EYE IMPAIRMENT OF MUSCLES OF

DELYVONNE M. WHITEHEAD · 2026 · Case ID: A26026301

GRANTED

Summary

The veteran, who served from June 1968 to June 1988, appeals the rating assigned for bilateral post-operative cataracts with pseudophakia and vitreous degeneration, and for dry eye syndrome. The veteran sought an increased rating for his eye conditions, specifically challenging the noncompensable rating for cataracts and seeking separate ratings for other claimed eye issues. The Board reviewed multiple VA examinations from May 2022, January 2023, November 2023, and May 2024, along with the veteran's testimony from a December 2025 hearing. The Board found that the veteran's visual field impairment, specifically the remaining visual field of 21.5 degrees in the right eye and 26.5 degrees in the left eye, met the criteria for a 50 percent rating under Diagnostic Code 6066. The Board acknowledged conflicting findings from other examiners but afforded the veteran the benefit of the doubt regarding the visual field impairment. The Board denied a higher rating for visual acuity, as the veteran's corrected vision was consistently 20/40 or better. The Board also denied a higher rating based on incapacitating episodes, as the veteran's reported symptoms did not meet the regulatory definition requiring clinic visits for treatment. However, the Board found that the veteran's dry eye syndrome, which caused discomfort, tearing, and occasional blurry vision, warranted a separate 20 percent rating by analogy to disorders of the lacrimal apparatus (Diagnostic Code 6025), as it affected both eyes. The Board found no basis for higher ratings for other claimed conditions like conjunctivitis or diplopia, as these were not supported by the evidence. The Board also noted that a TDIU claim was pending adjudication at the AOJ.

Rationale

50 percent rating assigned for visual field impairment; Remaining visual field in right eye 21.5 degrees; Remaining visual field in left eye 26.5 degrees; Meets criteria for 50 percent rating under DC 6066

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

6066

Docket No.

241113-489418

Full Decision Text

Citation Nr: A26026301
Decision Date: 03/24/26 Archive Date: 03/24/26

DOCKET NO. 241113-489418
DATE: March 24, 2026

ORDER

Entitlement to a 50 percent rating, but no higher, for post-operative cataracts with pseudophakia (intraocular lenses) and vitreous degeneration, is granted.

Entitlement to a separate 20 percent rating, but no higher, for dry eye syndrome is granted.

FINDINGS OF FACT

1. The Veteran has bilateral post-operative cataracts with pseudophakia (implantation of intraocular lenses) which cause decreased visual fields.

2. The Veteran's corrected near or distance vision has been no worse than 20/40 is either eye. The average remaining visual field in the right eye was 21.5, and the average remaining visual field in the left eye was 26.5.

3. The Veteran has dry eye syndrome, which causes excessive watering and tearing in the left eye.

CONCLUSIONS OF LAW

1. The criteria for a rating of 50 percent, but no higher, for post-operative cataracts with pseudophakia (intraocular lenses) and vitreous degeneration have been met.? 38 U.S.C. §§ 1155, 5107;?38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.75-4.78, 4.79, Diagnostic Codes 6027, 6066, 6080.

2. The criteria for a separate rating of 20 percent, but no higher, for dry eye syndrome have been met. ?38 U.S.C. §§ 1155, 5107;?38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.75-4.78, 4.79, Diagnostic Codes 6018, 6025.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from June 1968 to June 1988.

In a February 2023 rating decision, the Department of Veterans Affairs (VA) Regional Office, which is the Agency of Original Jurisdiction (AOJ), issued a rating decision that continued the noncompensable rating for bilateral cataracts. The Veteran submitted a Supplemental Claim in July 2023, and a rating decision was issued in November 2023. The Veteran then requested Higher-Level Review, and in April 2024 a Higher-Level Review decision found that a duty to assist error had occurred. After completing more development, a special review decision was issued in August 2024.

The Veteran then submitted a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) in November 2024, which appealed the decision to the Board of Veterans' Appeals (Board), under the Hearing docket. A Board hearing was held on December 4, 2025.

Therefore, the Board may only consider the evidence of record at the time of the August 2024 AOJ decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

The Board notes that the Veteran raised the issue of entitlement to a TDIU and the impact of his eye disorder on his ability to work at the December 2025 Board hearing. This issue was not raised prior to the August 2024 rating decision, and the Board therefore does not find that there was any predecisional duty to assist error or procedural error in the AOJ not adjudicating this issue at that time. While a claim for a TDIU can be intertwined with a claim for an increased rating when such a claim is raised during the development of the claim, the Board does not find that to be the case here. See Rice v. Shinseki, 22 Vet. App. 447 (2009). Additionally, the Veteran submitted a claim for a TDIU in September 2025, and this claim is still undergoing development by the AOJ and has not yet been adjudicated in the first instance. If the Veteran would like to appeal this issue to the Board, he may submit a VA Form 10182 appealing the issue, after a rating decision is issued by the AOJ.

Bilateral Eye Disorder

The Veteran was initially granted service connection for bilateral cataracts in a February 2015 rating decision which assigned a noncompensable (0 percent) rating from April 10, 2014. In April 2022, the Veteran submitted a claim requesting additional service connection for other eye conditions: conjunctivitis, eye pain, loss of vision, eye spasms, blurry vision, double vision, and loss of light perception. In a November 2023 rating decision, the Veteran was awarded a separate noncompensable rating for vitreous degeneration with dry eye syndrome. An August 2024 rating decision then found that it had been clear and unmistakable error to assign two separate ratings for the eyes, and the conditions were combined into a single noncompensable rating for "vitreous degeneration with dry eye syndrome and with the presence of intraocular lens," "previously rated as bilateral cataracts status post pseudophakia." The Veteran has appealed this rating.

The Veteran testified at a Board hearing in December 2025 that he had surgery in service to remove his cataracts, but that he continues to have problems with his eyes. He discussed how his vision became blurry and made it hard to read the board when he was a teacher, that he has dry eyes and sometimes feels like he has grit in his eyes, and that he continues to have blurred vision and tearing. He said that he avoids driving long distances, although he had driven himself that day, because it was not very far. He had not had any accidents while driving, because he was very careful.

Postoperative cataracts are evaluated under Diagnostic Code 6027, which states that if a replacement lens is present (pseudophakia), it should be evaluated under the General Rating Formula for Diseases of the Eye. If there is no replacement lens, evaluate based on aphakia. Here, the Veteran has replacement lenses on both eyes, and the General Rating Formula for Diseases of the Eye applies. 38 C.F.R. § 4.79, Diagnostic Code 6027.

The General Rating Formula for Diseases of the Eye instructs the rater to rate on the basis of either visual impairment or on incapacitating episodes, whichever results in a higher rating.

For incapacitating episodes, a 10 percent rating is warranted when there are documented incapacitating episodes requiring at least 1 but less than 3 treatment visits for an eye condition during the past 12 months. A 20 percent rating is assigned for documented incapacitating episodes requiring at least 3 but less than 5 treatment visits in the past 12 months. A 40 percent rating is assigned for documented incapacitating episodes requiring at least 5 but less than 7 treatment visits for an eye during the past 12 months. A 60 percent rating is assigned for 7 or more treatment visits for an eye condition during the past 12 months Note: (1) states that an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes. Note: (2) states that examples of treatment may include but are not limited to: systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions. 38 C.F.R. § 4.79.

The rating of visual impairment is based on impairment
documented incapacitating episodes requiring at least 5 but less than 7 treatment visits for an eye during the past 12 months. A 60 percent rating is assigned for 7 or more treatment visits for an eye condition during the past 12 months Note: (1) states that an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes. Note: (2) states that examples of treatment may include but are not limited to: systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions. 38 C.F.R. § 4.79.

The rating of visual impairment is based on impairment of visual acuity (excluding developmental errors of refraction), visual field, and muscle function. 38 C.F.R. § 4.75(a). To determine the evaluation for visual impairment when both decreased visual acuity and visual field defect are present in one or both eyes and are service connected, visual acuity and visual field defects are evaluated separately, and then combined under the provisions of § 4.25.

Impairment of muscle function is rated based on the presence of diplopia. 38 C.F.R. § 4.79, Diagnostic Code 6066. In this case, the Veteran has never been found to have diplopia, and this diagnostic code does not apply.

The rating of visual acuity is based on corrected distance vision with central fixation. 38 C.F.R. § 4.76(b)(1). The measurements for each eye are applied to the table for Impairment of Central Visual Acuity. Diagnostic Code 6066 provides ratings where vision in one eye (the poorer eye) is 10/200 or better. Where the visual acuity in both eyes is 20/40, a 0 percent (noncompensable) rating is warranted. Where the visual acuity in the poorer eye is 20/50, a 10 percent rating is warranted where vision in the other eye is either 20/50 or 20/40. 38 C.F.R. § 4.79, Diagnostic Code 6066.

Rating of visual field is based on the remaining field of vision in each eye. Normal visual field extant at eight principle meridians is as follows: temporally is 85 degrees, down temporally is 85 degrees, down is 65 degrees, down nasally is 50 degrees, up nasally is 55 degrees, up is 45 degrees, and up temporally is 55 degrees. 38 C.F.R. § 4.76a, Table III.

The extent of contraction of visual field in each eye is determined by recording the extent of the remaining visual fields in each of the eight 45 degree principal meridians. The number of degrees lost is determined at each meridian by subtracting the remaining degrees from the normal visual fields given in Table III. 38 C.F.R. § 4.77(a). The degrees lost are then added together to determine total degrees lost. The sum is divided by eight and represents the average contraction of the visual field.

Under Diagnostic Code 6080, a 10 percent rating is warranted for bilateral concentric contraction of the visual field with remaining field of 16 to 60 degrees. A 30 percent rating is warranted for bilateral concentric contraction of the visual field with remaining visual field of 31 to 45 degrees. A 50 percent rating is warranted for bilateral concentric contraction of the visual field with remaining visual field of 16 to 30 degrees. A 70 percent rating is warranted for bilateral concentric contraction of the visual field with remaining visual field of 6 to 15 degrees. A 100 percent is warranted for bilateral concentric contraction of the visual field with remaining visual field of 5 degrees. 38 C.F.R. § 4.79, Diagnostic Code 6066.

Turning to the evidence, the Veteran attended a VA examination in May 2022. The Veteran had surgery in 1989 to have new lenses implanted following treatment for cataracts. The Veteran reported that he had non-functional vision prior to this surgery, and that he currently wore spectacles. The VA examiner found that the Veteran currently had intraocular lenses, and that the Veteran had minimal dependence on spectacles to complete activities of daily living. The examination found postoperative replacement of the intraocular lenses in both eyes, and they caused no decrease in visual acuity or other visual impairment. He had near and distance corrected vision of 20/20 or better in both eyes. There was no diplopia or documented visual field defect. He did not have any
examination in May 2022. The Veteran had surgery in 1989 to have new lenses implanted following treatment for cataracts. The Veteran reported that he had non-functional vision prior to this surgery, and that he currently wore spectacles. The VA examiner found that the Veteran currently had intraocular lenses, and that the Veteran had minimal dependence on spectacles to complete activities of daily living. The examination found postoperative replacement of the intraocular lenses in both eyes, and they caused no decrease in visual acuity or other visual impairment. He had near and distance corrected vision of 20/20 or better in both eyes. There was no diplopia or documented visual field defect. He did not have any diplopia. His eye disorder did not impact his ability to work.

This VA examiner was also asked to specifically address whether the Veteran currently had any of his other claimed eye disorders. The examiner found that there was no ocular evidence of conjunctivitis, eye pain, eye spasms, and diplopia. The Veteran did have blurry vision that was related to his cataract extraction in the years when he was aphakic, 1982-1989, and would have been incapacitated without high-powered spectacles. The Veteran's vision was currently corrected to adequate visual acuity with spectacle correction.

The Veteran next attended a VA eye examination in January 2023. The Veteran reported that he was still unable to see properly and was prescribed contact lenses and eyeglasses to improve his vision. He reported experiencing loss of vision, pain/spasm of both eyes, loss of light perception and blurry vision during the first and second surgeries he had to remove his cataracts. He then went to a civilian eye doctor for surgery to implant lenses, and his vision had improved after that. He reported still having loss of light perception at near vision task even with reading glasses, although his vision at distance was satisfactory, and having pain/spasms in his eyes. He reported that his dry eye syndrome caused tearing and occasional discomfort in both eyes. The examiner explained that pseudophakia is a substitution of the natural crystalline lens of the eye with a synthetic lens, which the Veteran had undergone during surgery, and was a progression of Veteran's cataract condition. His current corrected distance and near vision was 20/20 or better in both eyes. He had no diplopia or corneal irregularity that resulted in severe irregular astigmatism. He had non-contact tonometer. Slit lamp testing showed dry eye syndrome and pseudophakia. He did have decrease in the visual field. The right eye degrees of vison, at each of the 8 meridian points, were 13, 18, 24, 31, 27, 17, 24, and 18. The left eye degrees of vison, at each of the 8 meridian points, were 16, 28, 44, 33, 26, 25, 22, and 18. The Veteran's dry eye syndrome was treated with eye drops. It did not cause any decrease in visual acuity or other visual impairment. His postoperative cataracts also did not cause decrease in visual acuity or other visual impairment.

The examiner also provided opinions explaining that the Veteran did not currently have any loss of light perception. He wrote that although light perception had not been measured, his visual acuity was 20/20, and it was not possible to have a loss of light perception with near vision only. He also found that there was no current loss of vision or conjunctivitis. The Veteran's reported blurry vision was found to be intermittent and related to his dry eye syndrome, as were his reports of eye spasms. The Veteran did not have double vision, and there were no signs of any causative factor such as a dislocated implant lens, corneal anomaly or abnormal astigmatism found in today's eye exam. The examiner also found that the Veteran's reports of eye pain were at least as likely as not related to his service-connected cataract condition.

The Veteran attended a VA examination in November 2023. He was diagnosed with pseudophakia, dry eye syndrome, and vitreous degeneration. The veteran had extracapsular cataract extraction on the right eye in 1982 and was aphakic in the right eye following his cataract surgery. He had cataract surgery in the left eye in 1986, and this eye was also left aphakic. To correct his vision, he had to wear high-plus-powered contact lenses for distance vision, as well as reading glasses to see up close. In 1989, a civilian ophthalmologist implanted intraocular lenses in his eyes. His current symptoms were that he used glasses for near tasks, and he reported aching eye pain and fatigue that causes his vision to blur, worsening as the day progresses. He reported having increased tearing and discomfort with contact lens wear due to dry eyes. He also reported having photophobia, and cloudy vision that was alleviated by blinking, with dryness and itching. He used Visine eye drops. His uncorrected distance vision was 20/40 in both eyes, and his corrected and uncorrected near vision was 20/20 or better in both eyes. He did not have a corneal irregularity that resulted in severe irregular astigmatism, and there was no diplopia. There was non-contact tonometry, and the corneas had reduced tear breakup time. The posterior chambers of the intraocular lens were well-centered. There was posterior vitreous detachment (floaters). There was no documented visual field defect. The Veteran's dry eye syndrome and posterior vitreal detachment did not cause any decrease in visual acuity or other visual impairment. The Veteran also had posterior vitreous detachment (floaters), and there caused no decrease in visual acuity or other visual impairment. He had not had any incapacitating episodes in the past 12 months. The condition did not impact his ability to work. The examiner also found that the Veteran did start having symptoms of blurry vision after his cataract surgery, and that this condition had improved since then. He also had symptoms of fluctuating, cloudy vision and eye pain.

The Veteran also attended a VA eye examination in May 2024. He was found to have dry eye syndrome, vitreous degeneration, and presence of intraocular lens. The Veteran reported that his dry eyes had gradually worsening, and he used Visine drops as needed. He reported that it felt like sand or grit in his eyes, that he had difficulty focusing that was alleviated with blinking and intermittent achy pain in both eyes. His vitreous degeneration caused floaters when watching TV for the past couple of years. The Veteran also reported that he had undergone intraocular lens impacts in both eyes in 1989, which improved his distance vision. He currently wore progressive glasses to improve distance and near vision. The examiner found that the Veteran had 20/20 or better corrected distance vision in both eyes. The examiner marked that the corrected near vision was 20/40 in the left eye and 20/20 or better in the right eye, and he later wrote that the corrected visual acuity in the left eye was 20/30, but that there was not a box he could check on the form for this option. There was no corneal irregularity resulting in severe irregular astigmatism and no diplopia. There was non-contact tonometry, and the eyes were mildly dry with mildly reduced tear prism. He treated the dry eye syndrome with artificial tear drops, and it did not cause a decrease in visual acuity or other visual impairment. The posterior chambers of the intraocular lens were clear and centered. There was no documented visual field defect. The Veteran had postoperative cataract removal with replacement lenses in both eyes. There was no aphakia or dislocation of the lenses, and no decrease in visual acuity or other visual impairment. The Veteran also had posterior vitreous detachment (floaters), and there caused no decrease in visual acuity or other visual impairment. He had not had any incapacitating episodes in the past 12 months. The condition did not impact his ability to work.

The Veteran's VA treatment records show that in August 2022, he reported that late afternoon and evenings he gets spasms of the eyelids and that this began 40 years ago. The Veteran's corrected distance acuity was 20/20-1 in the right eye and 20/20 in the left eye. He was found to have pseudophakia,
location of the lenses, and no decrease in visual acuity or other visual impairment. The Veteran also had posterior vitreous detachment (floaters), and there caused no decrease in visual acuity or other visual impairment. He had not had any incapacitating episodes in the past 12 months. The condition did not impact his ability to work.

The Veteran's VA treatment records show that in August 2022, he reported that late afternoon and evenings he gets spasms of the eyelids and that this began 40 years ago. The Veteran's corrected distance acuity was 20/20-1 in the right eye and 20/20 in the left eye. He was found to have pseudophakia, dry eye syndrome, and presbyopia in both eyes. He was also diagnosed with facial myokymia, causing lid twitching in both eyes, and he was educated on the condition and the importance of minimizing stress and caffeine intake.

In August 2023, the Veteran had an eye evaluation, and he reported that he had occasional fogging of vision what was fixed with blinking. His visual distance acuity was found to be 20/20-1 in both eyes. The corneas and irises were clear, and the condition was found to be stable. The Veteran was diagnosed with dry eye syndrome of the bilateral lacrimal glands, pseudophakia, and presbyopia. His lenses were well-centered, clear, and in good condition. There are no other VA treatment records or private treatment records that show any worse findings of visual acuity or visual field defect, or that show any additional symptoms related to the Veteran's eye conditions which have not already been discussed.

After reviewing all of the evidence of record, the Board finds that a 50 percent rating can be assigned based on the Veteran's decreased visual field. The January 2023 VA examiner found that the Veteran's visual field was greatly impaired in both eyes.

The average remaining visual field in the right eye was 21.5. The average remaining visual field in the left eye was 26.5. This meets the criteria for having a remaining field of 16 to 30 degrees in both eyes, and a 50 percent rating can be assigned. The Board acknowledges that the other VA examiners did not find that the Veteran had impairment of the visual field. However, the Board will afford the Veteran the benefit of the doubt, and accepts that he had this level of impairment of his visual field for the entire period on appeal. There is no evidence indicating that the Veteran's visual field has ever been worse than was found at the January 2023 VA examination at any time during the appeal period, and a rating higher than 50 percent based on decreased visual field is not warranted. 38 C.F.R. § 4.79, Diagnostic Code 6066.

There is no basis to assign any higher rating based on impairment of visual acuity, because at no time has the Veteran been found to have at least 20/50 corrected vision in either eye. The Veteran's near and distance eyesight has generally been found to be 20/20 in both eyes, and they have never been found to be worse than 20/40 in either eye. When visual acuity is 20/40 in both eyes, a 0 percent rating is assigned. Id. The Board acknowledges that the Veteran has asserted that there was a period in the 1980s when even his corrected vision was very poor. However, this was many years before the current appeal period, and the evidence shows that his vision was largely corrected through the implantation of lenses into his eyes, and his eyesight can now be corrected to levels that are not compensable.

The evidence is also against assigning a higher rating based on incapacitating episodes. Under the revised regulations, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes. 38 C.F.R. § 4.79, General Rating Formula for Diseases of the Eye, Note 1. The record shows that the Veteran does receive occasional treatment for his eyes by attending eye evaluations for eyeglasses and using artificial tear eye drops. The evidence does not show, however, that he ever required treatment at least 7 times in a 12-month period, nor has he asserted that he requires treatment with such frequency. The evidence shows that the Veteran attended regular eye evaluations approximately once or twice a year. He has not indicated that he required any additional treatment or clinic visits beyond this amount.

At the December 2025 Board hearing, the Veteran and his attorney said that the Veteran had 7 to 10 incapacitating episodes a year. However, when asked to describe those episodes, he said that while
1. The record shows that the Veteran does receive occasional treatment for his eyes by attending eye evaluations for eyeglasses and using artificial tear eye drops. The evidence does not show, however, that he ever required treatment at least 7 times in a 12-month period, nor has he asserted that he requires treatment with such frequency. The evidence shows that the Veteran attended regular eye evaluations approximately once or twice a year. He has not indicated that he required any additional treatment or clinic visits beyond this amount.

At the December 2025 Board hearing, the Veteran and his attorney said that the Veteran had 7 to 10 incapacitating episodes a year. However, when asked to describe those episodes, he said that while teaching, he would be unable to focus his eyes on the writing on the chalkboard, and would have to ask a student to read the writing. This description of his "incapacitating episodes" is not consistent with the VA regulation definition of an incapacitating episode, which requires a clinic visit to a provider for treatment purposes. A higher rating is therefore not warranted on the basis of incapacitating episodes.

The Board now turns to whether separate ratings can be assigned based on the Veteran's additional symptoms and diagnoses pertaining to his left eye. The Veteran wrote in April 2022 that he was seeking service connection for conjunctivitis, eye pain, loss of vision, eye spasms, blurry vision, double vision, and loss of light perception.

The June 2022 VA examiner did address whether the Veteran had any of these additional vision disorders, but found that he had no conjunctivitis, eye spasms, double vision (diplopia), or loss of light perception. The January 2023 VA examination and accompanying medical opinions also found that the Veteran had no conjunctivitis, double vision, or loss of light perception. This examiner did acknowledge that the Veteran had intermittent blurry vision, which he attributed to his dry eye syndrome, and this condition is addressed below.

A November 2023 VA medical opinion was also obtained to further address the Veteran's blurry vision. The examiner wrote that cataract surgery can cause a temporary increase in dry eye symptoms due to the irritation to the ocular surface from the incisions made in the eye to remove the natural lens and foreign material interacting with the cornea. She explained that blurry vision would be associated with the removal of his cataracts in the 1980s, and that the condition would theoretically would have resolved after the intraocular lenses were implanted in 1989. His symptoms had persisted beyond the expected resolution however, and the examiner attributed this to his dry eye condition, which was found on examination. This examiner also found that the Veteran did not have loss of light perception or double vision, and also pointed out that neither of these symptoms would be associated with his service-connected condition.

The Board therefore finds that the weight of the evidence is against finding that the Veteran has conjunctivitis, eye spasms, blurry vision, double vision, or loss of light perception, and no higher or separate rating is warranted for these conditions.

While the Veteran's VA treatment records show that he was found to have facial myokymia in 2022, and he has reported having occasional "floaters" in his eyes, there is no evidence linking these conditions to his service-connected post-surgical cataracts, and furthermore, there is no indication that they have caused any functional impairment that would allow for a higher or separate rating. None of the evidence, including the Veteran's lay statements, indicates that they have caused any visual impairment, incapacitating episodes, or any other type of functional impairment, nor has the Veteran asserted that they have.

Based on the Veteran's lay statements, his "loss of vision" claim appears to refer to his frustration that he had greatly impaired vision in the 1980s. However, as was discussed above, this was repaired by the surgery he underwent in 1989, and this was many years before the current appeal period. The June 2022 VA examiner also found that the Veteran's blurry vision was present following his first cataract surgeries, but this was also repaired by his 1989 lens implantation surgery. The Veteran's currently impaired field of vision is now being compensated by the 50 percent rating that has been assigned.

The Board does, however, finds that a separate 10 percent rating can be assigned for the Veteran's dry eye syndrome, which is the diagnosis that has been attributed to his reports of eye pain and discomfort, as well as occasional blurry vision.

The Veteran has written that he has chronic problems with discomfort and watering in his eyes. He has described how it sometimes feels like he has grit or sand in his eyes, and that they often water and produce tears. The VA examinations all found that
vision was present following his first cataract surgeries, but this was also repaired by his 1989 lens implantation surgery. The Veteran's currently impaired field of vision is now being compensated by the 50 percent rating that has been assigned.

The Veteran has written that he has chronic problems with discomfort and watering in his eyes. He has described how it sometimes feels like he has grit or sand in his eyes, and that they often water and produce tears. The VA examinations all found that he did have dry eye syndrome, and that the Veteran treated this with artificial tear eye drops. Symptoms of pain, discomfort, and eye watering are separate from visual impairment, and they can be assigned a separate rating.

Dry eye syndrome is not a condition that is specifically listed in the Rating Schedule. With an unlisted disability, it may be rated by analogy to a closely related disease or injury with a closely related disease or injury demonstrating similar affected function, anatomical location, and symptomatology. 38 C.F.R. § 4.20; see Stankevich v. Nicholson, 19?Vet. App.?470, 472 (2006). The Disability Benefits Questionnaire completed for the VA examinations indicates that dry eye syndrome is a type of lacrimal system condition, and disorders of the lacrimal apparatus are listed in the Rating Schedule. The Board finds that this is an appropriate diagnostic code to apply to dry eye syndrome, as the Veteran has asserted that he has chronic discomfort in his eyes caused by dry eye syndrome, and which causes occasional watering or the need for artificial tears. This condition affects the tearing and the moisture level in the Veteran's eye, and it is appropriate to apply the rating criteria for disorders of the lacrimal apparatus.

Disorders of the lacrimal apparatus (epiphora, dacryocystitis, etc.) are assigned a 10 percent rating when they are unilateral, and a 20 percent rating when they are bilateral. 38 C.F.R. § 4.79, Diagnostic Code 6025.

This condition affects both of the Veteran's eyes, and a 20 percent rating can be assigned. This is the highest rating possible under Diagnostic Code 6025.

The Board has considered whether any higher rating could be assigned under any other possibly appropriate diagnostic code. Diagnostic Code 6018, for chronic conjunctivitis, allows for a 10 percent rating when the condition is active, but this would not be higher than the 20 percent now assigned. For a rating higher than 10 percent under Diagnostic Code 6018, the condition is rated under the General Rating Formula for Diseases of the Eye, but there is no indication that the Veteran's dry eye disorder, alone, causes any visual impairment or incapacitating episodes. All VA examiners found that the dry eye disorder did not cause a decrease in visual acuity or other visual impairment. The VA treatment records also do not show any episodes of symptoms severe enough to require a clinic visit to a provider specifically for treatment purposes. The Board therefore finds that a higher rating cannot be assigned under Diagnostic Code 6018, and there are no other diagnostic codes which would be appropriately analogous to this condition.

The Board has considered the other diagnostic codes pertaining to the eye, but does not find that separate compensable ratings are warranted under any other relevant diagnostic code.

In sum, the Board finds that a rating of 50 percent, but no higher, can be assigned for the Veteran's post-operative cataracts with pseudophakia (intraocular lenses) and vitreous degeneration due to visual field impairment, and a separate rating of 20 percent, but no higher, can be assigned for his dry eye syndrome. The weight of the evidence is against finding that any additional separate or higher ratings should be assigned. The Board has considered the applicability of the benefit-of-the doubt doctrine; however, as the weight of the evidence is against assignment of any additional or ratings higher than those now assigned, that doctrine is not applicable. See 38 U.S.C. § 5107(b), Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021).

DELYVONNE M. WHITEHEAD

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Mary E. Rude, Counsel

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

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