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68UE1-E3

Eye Specialist

E-1 to E-3 (Junior Enlisted) · Army

HEADS UP

AIT at the AMEDDC&S (Army Medical Department Center and School) at JBSA-Fort Sam Houston is roughly 23 weeks. You will leave with the basics of autorefraction, lensometry, optical fabrication, and tonometry. Your gaining unit's optometrist will form a read of you in the first 30 days based on whether your screening numbers are consistent and whether your lab work comes back within tolerance. The CPOT (Certified Paraoptometric Technician) credential through ABO/NCLE is your first civilian-recognized goal — start studying before you leave AIT.

The Honest MOS Read
You signed for 68U Eye Specialist, and you are heading to or just left the AMEDDC&S at JBSA-Fort Sam Houston for AIT. The course is roughly 23 weeks of classroom and clinical instruction covering vision screening, autorefraction, tonometry, visual field testing, spectacle fabrication, frame fitting, and the basics of ocular anatomy and pathology. You will learn on the same equipment you will use at your first duty station — tabletop autorefractors, non-contact tonometers, lensometers, manual and semi-automated edgers, and the Humphrey visual field analyzer. The instructors are a mix of senior 68U NCOs and civilian optometric professionals, and the pace is clinical — you are learning healthcare skills, not tactical skills, and the tolerance for sloppy work is correspondingly low. Your gaining unit assignment determines whether you work in a standalone optometry clinic at a troop medical clinic (TMC), a department within a larger military treatment facility (MTF), or a deployable medical unit with an optometry capability. Most junior 68Us go to an MTF optometry clinic — places like Womack Army Medical Center at Fort Liberty, Darnall Army Medical Center at Fort Cavazos, or the optometry clinics at Fort Campbell, Fort Drum, Fort Stewart, or installations in Germany, Korea, and Hawaii. The job is the same everywhere: screen patients, run the lab, fit glasses, and keep the eye readiness posture green. The daily rhythm splits between two workstreams. The clinic side is patient-facing: you run the autorefractor and tonometer, measure PD (pupillary distance), do color vision testing with Ishihara plates, run visual acuity on the Snellen chart, and prepare the patient for the optometrist's exam. The lab side is production: you take the provider's prescription, select the appropriate lens blanks, edge and mount them on the edger, verify the finished pair on the lensometer against ANSI Z80.1 tolerances, and dispense them to the soldier with proper frame adjustment. In a busy clinic you will fabricate 15-30 pairs of spectacles per day. During SRP (Soldier Readiness Processing) surges before a deployment, that number can double. The readiness screening piece is the part of the job that touches the line units directly. AR 40-63 governs ophthalmic services, and AR 40-501 sets the vision standards for deployability and MOS qualification. A soldier who cannot be corrected to 20/20 in at least one eye, or who does not have serviceable spectacles and MCEP (Military Combat Eye Protection) inserts, is non-deployable. You are the technician who catches that gap at the screening station. When the battalion surgeon briefs the BDE commander that 97% of the battalion is eye-ready, that number came from your screening list. The civilian credential conversation starts now, not later. The CPOT (Certified Paraoptometric Technician) through the ABO (American Board of Opticianry) and NCLE (National Contact Lens Examiners) is the entry-level civilian credential that every optometrist's office recognizes. The COA (Certified Ophthalmic Assistant) through JCAHPO (Joint Commission on Allied Health Personnel in Ophthalmology) is the ophthalmology-side equivalent. Both are achievable during your first enlistment with study and the clinical hours you accumulate on the job. Do not wait until your ETS window to start studying — the optometrist you work for will mentor you through the material if you ask.
Career Arc
  • 01AIT at AMEDDC&S, JBSA-Fort Sam Houston — roughly 23 weeks of optometric and optical lab training.
  • 02PCS to gaining unit (MTF optometry clinic, TMC, or deployable medical unit).
  • 03Month ~6 TIS: E-2 (automatic per AR 600-8-19). Clinic orientation complete; running basic screenings independently.
  • 04Month ~12 TIS: E-3 / PFC. Running autorefraction, tonometry, and visual acuity lanes without direct supervision.
  • 05First SRP or deployment screening cycle — your screening station's throughput and accuracy are visible to the BN surgeon.
  • 06CPOT study plan initiated — target exam within first 24 months at the unit.
  • 07Month ~18-24: first re-enlistment window approaches. Credential status, clinic performance, and ACFT score are the decision inputs.
Common Screwups
  • ×Sleeping on TSP enrollment under BRS. The 1% automatic plus 4% match if you contribute 5% is the most valuable financial decision of your first enlistment — and medical MOSes lose the same money as combat arms when they skip it.
  • ×DUI or drug pop — separation under AR 635-200 ch.14. Medical MOSes are not exempt from the same UCMJ consequences as every other soldier.
  • ×ACFT fails. Repeated failures trigger flagging, no promotions, no schools, eventual chapter action. The clinic NCO has zero patience for a tech who cannot pass the fitness test while briefing soldiers on readiness.
  • ×Waiting until the ETS window to think about the CPOT. The credential requires study and a proctored exam; it is not something you cram in the last 60 days of your contract.
  • ×Getting comfortable in the clinic and neglecting military bearing — uniform standards, haircut, PT, and the common-task skills that the MTF NCOIC spot-checks. You are a soldier first and a technician second.

A Day in the Life

  • 0500Wake. Shave, uniform check, PT clothes on. The clinic does not excuse you from the standard.
  • 0530-0630PT formation with your assigned medical company or detachment. Unit PT — run days, lift days, recovery days. Medical units PT together; the clinic schedule starts after.
  • 0630-0800Hygiene, change to duty uniform, breakfast at the DFAC or barracks. Drive or walk to the clinic.
  • 0800Clinic opens. Power on the autorefractor, lensometer, tonometer, and edger. Calibration check on the lensometer (verify against the test lens). Pull the day's patient schedule from MHS GENESIS. Check the lab work-order queue for spectacles in progress.
  • 0815-1130Morning clinic flow. Screen patients for the optometrist — visual acuity, autorefraction, tonometry, color vision, PD measurement. Between patients, work the lab queue — edge lenses, mount, verify, dispense. Frame adjustments for walk-ins. Document everything in MHS GENESIS.
  • 1130-1300Lunch. DFAC or barracks. The lab queue does not stop — if you are behind on production, you eat fast and come back to the edger.
  • 1300-1600Afternoon clinic flow. More screenings, more lab production. Walk-in frame adjustments and spectacle repairs. Contact lens insertion/removal training if the clinic handles contacts. Restock lens blanks and frames from supply.
  • 1600-1630Clinic close-out. Shut down equipment, clean the autorefractor and tonometer heads, file the day's work orders, update the lab production log. Brief the clinic NCOIC on the day's throughput and any exceptions.
  • 1630-1700Company or detachment final formation. Announcements, accountability, sensitive items check. Released.
  • 1700-2000Personal time. Gym, barracks, errands. The smart cherry 68U uses 30 minutes of this for CPOT study — the credential does not earn itself.
  • 2000-2200Study, phone calls, rest. Review the STP 8-68U13 tasks you have not been signed off on. The clinic NCOIC's next validation is closer than you think.
  • SRP / Deployment SurgeThe clock changes. Screening stations run 0700-1800 or longer. You process 80-150 soldiers per day through the eye readiness lane. The lab runs double shifts to fill spectacle and MCEP insert orders. Meals are when you can grab them. The surge lasts 3-7 days per battalion and then the next battalion cycles through.

Weekly Cadence

The Mon-Fri rhythm for a junior 68U is dictated by the clinic schedule, not the field training calendar. Monday is high-tempo — the weekend's walk-in spectacle repair requests pile up, the autorefractor queue is full from soldiers who skipped Friday sick call, and the lab has work orders that need to ship. Tuesday through Thursday is steady-state clinic flow: morning screenings, afternoon lab production, walk-ins scattered throughout. Friday is often the lighter clinic day — the optometrist may have admin time blocked, and the lab catches up on the week's backlog. The second rhythm is the readiness calendar. When a battalion enters SRP or deployment processing, the clinic pivots from steady-state to surge mode. Screening stations multiply, the lab runs extended hours, and MCEP insert orders spike. These surges happen on a cycle tied to the installation's deployment schedule — sometimes quarterly, sometimes less predictably. The junior tech's job during a surge is to run the screening station cleanly and keep the lab producing without dropping quality. The third rhythm is training. Monthly AMEDD training events, annual competency verification (per TC 8-800), quarterly equipment calibration checks, and the ongoing CPOT study plan. The clinic NCOIC schedules training around the patient flow — usually Tuesday or Thursday afternoon when the appointment book is lighter. The junior tech who treats training time as free time instead of credential-building time is the one who ETSes without the CPOT and walks into the civilian market at a disadvantage.

Key Skills — How to Drill Each

  1. 01
    Perform automated refraction (autorefractor) and manual lensometry — read and record sphere, cylinder, axis, and add power without transposing errors.
    Practice the transposition formula (converting between plus-cylinder and minus-cylinder notation) until it is automatic. The autorefractor gives you an objective starting point; the lensometer confirms what the patient is currently wearing. Run both on every patient, compare the readings, and flag discrepancies for the optometrist. The tech who hands the provider a clean, accurate pre-screening saves 5 minutes per patient — and the provider notices.
  2. 02
    Measure intraocular pressure with a non-contact tonometer (NCT) or Tono-Pen — and know when a reading flags for immediate referral.
    Position the patient correctly every time — chin on the rest, forehead against the bar, eyes wide open, looking straight at the fixation target. A poorly positioned patient gives you artificially high readings and sends the optometrist chasing a false positive. Anything above 21 mmHg gets flagged; anything above 30 mmHg gets the optometrist immediately. Practice on your peers during slow clinic days until your technique produces consistent readings within 2 mmHg across three consecutive measurements.
  3. 03
    Conduct visual field screening on the Humphrey or equivalent perimeter — position the patient, coach fixation, and flag abnormal results.
    The visual field test is only as good as the patient's fixation. Explain the test clearly before you start — patients who understand the fixation target and the response button produce reliable fields. Watch the fixation monitor during the test; a fixation loss rate above 20% means the test is unreliable and you will have to repeat it. Flag any scotoma (blind spot beyond the normal physiologic blind spot) for the provider's review.
  4. 04
    Edge, mount, and verify spectacle lenses on the optical lab's edger and lensometer to ANSI Z80.1 tolerances.
    Trace the frame before you cut the lens. Confirm the frame's A, B, and DBL measurements against the work order. Set the edger for the correct lens material (CR-39, polycarbonate, Trivex, high-index — each has a different edging speed and pressure). After mounting, verify on the lensometer: sphere power within ±0.13D for lenses under 6.50D, cylinder power within ±0.13D, axis within ±2 degrees for cylinders above 0.75D, and optical center within 1mm of the specified PD. If it does not meet tolerance, do not dispense it.
  5. 05
    Fit and adjust spectacle frames — nose pads, temple bend, pantoscopic tilt — so the glasses stay on under a helmet and behind ballistic eyewear.
    The military fit is different from the civilian fit. The soldier needs glasses that stay put under an ACH, behind MCEP ballistic eyewear, and through a ruck march. Bend the temples to follow the ear closely; set pantoscopic tilt to 8-12 degrees; adjust nose pads so the frame sits at the correct vertex distance without sliding. Test the fit by having the soldier shake his head and look down — if the glasses shift, adjust again.
  6. 06
    Run an eye readiness screening station during SRP — vision, spectacle serviceability, MCEP insert verification — and flag non-deployable soldiers.
    Set up the station the night before: Snellen chart at 20 feet, autorefractor calibrated, lensometer ready, MCEP insert verification kit, MHS GENESIS open on the laptop. Run every soldier through the same checklist: distance VA with and without correction, near VA if over 40, spectacle serviceability check, MCEP insert Rx match, and profile review. Document exceptions immediately. The BN surgeon's non-deployable list starts with your exceptions log.

Manuals & References — What Chapters Matter

  • STP 8-68U13-SM-TG — Soldier's Manual and Trainer's Guide for MOS 68U (skill levels 1-3).
    This is the validation manual for every clinical and technical task you perform. Your clinic NCOIC will validate you against these tasks during your first 90 days. Print the task sheets for the tasks you have not yet been signed off on.
  • AR 40-63 — Ophthalmic Services.
    The governing regulation for spectacle fabrication timelines, clinic operations, MCEP insert production, and optical lab quality standards. Know the spectacle delivery timeline — it is the metric the BN surgeon briefs.
  • AR 40-501 — Standards of Medical Fitness.
    Chapter on vision standards defines what makes a soldier deployable or non-deployable from an eye readiness perspective. The vision acuity and refraction thresholds in this regulation are the numbers you screen against during SRP.
  • TC 8-800 — Medical Education and Demonstration of Individual Competence.
    The umbrella training circular for all AMEDD enlisted skills validation. Your annual competency verification references this document. Read it once so you know the structure of the validation framework.
  • ANSI Z80.1 — Prescription Ophthalmic Lenses.
    The tolerance standard your lab work is measured against. Know the sphere, cylinder, axis, optical center, and prism tolerances for each lens power range. The optometrist who catches a pair outside Z80.1 tolerance traces it to the tech who fabricated it.

Standards — How to Hit Each

  • Spectacle fabrication accuracy within ANSI Z80.1 tolerances on every pair.
    Verify every pair on the lensometer before dispensing — no exceptions. Record sphere, cylinder, axis, and optical center measurements. Compare against the Rx. If any parameter is outside tolerance, re-edge or re-order. The temptation to 'close enough' a pair during a production surge is the mistake that trains you to accept bad work.
  • Autorefraction and tonometry readings consistent enough that the optometrist does not have to repeat the screening.
    Run three consecutive autorefraction readings and average them. If the readings diverge by more than 0.50D in any meridian, reposition the patient and try again. For tonometry, three readings within 2 mmHg of each other. The provider who has to re-screen your patients stops trusting your numbers — and trust is the currency you run on in this clinic.
  • ACFT 500+ to stay off the medical-readiness conversation.
    The irony of being the tech who screens soldiers for deployment readiness while failing the fitness test is not lost on anyone in the clinic — or on the line units you screen. Build the score the same way every other soldier does: PT on your own time, not just during unit PT. The clinic schedule does not excuse you from the standard.
  • Eye readiness screening completion rate at or above 95% for your assigned unit population.
    Track the screening list in MHS GENESIS and cross-reference with the unit's Alpha roster. Chase the no-shows — the 5% who skip the screening are the 5% who show up non-deployable at SRP. Coordinate with the unit's readiness NCO to get the holdouts through the clinic before the BN surgeon's milestone.

Technical Mistakes — Concrete Consequences

  • Transposing cylinder axis on a refraction record.
    A 90-degree axis error on a cylinder of 1.00D or more produces spectacles that actively degrade the soldier's vision. The optometrist catches it at the dispense check or — worse — the soldier comes back in three days with headaches and the work order traces to your screening. One axis transposition is a training moment; two is a pattern the clinic NCO documents.
  • Dispensing spectacles without verifying on the lensometer.
    You have no way to know the edger cut correctly until you verify the finished lens. Skipping verification means you are gambling that the equipment, the lens blank, and your setup were all perfect. The soldier who gets wrong-power glasses in the field cannot read a map, cannot use a scope, and cannot do the job — and the work order has your initials on it.
  • Failing to flag elevated IOP readings for the optometrist.
    Intraocular pressure above 21 mmHg is a potential indicator of glaucoma. Missing the flag delays diagnosis. Glaucoma damages the optic nerve irreversibly — the soldier loses peripheral vision permanently, and the screening record shows you had the number and did not escalate. This is not a minor oversight.
  • Adjusting ballistic eyewear inserts without confirming the prescription matches the current Rx.
    MCEP inserts carry a prescription. Soldiers rotate through multiple pairs over time. If you send a soldier downrange with last year's Rx in the ballistic insert, she has corrected vision in garrison glasses but uncorrected or mis-corrected vision behind her combat eyewear — where she actually needs it most.

Career Decisions at This Rank

  • TSP enrollment under BRS.
    Same math as every other MOS: 5% contribution gets you the full 5% government match. At E-1/E-2 pay the monthly dollar amount feels small, but starting at 19 versus starting at 26 is a 4x difference in terminal TSP balance. The medical MOS community is not exempt from the retirement math. Talk to S-1 in your first week at the unit.
  • CPOT (Certified Paraoptometric Technician) vs. COA (Certified Ophthalmic Assistant) — which credential first.
    CPOT through ABO/NCLE is the optometry-side credential. COA through JCAHPO is the ophthalmology-side credential. If you work in an optometry clinic (most 68Us do), CPOT is the natural first step — the exam content maps directly to your daily work. If you are assigned to an ophthalmology department at a larger MTF, COA may be more relevant. Either credential opens civilian doors; having both makes you competitive for senior tech roles. Start with the one that matches your current assignment.
  • Stay 68U vs. reclass at the first re-enlistment window.
    The 68U field is small. Promotion velocity to E-5 and E-6 is generally favorable compared to larger medical MOSes (68W is the comparison), but the number of senior billets is correspondingly small. If you discover that optometry is your calling, the credential pathway (CPOT, COA, COT, eventually COMT) builds a civilian career that pays well. If you want more tactical medical work, a reclass to 68W (Combat Medic) opens a completely different career arc. The key question: do you want to stay clinical or go operational?
  • Re-enlist vs. ETS with the CPOT and enter the civilian optometric technician market.
    Civilian optometric technician salaries vary by region and credential level. A CPOT with 3-4 years of clinical experience and spectacle fabrication skills is employable at any optometrist's office, optical chain (LensCrafters, Visionworks, private practice), or ophthalmology practice. The military advantage: your clinical hours count toward credential requirements, your lab skills are directly transferable, and your readiness screening experience is unique. The honest test: if you have the CPOT and enjoy the clinical work, the civilian market is waiting. If you want the stability, benefits, and advancement of staying in, the 68U career path to E-7 and beyond is achievable.
  • Marriage and the barracks-to-off-post transition.
    Same as every other junior enlisted MOS: marriage unlocks BAH (with-dependents rate), which is a significant financial shift. The honest test: if the relationship is real and survived AIT, the Army's family infrastructure (Tricare, ACS, on-post housing) is functional. Off-post housing decisions should factor in PCS timing — your next move could be in 24 months. The clinic schedule is more predictable than combat arms, which is a real advantage for family stability, but SRP surges and extended hours still happen.

How the Seat Varies by Unit Type

  • MTF Optometry Clinic (Womack at Liberty, Darnall at Cavazos, Blanchfield at Campbell, etc.)
    The most common first assignment. You work in a dedicated optometry department with 1-3 optometrists, a clinic NCOIC, and 3-8 techs. The patient volume is steady, the lab is well-equipped, and the training opportunities are strong. The readiness screening load depends on the installation's deployment tempo — high-deployment installations (Liberty, Campbell, Drum) mean more SRP surges.
  • TMC (Troop Medical Clinic) with Optometry Capability
    Smaller operation. You may be the only 68U in the building, working with a single optometrist who visits on a rotating schedule. The lab may be basic — a manual edger, a lensometer, and limited frame stock. You do everything: screen, fabricate, fit, adjust, and manage the supply chain. The independence is real, but so is the isolation — you are your own QC, your own trainer, and your own supply NCO.
  • Deployable Medical Unit (FST, CSH, or Medical Detachment)
    The least common but most operationally relevant assignment. You deploy with a medical unit that has an optometry capability — screening, basic spectacle repair, and readiness support for the deployed force. The lab capability is limited to what you can carry; complex fabrication gets shipped to a rear-area facility. The work is field-condition screening and triage — not clinic-quality diagnostics.
  • OCONUS (Germany, Korea, Hawaii, Japan)
    OCONUS optometry clinics serve the installation population plus dependent and retiree communities. The patient mix is broader than CONUS — you see more pediatric cases, more retiree bifocal/progressive work, and more complex Rx work. The lab equipment is often newer (OCONUS clinics get priority resourcing). The lifestyle is OCONUS — travel, culture, distance from home. The professional growth is strong if you take advantage of it.

What Good Looks Like at This Rank

The good cherry 68U is the tech whose numbers the optometrist trusts on the first pass. Her autorefraction readings are consistent — three measurements within 0.25D, properly recorded in minus-cylinder notation, PD measured to the millimeter. Her tonometry is clean: patient positioned correctly, three readings within 2 mmHg, anything above 21 flagged with a sticky note on the chart and a verbal heads-up to the provider before the patient walks into the exam room. In the lab, her edgework is precise. She traces the frame, confirms the measurements, selects the right blank, and verifies the finished pair on the lensometer before it leaves the bench. Her rejection rate is near zero — not because she is cutting corners, but because she checks every parameter before she considers the pair done. The frame adjustments hold: nose pads seated, temples bent to the ear, pantoscopic tilt correct, and the soldier can shake his head without the glasses moving. By month nine, the clinic NCO is letting her run the SRP screening station independently — setting up the equipment, running the soldiers through the checklist, documenting exceptions, and handing the BN surgeon's readiness NCO a clean exceptions list at the end of the day. By month eighteen, the CPOT study materials are open on her desk during lunch, and the optometrist has started quizzing her on ocular anatomy during slow afternoons because she asked. The retention NCO has been told by the clinic NCOIC that this is a tech worth keeping — and the SRB conversation is on the table because the section cannot afford to train a replacement from scratch.

Preview — The Next Rank

E-4 Specialist is the rank where the optometrist and the clinic NCOIC start expecting you to run the lab or the screening lane without being watched. You are the experienced tech — the one who trains the new privates on the autorefractor, who manages the spectacle order queue, and who the clinic NCOIC trusts to run the SRP screening station solo. The CPOT credential becomes the visible differentiator. The SPC who has the CPOT or is actively studying for it gets the BLC roster slot, the additional duty assignments, and the optometrist's mentorship. The SPC who is coasting on AIT knowledge gets the lab production queue and a counseling statement about professional development. The promotion math starts: 36 months TIS, 8 months TIG (waivable), BLC graduation required under STEP before pinning sergeant. The school and credential stack — CPOT, BLC, any additional clinical training — is what separates you from every other SPC in the section competing for the same E-5 slot.
FAQ

68U E1-E3 — Frequently Asked Questions

Q01What does a E1-E3 68U (Eye Specialist) actually do?
You run vision screenings at the troop medical clinic or the optometry clinic — visual acuity on the Snellen chart, autorefraction on the tabletop autorefractor, tonometry for intraocular pressure, and color vision testing with Ishihara plates.
Q02What's the most important thing to know as a E1-E3 68U?
AIT at the AMEDDC&S (Army Medical Department Center and School) at JBSA-Fort Sam Houston is roughly 23 weeks.
Q03What does a typical day look like for a E1-E3 68U?
Time-blocked day at the E1-E3 68U rank tier: 0500 Wake. Shave, uniform check, PT clothes on. The clinic does not excuse you from the standard, 0530-0630 PT formation with your assigned medical company or detachment. Unit PT — run days, lift days, recovery days. Medical units PT together; the clinic schedule starts after, 0630-0800 Hygiene, change to duty uniform, breakfast at the DFAC or barracks. Drive or walk to the clinic, 0800 Clinic opens. Power on the autorefractor, lensometer, tonometer, and edger. Calibration check on the lensometer (verify against the test lens).…
Q04What mistakes get E1-E3 68U soldiers fired or relieved?
Sleeping on TSP enrollment under BRS. The 1% automatic plus 4% match if you contribute 5% is the most valuable financial decision of your first enlistment — and medical MOSes lose the same money as combat arms when they skip it; DUI or drug pop — separation under AR 635-200 ch.14. Medical MOSes are not exempt from the same UCMJ consequences as every other soldier; ACFT fails. Repeated failures trigger flagging, no promotions, no schools, eventual chapter action.…
Q05What career decisions matter most at the E1-E3 68U rank tier?
TSP enrollment under BRS — Same math as every other MOS: 5% contribution gets you the full 5% government match. At E-1/E-2 pay the monthly dollar amount feels small, but starting at 19 versus starting at 26 is a 4x difference in terminal TSP balance. The medical MOS community is not exempt from the retirement math. Talk to S-1 in your first week at the unit; CPOT (Certified Paraoptometric Technician) vs. COA (Certified Ophthalmic Assistant) — which credential first — CPOT through ABO/NCLE is the optometry-side credential. COA through JCAHPO is the ophthalmology-side credential.…
Q06What's next after E1-E3 for a 68U (Eye Specialist) in the Army?
E-4 Specialist is the rank where the optometrist and the clinic NCOIC start expecting you to run the lab or the screening lane without being watched.
Q07What manuals and regulations does a E1-E3 68U need to know cold?
STP 8-68U13-SM-TG — Soldier's Manual and Trainer's Guide for MOS 68U (skill levels 1-3).; TC 8-800 — Medical Education and Demonstration of Individual Competence.; AR 40-63 — Ophthalmic Services.

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Published by the Honest MOS Editorial DeskVerified against DoD/.gov sourcesUpdated May 2026Editorial standards