GLAUCOMA

G. A. WASIK · 2026 · Case ID: 26005083

DENIED

Summary

The veteran, who served in the U.S. Army from September 1972 to September 1992, appeals the denial of service connection for bilateral glaucoma and residuals of cataracts, status post-surgery. The veteran contended these conditions were related to an in-service left eye injury and, alternatively, to in-service exposure to toxins and other chemicals, including artillery ordnance and diesel exhaust. The Board reviewed the veteran's service treatment records (STRs), which documented a left eye injury in August 1984 with a diagnosis of traumatic iritis, but no ongoing eye disorders or complaints thereafter. Separation records showed normal vision and no history of eye problems. Post-service VA examinations and private medical opinions were considered. Multiple VA ophthalmologists opined that the veteran's bilateral open-angle glaucoma and cataracts were less likely than not related to service, noting the bilateral nature of the conditions, the lack of traumatic glaucoma findings, and the typical age-related etiology of his glaucoma. A private orthopedic surgeon's opinion linking the conditions to toxic exposure was deemed speculative and of limited probative value due to the author's lack of expertise in ocular diseases. The Board found the competent medical evidence clearly weighed against the veteran's claims, denying service connection for both conditions.

Rationale

STRs do not document ongoing glaucoma or residuals from in-service left eye injury.; VA ophthalmologists opined less likely than not related to service.; Private orthopedic surgeon's opinion deemed speculative and lacking expertise in ocular diseases.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

19-15 586

Full Decision Text

Citation Nr: 26005083
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 19-15 586
DATE: April 30, 2026

ORDER

Entitlement to service connection for glaucoma to include due to in-service exposure to toxins and other chemicals is denied.

Entitlement to service connection for residuals of cataracts, status post-surgery, to include due to in-service exposure to toxins and other chemicals is denied.

FINDINGS OF FACT

1. The competent medical evidence of record clearly weighs against finding the Veteran's diagnosed glaucoma of the bilateral eyes was incurred in or is otherwise related to an in-service event, injury, or illness, to include his conceded in-service exposure to toxins and other chemicals.

2. The competent medical evidence of record clearly weighs against finding the Veteran's diagnosed residuals of cataracts, status post-surgery, were incurred in or are otherwise related to an in-service event, injury, or illness, to include his conceded in-service exposure to toxins and other chemicals.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for glaucoma are not met. 38?U.S.C. §§?1110, 1131, 5107; 38?C.F.R. §§?3.102, 3.303.?

2. The criteria for entitlement to service connection for residuals of cataracts, status post-surgery are not met. 38?U.S.C. §§?1110, 1131, 5107; 38?C.F.R. §§?3.102, 3.303.?

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from September 1972 to September 1992.

These matters come before the Board of Veterans' Appeals (Board) on appeal from rating decisions, issued by a Regional Office (RO) of the Department of Veterans Affairs (VA).

In September 2021, September 2023 and February 2024, the Veteran testified at hearings before Veterans Law Judges (VLJs), transcripts of the hearings are of record.

These matters were previously before the Board, most recently in July 2025, at which time the Board remanded the claims for further development. In October 2025 correspondence, the Veteran, through his then attorney representative, requested to be scheduled for a virtual Board hearing to enable him to provide additional testimony in support of his claims. See October 2025 Third Party Correspondence. Pursuant to his request, in a January 2026 letter, the Board notified the Veteran that a hearing had been scheduled for March 3, 2026. See January 2026 Board of Veterans' Appeals Hearing Scheduled Letter.

In February 2026 correspondence, the Veteran's attorney representative moved to withdraw from representation of the Veteran. See February 2026 Third Party Correspondence. His then representative did not therein address the Veteran's upcoming March 3, 2026, Board hearing; however, the Board incorrectly treated the above noted February 2026 correspondence as a withdrawal of the Veteran's hearing request. Consequently, no Board hearing was conducted on March 3, 2026.

In March 2026, after noting the above error, the Board sent the Veteran a letter notifying him of his former representative's February 2026 motion to withdraw as his representative, without addressing his prior request for hearing. See March 2026 Board Letter. The Board therein provided the Veteran with an opportunity to: (1) indicate that he did not want a Board hearing, inviting him to submit a written statement in lieu of hearing if preferred; or (2) request a hearing by video or in person. Id. Finally, the Board notified the Veteran that if he did not respond within 30 days from the date of the March 2026 letter, the Board would assume that he did not want a hearing and would decide his appeal without hearing. Id.

The Veteran did not timely respond to the Board's March 2026 letter. Consequently, the Board assumes that the Veteran did not wish to have a Board hearing and will address the claims without hearing.

1. Entitlement to service connection for glaucoma to include due to in-service exposure to toxins and other chemicals is denied.

2. Entitlement to service connection for residuals of cataracts, status post-surgery, to include due to in-service exposure to toxins and other chemicals is denied.

The Veteran contends that his diagnosed: (1) cataracts of the bilateral eyes, status post removal surgeries; and (2) glaucoma of the bilateral eyes were incurred in or are otherwise related to an in-service event, injury, or illness. Specifically, he contends his diagnosed eye disorders are related
2026 letter. Consequently, the Board assumes that the Veteran did not wish to have a Board hearing and will address the claims without hearing.

1. Entitlement to service connection for glaucoma to include due to in-service exposure to toxins and other chemicals is denied.

2. Entitlement to service connection for residuals of cataracts, status post-surgery, to include due to in-service exposure to toxins and other chemicals is denied.

The Veteran contends that his diagnosed: (1) cataracts of the bilateral eyes, status post removal surgeries; and (2) glaucoma of the bilateral eyes were incurred in or are otherwise related to an in-service event, injury, or illness. Specifically, he contends his diagnosed eye disorders are related to an in-service left eye injury. Alternatively, he contends his eye disorders were caused by his in-service exposure to toxins and other chemicals while performing his military occupational specialty, including detonation of artillery field ordnance and exposure to diesel engine exhaust.

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38?U.S.C. §§ 1110,?1131; 38?C.F.R. §?3.303.?????????

To establish a right to compensation for a present disability, a claimant must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during active service.?Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).?????????

For veterans who served 90 days or more of active duty during a war period or after December 31, 1946, certain chronic disorders?are presumed to have been incurred in service if they manifested to a compensable degree within one year of?separation from service. 38?U.S.C. §§?1110, 1131, 1112, 1113; 38?C.F.R. §§?3.307(a), 3.309(a). For the showing of chronic disease in service, there is?required?a combination of manifestations sufficient to?identify?the disease entity, and sufficient observation to?establish?chronicity at the time. If chronicity in service is not?established, a showing of continuity of symptoms after discharge is?required?to support the claim. 38?C.F.R. §?3.303(b);?Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) (the theory of continuity of symptomatology can be used only in cases involving those disabilities specified as chronic under 38?C.F.R. §?3.309(a)).???????

Service connection may be granted for a disability diagnosed after service if the evidence?establishes?the disability is due to disease or injury that was incurred or aggravated in service. 38?C.F.R. §?3.303.??????

Where there is an approximate balance of positive and negative evidence?regarding?any issue material to the determination of a matter, the benefit of the doubt will be granted to the claimant. 38?U.S.C. §?5107; 38?C.F.R. §?3.102;?Gilbert v.?Derwinski, 1?Vet. App.?49, 53 (1990). To deny a claim, the evidence must clearly weigh against the claim.?Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).?

For the following reasons, entitlement to service connection for the Veteran's diagnosed cataracts and/or glaucoma is not warranted.

The Veteran has long contended that his diagnosed cataracts and glaucoma are related to a left eye injury he sustained during service. See e.g., October 2010 Report of General Information (contending cataracts were developed due to being hit with a cable in the 1980s during service); September 2021 Board Hearing Transcript; February 2024 Board Hearing Transcript.

The service treatment records (STRs) do not document any eye disorders upon entering service. See September 1972 Enlistment Report of Medical Examination (normal eyes, distant vision of 20/20 in both eyes); September 1972 Enlistment Report of Medical History (denies a history of eye trouble, has vision in both eyes, does not use glasses and/or contact lenses).

In August 1984, the Veteran was treated for a complaint of left eye pain after being struck across the left eye 4 days prior, then assessed as left
acts were developed due to being hit with a cable in the 1980s during service); September 2021 Board Hearing Transcript; February 2024 Board Hearing Transcript.

In August 1984, the Veteran was treated for a complaint of left eye pain after being struck across the left eye 4 days prior, then assessed as left eye traumatic iritis. See August 1984 Consultation Sheet. In September 1984, the Veteran was seen in follow up for left eye trauma, then assessed as residual left eye iritis. See September 1984 Chronological Record of Medical Care. His service treatment records do not contain any complaints, treatment, and/or diagnosis of any right eye disorder(s).

STRs dated thereafter do not document any ongoing or persistent left eye disorder. See e.g., April 1988 Periodic Report of Medical Examination (normal eyes, near and distance vision 20/20 uncorrected in both eyes); June 1992 Eye Examination (distant and near vision 20/20 in both eyes without correction); June 1992 Separation Report of Medical Examination (normal eyes, distant and near vision of 20/20 in both eyes). In his separation report of medical history, the Veteran affirmatively denied having a medical history of eye problems. See June 1992 Separation Report of Medical History (denies eye trouble, has vision in both eyes).

In a July 1997 VA ambulatory care note (dated some 5 years after his separation from service, and some 13 years after his above-noted in-service left eye injury), the Veteran requested to see an eye doctor for a routine evaluation, he then denied a history of cataracts or glaucoma, but he reported poor vision bilaterally. See July 1997 Ambulatory Care Note. In November 1998, he was noted to have a mature cataract in his right eye and a "#1 cataract" in his left eye, inconsistent with his above-noted service treatment records, he therein reported having sustained a right eye injury during service after being hit with a coaxial cable, he was not then diagnosed with glaucoma and he was referred for cataract removal surgery. See November 1998 Optometry Note.

A February 2021 optometry note documents a past medical history of cataracts, both eyes, and pseudophakia (replacement lenses following cataract removal surgery) then noted to be stable, he was not then diagnosed with glaucoma. See February 2001 Optometry Note. In June 2009, he was diagnosed with glaucoma affecting both eyes. See June 2009 Optometry Note.

In April 2011, the Veteran underwent a VA examination. The examiner diagnosed bilateral glaucoma and pseudophakia and did not note any corneal scarring on examination. See April 2011 VA Examination. The examiner opined it is less likely than not the glaucoma and/or cataracts were incurred in or are otherwise related to an in-service event, injury, or illness, pointing out that: (1) the eye conditions are bilateral whereas the in-service injury affected solely the left eye; and (2) being African American is a risk factor for developing glaucoma. Id.

In a December 2011 addendum VA medical opinion, the examiner opined it is less likely than not the Veteran's cataracts were incurred in or are otherwise related to an in-service event, injury, or illness, to include his left eye injury documented in his STRs, noting that his more advanced cataract upon diagnosis affected his right eye, and explaining that if his cataracts were due to in-service trauma, one would expect the more advanced cataract to be in his trauma affected left eye. See December 2011 VA Medical Opinion.

In November 2018, the Veteran underwent a further VA examination. The examiner diagnosed bilateral glaucoma and bilateral pseudophakia (replacement lenses status post cataract removal surgeries). See November 2018 VA Examination. The examiner indicated the Veteran then experienced no decrease in visual acuity or other visual impairment attributable to his glaucoma and/or cataracts. Id.

In a corresponding November 2018 VA medical opinion, a different examiner opined it is less likely than not the glaucoma and/or cataracts were incurred in or are otherwise related to an in-service event, injury, or illness, pointing solely to the dates of the diagnoses after separation from service. See November 2018 VA Medical Opinion. The November 2018 VA medical opinion contained an inadequate rationale and, consequently, the Board remanded the claims to obtain an adequate addendum VA medical opinion addressing the nature and etiology of the glaucoma and pseudophakia. See October 2022 Board Decision.

In separate December 2022 VA medical opinions, the examiner opined it is less likely than not the Veteran's cataracts were incurred in or are otherwise related to an in-service event, injury, or illness. See December 2022 VA Medical Opinions. As a rationale, the examiner pointed to: (1) prior examinations which the examiner indicated showed no residuals from cataract surgery; and (2) a review of the evidence then of record documenting well positioned intraocular chambers, without complications post cataract removal surgeries. Id.

In separate December 2022 VA medical opinions, the examiner further opined it is less likely than not the Veteran's right and left glaucoma, respectively, were incurred in or are otherwise related to an in-service event, injury, or illness. See December 2022 VA Medical Opinions. As a rationale, the examiner indicated his bilateral glaucoma is primary open angle type glaucoma, not traumatic or angle recession type glaucoma which can develop due to ocular trauma. Id. The examiner explained that his primary open angle glaucoma is a type of glaucoma defined by open, normal appearing anterior chamber angle and raised intraocular pressure (IOP) with no other underlying disease. Id.

In April 2024, the Veteran submitted a private medical opinion in which a doctor (F.G., M.D., P.C., an orthopedic surgeon who did not physically examine the Veteran but did review his claims file through the date of the evaluation) opined the cataracts and glaucoma, among other conditions, developed in response to the Veteran's exposure to multiple toxicants while performing his military occupational specialty, to include detonation of artillery field ordnance and diesel engine exhaust. See March 2024 Private Medical Evaluation, F.G., M.D., P.C., Received April 2024.

As a rationale, the private doctor indicated only that nanoparticles of particulate matter can be inhaled while larger particles can be swallowed, and other toxins can enter the body through direct skin contact. Id. The private doctor pointed specifically to the Veteran's in-service exposure to "2 Legacy diesel engines exhaust" which he indicated are causal to a loss of telomere length and accelerate the onset of age-related conditions, including cataract formation. Id.

In sum, the private doctor (an orthopedic surgeon) opined that the Veteran's in-service toxic exposure risk activities can cause loss of telomere length which, in turn, can accelerate the onset of age-related cataracts. However, the private doctor did not specifically opine that the Veteran's age-related cataracts were accelerated by his in-service toxic exposure risk activities and did not specifically address the onset and course of the Veteran's cataracts and whether the evidence of record establishes acceleration of their onset. Finally, the private doctor did not indicate that glaucoma is among the age-related conditions that can be accelerated by the Veteran's in-service toxic exposure risk activities. See Bloom v. West, 12?Vet. App.?185, 187 (1999) (the value of a physician's statement is dependent, in part, upon the extent to which it reflects clinical data or other rationale to support the opinion).

Based on the foregoing, the Board finds the April 2024 private medical opinion to be of limited probative value.

In July 2024 the Veteran underwent a further VA examination, the examiner diagnosed primary open-angle glaucoma, moderate stage, both eyes and pseudophakia, both eyes. See July 2024 VA Examination. The examiner indicated the Veteran did not exhibit any decrease in visual acuity or other visual impairment attributable to his glaucoma and/or cataracts/pseudophakia. Id.

Vet. App.?185, 187 (1999) (the value of a physician's statement is dependent, in part, upon the extent to which it reflects clinical data or other rationale to support the opinion).

Based on the foregoing, the Board finds the April 2024 private medical opinion to be of limited probative value.

In July 2025, the Board remanded the claims to obtain further VA medical opinions, including addressing the Veteran's contention his eye disorders were caused by his in-service exposure to toxins and other chemicals. See July 2025 Board Decision.

In a July 2025 VA medical opinion, the examiner opined it is less likely than not the Veteran's glaucoma was incurred in or is otherwise directly related to an in-service event, injury, or illness. See July 2025 VA Medical Opinion.

As a rationale, the examiner, an ophthalmologist, indicated the cause of glaucoma, which is a progressive optic neuropathy associated with elevated interocular pressure, is not known. Id. However, he indicated that based on current medical knowledge, ocular trauma is not known to cause the Veteran's open-angle type glaucoma. Id. He further opined that even if ocular trauma were known to cause open-angle type glaucoma, the Veteran's in-service left eye injury could not have caused open-angle type glaucoma in his uninjured right eye. Id.

In a separate July 2025 VA medical opinion, regarding his glaucoma, the examiner conceded that trauma can cause (traumatic) glaucoma; however, he indicated that: (1) most eye injuries do not cause glaucoma; (2) traumatic glaucoma occurs only in the trauma affected eye (and thus, trauma to the Veteran's left eye would not cause his glaucoma affecting the right eye); (3) the Veteran's eye examinations do not show evidence of traumatic glaucoma; (4) if the Veteran's documented in-service left eye trauma had caused his left eye glaucoma, his left eye glaucoma would be expected to be worse than his non-trauma-related right eye glaucoma (which is not the case); and (5) the Veteran's glaucoma has been diagnosed as open-angle glaucoma, not traumatic glaucoma, indicating his treating providers do not believe his glaucoma is traumatic in nature. Id. Based on the foregoing, the examiner again opined the glaucoma was less likely than not incurred in or otherwise directly related to an in-service event, injury, or illness, to include the documented in-service left eye trauma. Id.

In a separate July 2025 VA medical opinion, the examiner opined the Veteran's cataracts (and resulting artificial lenses status post cataract removal surgery) were less likely than not incurred in or otherwise directly related to an in-service event, injury, or illness. See July 2025 VA Medical Opinion. As a rationale, the examiner conceded that cataracts can be caused by trauma; however, he noted that when treated in service in 1984, the Veteran was diagnosed with traumatic iritis, not cataract. Id. Based on the foregoing, the examiner opined the evidence of record does not support trauma as the likely etiology of the Veteran's cataracts. Id.

In a separate July 2025 VA medical opinion, the examiner again opined the Veteran's cataracts were less likely than not incurred in or otherwise directly related to an in-service event, injury, or illness. See July 2025 VA Medical Opinion. Again, the examiner conceded that trauma can cause cataracts; however, he indicated cataracts caused by trauma occur at the time of the trauma (which the record does not support having occurred in the Veteran's case). Id.

In all of the above-noted July 2025 VA medical opinions, the examiner, an ophthalmologist, characterized the above-noted private nexus opinion as based on "unsupported speculation" concerning the etiology of the Veteran's eye disorders and indicated it would be "highly unusual" for an orthopedic surgeon, such as the authoring private doctor, to have any expertise in ocular diseases of cataracts and glaucoma. See July 2025 VA Medical Opinions.

In a separate July 2025 VA medical opinion, the examiner opined it is less likely than not one or more of the Veteran's eye
of the trauma (which the record does not support having occurred in the Veteran's case). Id.

In a separate July 2025 VA medical opinion, the examiner opined it is less likely than not one or more of the Veteran's eye disorders were caused by his indicated toxic exposure risk activities, after considering his total potential exposure through all applicable military deployments and the synergistic, combined effect of all such toxic exposure risk activities. See July 2025 VA Medical Opinion.

As a rationale, the examiner conceded that, rarely, toxins, typically certain drugs, have been purported to cause cataracts. Id. However, he opined the Veteran's cataracts were likely proximately due to aging and not due to his in-service toxic exposure risk activities, noting that if due to such activities, his cataracts would be expected to have developed at the time of such exposure (rather than, as here, years after his separation from service). Id. Regarding his glaucoma, the examiner indicated that the cause of (his open angle type) glaucoma is not known and, as such, opined a nexus cannot be established between his glaucoma and his in-service toxic exposure risk activities. Id.

The July 2025 VA medical opinions are explained with citations to facts in the record, provided by a qualified medical professional who demonstrated a familiarity with the case and medical issues presented, and are supported by the evidence of record. See Bloom v. West, 12?Vet. App.?185, 187 (1999) (the value of a physician's statement is dependent, in part, upon the extent to which it reflects clinical data or other rationale to support the opinion).

In sum, notwithstanding the documented in-service left eye traumatic iritis, the evidence of record does not document ongoing left eye complaints, treatment, and/or diagnosis during the remainder of the Veteran's service from 1984 through 1992. On his separation from service, the Veteran affirmatively denied a medical history of eye problems at the time of discharge or prior to this. No medical professional (private or VA) who has considered the evidence of record has opined that it is at least as likely as not his cataracts and/or glaucoma were incurred in or are otherwise directly related to an in-service event, injury, or illness, including his documented in-service left eye injury.

(Continued on the next page)

Finally, regarding whether his cataracts and/or glaucoma were caused by his conceded in-service toxic exposure risk activities, as addressed above, the Board finds the July 2025 VA medical opinion more probative. First, the April 2024 private medical opinion was authored by an orthopedic surgeon, while the July 2025 VA examiner is an ophthalmologist (a medical specialist focused on diagnosing, treating, and managing eye diseases). Second, as noted above, the private doctor did not point to any evidence of record purportedly suggesting the existence of accelerated onset of the Veteran's (therein concededly age-related) cataracts; nor did he specifically address the Veteran's open-angle type glaucoma.

Therefore, based on the foregoing, the Board finds that the competent medical evidence of record clearly weighs against the Veteran's claims. As the competent medical evidence of record clearly weighs against the claims, the benefit-of-the doubt doctrine does not apply, and the claims must be denied.?See?38 U.S.C. § 5107; 38 C.F.R. § 3.102.

G. A. WASIK

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Given, R. A.

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

Analyze in VA Law Explorer