year of internship, and 3 years or more of specialized
medical training and experience in eye care. An additional 1 to 3 years may be spent in
sub-specialty training. Source: VHA Handbook 1121 (July 5, 2002): VHA Eye Care.
Optometrist: Doctors of Optometry are independent primary health care providers who
examine, diagnose, treat, and manage diseases and disorders of the visual system, the
eye and associated structures, as well as diagnose related systemic conditions. An
optometrist typically completes 4 years of baccalaureate training and 4 years of
optometry training. Residency training is 1 year beyond attainment of the optometry
degree. Source: VHA Handbook 1121 (July 5, 2002): VHA Eye Care.
Net-to-department gross factor (NTDG): This number, when multiplied by the
programmed net square foot (NSF) area, determines the departmental gross square feet
(DGSF) The NTDG factor adopted for Eye Clinic is 1.60.
Program for Design (PFD): A space program based on criteria set forth in this document
and specific information about Concept of Operations, workload projections and staffing
levels authorized.
Room Efficiency Factor: A factor that provides flexibility in the utilization of a room to
account for patient delays, scheduling conflicts, and equipment maintenance. Common
factors are in the 80 to 85% range. A room with 80% room efficiency provides a buffer to
assume that this room would be available 20% of the time beyond the planned
operational practices of the room. This factor may be adjusted based on the actual and/or
anticipated operations and processes of the room / department.
SEPS (VA-SEPS): Acronym for Space and Equipment Planning System, a digital tool
developed by the Department of Defense (DoD) and the Department of Veterans Affairs
to generate a Program for Design (PFD) and an Equipment List for a VA healthcare
project based on specific information entered in response to Input Data Questions. VA-
SEPS incorporates the propositions set forth in all VA Space Planning Criteria chapters.
VA-SEPS has been designed to aid healthcare planners in creating a space plan based
on a standardized set of criteria parameters.
Visual Fields: The area or extent of physical space visible to an eye in a given position.
Its average extent is approximately 65 degrees upward, 75 degrees downward, 60
degrees inward, and 95 degrees outward when the eye is in the straightforward position.
Workload: Workload is the anticipated number of procedures or suite stops that is
processed through a department/service area. The total workload applied to
departmental operational assumptions will determine overall room requirements by
modality.

Chapter 233: Eye Clinic - Page 3 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

3 OPERATING RATIONALE AND BASIS OF CRITERIA

A. Workload Projections or planned services / modalities for a specific VA medical
center, hospital or satellite outpatient clinic project are provided by the VA Central
Office (VACO) / VISN CARES Capacity Projection Model. The workload projections
are generated by methodology based upon the expected veteran population in the
respective market / service area. Healthcare planners working on VA medical center,
hospital or satellite outpatient clinic projects will utilize and apply the workload based
criteria set forth herein for identified services and modalities to determine room
requirements for each facility.
B. Space planning criteria have been developed on the basis of an understanding of the
activities involved in the functional areas of the Eye Clinic and its relationship with
other services of a medical facility. These criteria are predicated on established
and/or anticipated best practice standards, as adapted to provide environments
supporting the highest quality heath care for Veterans.
C. These criteria are subject to modification relative to development in the equipment,
medical practice, vendor requirements, and subsequent planning and design. The
selection of the size and type of Eye Clinic equipment is determined by VACO and
upon Veterans Health Administration (VHA) anticipated medical needs.
D. Room capacity per year should be based on:
Operating days per year x Hours of operation per day
= Number of
Minutes per clinic stop / 60 minutes annual clinic stops
1. The general planning model for VA facilities assumes 250 Operating Days per
Year and 8 Hours of Operation per Day. Room capacity will fluctuate as hours of
operation are modified, i.e., additional capacity may be generated by extending
the daily hours of operation within the same physical setting.
2. The Basic Room Efficiency Factor for Optometry is 80% (affiliated/non-affiliated).
The Efficiency Factor for Ophthalmology is 70% (affiliated/non-affiliated).
3. Average length of procedure for affiliated Optometry and Ophthalmology is 40
minutes, and for non-affiliated Optometry and Ophthalmology is 32 minutes.
Example: Assume an exam / treatment room for Optometry that averages 40
minutes per clinic stop:
250 operating days per year x 8 hours of operation per day
= 3,000 annual
40 minutes per clinic stop / 60 minutes clinic stops
A maximum capacity of 3,000 clinic stops per year, assuming 100% utilization.
However, 100% utilization is not realistic to achieve, thus, it is not realistic as a
design standard. Apply Room Efficiency Factor for an affiliated facility:
3,000 x 80% = 2,400 annual clinic stops.

Chapter 233: Eye Clinic - Page 4 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

TABLE 1: WORKLOAD PARAMETER CALCULATION

MINIMUM
AVERAGE WORKLOAD
LENGTH OF TO
CLINIC STOP UTILIZATION GENERATE
EYE CLINIC (minutes) RATE ONE ROOM
Optometry
Affiliated 40 80% 2,400
Non-Affiliated 32 80% 3,000
Ophthalmology
Affiliated 40 70% 2,100
Non-Affiliated 32 70% 2,625
The number of annual clinic stops per room will be used as a criteria
parameter to calculate the number of Exam / Treatment Rooms in the Space
Criteria section of this document.
4 INPUT DATA STATEMENTS
A. Mission Input Data Statements
1. Is Ophthalmology Service authorized? (M)
a. Is an affiliated Ophthalmology program authorized? (M)
2. Is Optometry Service authorized? (M)
a. Is an affiliated Optometry program authorized? (M)
3. Is an Eyeglass Fitting and Display, and Dispensing Room authorized? (M)
4. Is Ultrasound / Optical Coherence Tomography authorized? (M)
5. Is an Eye Procedure room authorized? (M)
6. Is a Laser Room authorized? (M)
7. Is an Electodiagnosis Room authorized? (M)
8. Is a Patient Education / Contact Lens Dispensing Room authorized? (M)
9. Is an Eyeglass Frame Storage Room authorized? (M)
10. Are Advanced Low Vision Services authorized? (M)
11. Are VICTORS Low Vision Services authorized? (M)
12. Is Intermediate or Polytrauma Facility Vision Rehabilitation Services authorized?
(M)
13. Is a Low Vision Exam / Training Room authorized? (M)
14. Is a Consultation / Viewing Room authorized? (M)
15. Is a Conference Room for the Staff and Administrative Area authorized? (M)
16. Is an Ophthalmology Residency Program authorized? (M)
17. Is an Optometry Residency Program authorized? (M)
B. Workload Input Data Statements
1. How many annual Ophthalmology clinic stops are projected? (W)
2. How many annual Optometry clinic stops are projected? (W)
C. Staffing Input Data Statements
1. How many Ophthalmology Section Chief FTE positions are authorized? (S)
2. How many Optometry Section Chief FTE positions are authorized? (S)
3. How many Clerical FTE positions are authorized? (S)
4. How many Ophthalmologist FTE positions are authorized? (S)
5. How many Optometrist FTE positions are authorized? (S)
6. How many Nurse Manager FTE positions are authorized? (S)
7. How many Administrative FTE positions are authorized? (S)

Chapter 233: Eye Clinic - Page 5 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

D. Miscellaneous Input Data Statements

1. Is a Resident Training Room for the Education Area authorized? (Misc)
2. How many FTE positions will work on peak shift? (Misc)
3. How many FTE positions are not authorized to have an office or work space?
(Misc)
5 SPACE CRITERIA
A. FA 1: Reception Area:
1. Waiting (WTG03) ....................................................................... 80 NSF (7.5 NSM)
Provide one if the projected number of Optometry and Ophthalmology Exam /
Treatment Rooms is two; provide WTG06 if the projected number of Optometry
and Ophthalmology Exam / Treatment Rooms is three or four; provide WTG09 if
the projected number of Optometry and Ophthalmology Exam / Treatment Rooms
is five or six; provide WTG12 if the projected number of Optometry and
Ophthalmology Exam / Treatment Rooms is seven or eight; provide WTG15 if the
projected number of Optometry and Ophthalmology Exam / Treatment Rooms is
nine or ten; provide WTG18 if the projected number of Optometry and
Ophthalmology Exam / Treatment Rooms is eleven or twelve; provide WTG21 if
the projected number of Optometry and Ophthalmology Exam / Treatment Rooms
is thirteen or fourteen; provide WTG24 if the projected number of Optometry and
Ophthalmology Exam / Treatment Rooms is fifteen or sixteen; provide WTG27 if
the projected number of Optometry and Ophthalmology Exam / Treatment Rooms
is seventeen or eighteen; provide WTG30 if the projected number of Optometry
and Ophthalmology Exam / Treatment Rooms is nineteen or twenty; provide
WTG33 if the projected number of Optometry and Ophthalmology Exam /
Treatment Rooms is twenty-one or twenty-two; provide WTG36 if the projected
number of Optometry and Ophthalmology Exam / Treatment Rooms is twenty-
three or twenty-four; provide WTG39 if the projected number of Optometry and
Ophthalmology Exam / Treatment Rooms is twenty-five or twenty-six.
WTG03: Allocated space accommodates one standard chair @ 9 NSF, one
bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total
three people.
WTG06: Allocated space accommodates four standard chairs @ 9 NSF each, one
bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total
six people.
WTG09: Allocated space accommodates seven standard chairs @ 9 NSF each,
one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation;
total nine people.
WTG12: Allocated space accommodates ten standard chairs @ 9 NSF each, one
bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total
twelve people.
WTG15: Allocated space accommodates eleven standard chairs @ 9 NSF each,
two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and
circulation; total fifteen people.
WTG18: Allocated space accommodates fourteen standard chairs @ 9 NSF each,
two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and
circulation; total eighteen people.

Chapter 233: Eye Clinic - Page 6 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

WTG21: Allocated space accommodates seventeen standard chairs @ 9 NSF

each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF
each, and circulation; total twenty-one people.
WTG24: Allocated space accommodates twenty standard chairs @ 9 NSF each,
two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and
circulation; total twenty-four people.
WTG27: Allocated space accommodates twenty-one standard chairs @ 9 NSF
each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF
each, and circulation; total twenty-seven people.
WTG30: Allocated space accommodates twenty-four standard chairs @ 9 NSF
each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF
each, and circulation; total thirty people.
WTG33: Allocated space accommodates twenty-seven standard chairs @ 9 NSF
each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF
each, and circulation; total thirty-three people.
WTG36: Allocated space accommodates twenty-eight standard chairs @ 9 NSF
each, four bariatric chairs @ 14 NSF each, four accessible spaces @ 10 NSF
each, and circulation; total thirty-six people.
WTG39: Allocated space accommodates thirty-one standard chairs @ 9 NSF
each, four bariatric chairs @ 14 NSF each, four accessible spaces @ 10 NSF
each, and circulation; total thirty-nine people.
2. Reception (RCP02) ............................................................... 260 NSF (24.2 NSM)
Provide one for Eye Clinic.
Allocated NSF accommodates two Receptionist FTEs, patient privacy area, and
circulation.
3. Toilet, Public (TNPG1) .............................................................. 60 NSF (5.6 NSM)
Provide two for Eye Clinic.
Allocated NSF accommodates one accessible toilet @ 25 NSF, one wall-hung
lavatory @ 12 NSF, ABA clearances, and circulation. One for male and one for
female.
B. FA 2: Patient Area:
1. Exam / Treatment Room, Optometry (EYOT2) .................. 130 NSF (12. 1 NSM)
Provide one for every increment of 2,400 annual Optometry clinic stops projected
if program is affiliated; provide one for every increment of 3,000 annual
Optometry clinic stops projected if program is not affiliated. (See Table 1)
2. Exam / Treatment Room, Ophthalmology (EYOT2) .......... 130 NSF (12. 1 NSM)
Provide one for every increment of 2,100 annual Ophthalmology clinic stops
projected if program is affiliated; provide one for every increment of 2,625 annual
Ophthalmology clinic stops projected if program is not affiliated. (See Table 1)
3. Waiting, Dilation (WTG03) ........................................................ 80 NSF (7.5 NSM)
Provide one for the Eye Clinic.
Allocated space accommodates one standard chair @ 9 NSF, one bariatric chair
@ 14 NSF, one accessible space @ 10 NSF, and circulation; total three people.

Chapter 233: Eye Clinic - Page 7 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

4. Visual Fields Room (EYVF1) ................................................ 120 NSF (11.2 NSM)

Minimum one; provide an additional one for every increment of five Optometry
and Ophthalmology Exam / Treatment Rooms.
The Visual Fields Room accommodates testing, evaluation, and monitoring of the
visual fields of a patient who may or may not be ambulant. This room may also be
used as a patient’s darkroom adaptation. One room will be provided in smaller
clinics and used for both manual and automated perimetry. A movable partition
separating the equipment should be provided. In larger clinics, two separate
rooms will be used for manual and automated perimetry.
5. Photography Room (EYVF1) ................................................ 150 NSF (14.0 NSM)
Minimum one; provide an additional one if the total number of Optometry and
Ophthalmology Exam / Treatment Rooms is greater than five.
6. Pre-testing Room (EYVS1) ................................................... 120 NSF (11.2 NSM)
Minimum NSF; provide an additional 50 NSF if the total number of Optometry and
Ophthalmology Exam / Treatment Rooms is greater than five.
The Pre-testing Room is used by the technician to assist in the performance of
preliminary testing and preparation of the patient’s profile with the supervision of
the optometrist or ophthalmologist. In Eye Clinics with greater than five Optometry
and Ophthalmology Exam / Treatment Rooms, space for a rotary screening
center which provides visual field screening, visual acuity, auto-refractor, auto-
lensometer, auto-tonometer, auto-keratometry, and auto-biometry instruments
located on a single table may be provided.
7. Eyeglass Fitting and Display,
and Dispensing Room (EYFD1) ........................................... 140 NSF (13.1 NSM)
Provide one if an Eyeglass Fitting and Display, and Dispensing Room is
authorized.
The Eyeglass Fitting and Display, and Dispensing Room is used by the technician
to assist in the fitting, adjustment, repair, and dispensing of eyeglasses. An area
for the display of eyeglasses should be included.
8. Ultrasound / Optical Coherence
Tomography Room (XDUS1) ................................................ 180 NSF (16.8 NSM)
Provide one if an Ultrasound / Optical Coherence Tomography Room is
authorized.
Diagnostic uses of the Ultrasound Room are for the location of unseen intraocular
foreign bodies, for retinal detachment, and for internal view when the patient’s eye
lid can not be opened or the patient’s eye is blocked by blood or cataracts
impeding the examiner’s view. The Ultrasound Room is provided with ultrasound
equipment with diagnostic A and B modes, a calculation / computer for intraocular
lens calculations, and a reclining patient chair. The Optical Coherence
Tomography Room for ocular imaging may be combined within the Ultrasound
Room space allocation.
9. Eye Procedure Room (EYOT2) ............................................. 220 NSF (20.5 NSM)
Provide one if an Eye Procedure Room is authorized.
The Eye Procedures Room is designed for any treatment that requires surgical
intervention that is deemed “an office procedure”. Procedures commonly

Chapter 233: Eye Clinic - Page 8 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

performed in this space are chalazion excisions, tarsorrhaphy, biopsy, eyelid

tumors, suture external eyelid lacerations, and pterygium removal.
10. Laser Room (TREY2) ............................................................ 130 NSF (12.1 NSM)
Provide one if a Laser Room is authorized.
The Laser Room accommodates treatment of ocular problems including diabetic
retinopathy, glaucoma, retinal detachment, occludable angles/ocular
hypertension. Equipment commonly provided is laser instruments, a laser cart, a
slit lamp delivery system, and safety equipment. The Laser Room may include
more than one laser system.
11. Electrodiagnosis Room (EYER1) ........................................ 150 NSF (14.0 NSM)
Provide one if an Electrodiagnosis Room is authorized.
The Electrodiagnosis Room accommodates visual digitized equipment for
conducting electro-oculographic, electroretinographic, and visual evoked cortical
potential testing of retina, optic nerve, and visual pathway functioning with
analysis.
12. Exam / Training Room, Low Vision (EYOT2)...................... 180 NSF (16.8 NSM)
Provide one if Low Vision Exam / Training Room is authorized.
The Low Vision Examination / Training Room is used for the examination of low
vision patients, storage of low vision devices, and for minor training and education
for adult daily living skills.
13. Training Room, Low Vision / Polytrauma (EYOT2)............ 400 NSF (37.2 NSM)
Provide one if Intermediate or Polytrauma Facility Vision Rehabilitation Services
are authorized.
The Low Vision / Poly-Trauma Training Room is used to provide vision
rehabilitation care. Patient education and eye care counseling sessions are
conducted so that patients can learn how to use prescribed low vision and other
aids in order to perform everyday skills, activities of daily living, and to improve
their overall functional independence. If Advanced, VICTORS, Poly-trauma
Rehabilitation Network Site or Polytrauma Rehabilitation Center Vision
Rehabilitation Services are authorized, two rooms are recommended.
14. Patient Education /
Contact Lens Dispensing Room (EYCL1) .......................... 130 NSF (12.1 NSM)
Provide one if a Patient Education / Contact Lens Dispensing Room is authorized.
The Patient Education / Contact Lens Dispensing Room is used to educate
patients about their eye diseases and vision conditions, instruct them on the
proper use and instillation of eye medications, provide training in the insertion and
removal of contact lenses, and dispense contact lenses.
C. FA 3: Support Area:
1. Supply Room, Clean (UCCL1) ................................................. 80 NSF (7.4 NSM)
Provide one for the Eye Clinic.
The Clean Supply Room provides storage for medical supplies used in the
delivery of patient care. It should be accessible from the corridor and located near
the Eye Procedure Room.

Chapter 233: Eye Clinic - Page 9 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

2. Utility Room, Soiled (USCL1) ................................................... 80 NSF (7.5 NSM)

Provide one for the Eye Clinic.
The Soiled Utility Room provides an area for cleanup of equipment, utensils, and
for disposal of waste material. It provides a temporary holding area for material
that will be picked up by Supply, Processing, and Distribution (SPD). It should be
accessible from the main corridor and located near the Eye Procedure Room.
3. Medication Preparation Room (MEDP1) .................................. 80 NSF (7.5 NSM)
Provide one for the Eye Clinic.
The Medication Preparation Room should be secured and provide storage for
medication. It should be accessible only from within the staff area.
4. Storage, Equipment (SRE01)................................................ 120 NSF (11.2 NSM)
Provide one for the Eye Clinic.
5. Storage Alcove, Medical Equipment (RCA01) ........................ 15 NSF (1.4 NSM)
Provide one for the Eye Clinic.
The Medical Equipment Storage Alcove is reserved for storage of equipment,
such as a crash cart, requiring monitoring by the eye clinic staff. The alcove
should be located in the clinic area but out of the main traffic flow.
6. Storage Alcove, Wheelchair (SRLW1) ..................................... 40 NSF (3.8 NSM)
Provide one for the Eye Clinic.
7. Storage, Eyeglass Frame (SRS01) ........................................... 80 NSF (7.5 NSM)
Provide one if Eyeglass Frame Storage is authorized.
8. Housekeeping Aides Closet (HAC) (JANC1) ........................... 60 NSF (5.6 NSM)
Minimum one; provide an additional 40 NSF per each additional increment of five
Exam / Treatment rooms greater than five.
D. FA 4: Staff and Administrative Area:
1. Office, Ophthalmology / Optometry Chief (OFA09) .............. 100 NSF (9.3 NSM)
Provide one if Ophthalmology or Optometry Service is authorized.
2. Office, Ophthalmology Service Chief (OFA09) ..................... 100 NSF (9.3 NSM)
Provide one if Ophthalmology Service is authorized.
3. Office, Optometry Service Chief (OFA09) ............................. 100 NSF (9.3 NSM)
Provide one if Optometry Service is authorized.
4. Waiting (WTG03)........................................................................ 80 NSF (7.5 NSM)
Provide one if Ophthalmology or Optometry Service is authorized.
Allocated space accommodates one standard chair @ 9 NSF, one bariatric chair
@ 14 NSF, one accessible space @ 10 NSF, and circulation; total three people.
5. Workstation, Secretary (OFA07) .............................................. 56 NSF (5.3 NSM)
Provide one if Ophthalmology or Optometry Service is authorized.
6. Workstation, Clerical (OFA07) .................................................. 56 NSF (5.3 NSM)
Provide one per each Clerical FTE position authorized.
7. Workstation, Eyecare Provider (OFA07) ................................. 56 NSF (5.3 NSM)
Provide one per each Ophthalmologist and Optometrist FTE position authorized.

Chapter 233: Eye Clinic - Page 10 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

8. Office, Social Work / Intake /

Adjustment Counseling (OFA04) ........................................ 120 NSF (11.2 NSM)
Provide one if Advanced Low Vision Clinic or VICTORS is authorized.
9. Nurse Workroom (WRCH1) .................................................. 120 NSF (11.2 NSM)
Provide one for the Eye Clinic.
10. Support Equipment Area (SRE01) .......................................... 40 NSF (3.8 NSM)
Provide one for the Eye Clinic.
11. Office, Nurse Manager (OFA09) ............................................ 100 NSF (9.3 NSM)
Provide one per each Nurse Manager FTE position authorized.
12. Workstation, Administration (OFA07)..................................... 56 NSF (5.3 NSM)
Provide one per each Administrative FTE position authorized.
13. Consult Room / Viewing Room (XVC01)............................. 175 NSF (16.3 NSM)
Provide one if a Consultation / Viewing Room is authorized.
The Consultation / Viewing room will provide staff, residents, and extern / intern
students an area to review specific case information as it relates to patient
examination and treatment. The confidential nature of this information should be
considered when planning this area.
14. Conference Room (CFR01) .................................................. 240 NSF (22.3 NSM)
Provide one if a Conference Room is authorized.
Allocated NSF accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x
2’-0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six
people. If Conference Room is programmed or available in potentially adjacent
clinic space, program only one space for maximum of two adjacent clinics.
15. Lounge, Staff (SL001) ............................................................... 80 NSF (7.5 NSM)
Minimum NSF; provide an additional 15 NSF per each Eye Clinic FTE position
working on peak shift greater than five; maximum 210 NSF.
16. Locker Room, Staff (LR001)..................................................... 80 NSF (7.5 NSM)
Minimum NSF if total number of Eye Clinic FTE positions not authorized to have
office or work space is between five and thirteen; provide an additional 6 NSF per
each Eye Clinic FTE position not authorized to have office or work space is
greater than thirteen.
Provide locker space only for those FTEs without assigned office or work space.
For less than five FTE combine Locker Room facilities with adjacent department
or sum in chapter 410.
17. Toilet, Staff (TNPG1) ................................................................. 60 NSF (5.6 NSM)
Minimum one; provide an additional one for every increment of fifteen Eye Clinic
FTE positions working on peak shift greater than fifteen.
Allocated NSF accommodates one accessible toilet @ 25 NSF, one wall-hung
lavatory @ 12 NSF, ABA clearances, and circulation.
E. FA 5: Education Area:
1. Office, Ophthalmology Residency Director (OFA09) .......... 100 NSF (9.3 NSM)
Provide one if Ophthalmology Residency is authorized.

Chapter 233: Eye Clinic - Page 11 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

2. Office, Optometry Residency Director (OFA09) ................... 100 NSF (9.3 NSM)
Provide one if Optometry Residency is authorized.
3. Training Room, Resident (CFR01) ....................................... 240 NSF (22.3 NSM)
Provide one if a Resident Training Room for the Education Area is authorized.
Allocated NSF accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x
2’-0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six
people.

6 PLANNING AND DESIGN CONSIDERATIONS

A. Net-to-department gross factor (NTDG) for Eye Clinic is 1.60. This number when
multiplied by the programmed net square foot (NSF) area determines the
departmental gross square feet.
B. The Eye Clinic should be located adjacent to the Ambulatory Care Clinic (Hospital
based).
C. The recommendations of these criteria are based on workload / number of clinical
stops at the Eye Clinic. An alternative staffing-generated method is based upon
having 2.5 Exam / Treatment Rooms per 1.0 FTE eye care provider (Optometrist or
Ophthalmologist), 1.0 FTE Eye Technician per 1.0 FTE eye care provider as well as
adequate clerical and administrative support. For workload planning purposes, there
are about two annual eye care provider visits per unique veteran. The number of
unique veterans seen at any VA facility will vary dependent upon the prevalence and
complexity of ocular disease conditions in the veteran population served. With a
higher incidence of mental health disorders and/or long term care patients, there is
expected to be fewer unique veterans receiving eye care services. The more
ambulatory procedures performed, the potentially fewer unique veterans receiving
care. For optometry, the majority of primary eye care services provided includes a
comprehensive eye examination with refraction, so although there may be fewer
visits, there will be a greater number of unique patients receiving care.
D. Exam / Treatment Rooms should be designed to accommodate the specialized
equipment required for eye testing. Windows to the exterior may be provided but total
room darkening capability should be able to be attained. Each Exam / Treatment and
Low Vision Examination / Training room should be provided with a hand washing
sink, paper towel dispenser, and waste receptacle. The sink needs to be provided
with either wrist blades or motion sensors for infection control purposes. Light
dimming should be available. The rooms should be designed to accommodate the
specialized equipment required for eye testing that includes special ophthalmic
equipment stand arms and ability to move / glide the patient examination chair
necessary for wheelchair, scooter, or gurneys patients.
E. Patient corridors should be a minimum of 8’-0” wide, to accommodate wheelchairs,
motorized scooters, or gurneys.
F. Consideration should be given to the effects of building vibration, as building vibration
could interfere with the accuracy of patient testing.

Chapter 233: Eye Clinic - Page 12 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

7 FUNCTIONAL RELATIONSHIPS
Relationship of Eye Clinic to services listed below:
TABLE 2: FUNCTIONAL RELATIONSHIP MATRIX
SERVICES RELATIONSHIP REASONS
Ambulatory Care 1 H,I
Pharmacy-Outpatient Satellite 2 G,H,I
Radiology-Outpatient Satellite 2 G,H,I
Pharmacy-Inpatient 3 G,H
Prosthetics Service 3 G,H
Supply Service-SPD 3 B

Legend:
Relationship: Reasons:
1. Adjacent A. Common use of resources
2. Close / Same Floor B. Accessibility of supplies
3. Close / Different Floor Acceptable C. Urgency of contact
4. Limited Traffic D. Noise or vibration
X. Separation Desirable E. Presence of odors or fumes
F. Contamination hazard
G. Sequence of work
H. Patient’s convenience
I. Frequent contact
J. Need for security
K. Others (specify)
L. Closeness inappropriate

Chapter 233: Eye Clinic - Page 13 of 14

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration December 2008
Washington, DC 20420 Revised: October 03, 2016

8 FUNCTIONAL DIAGRAM

Chapter 233: Eye Clinic - Page 14 of 14