Citation Nr: 19125331 Decision Date: 04/04/19 Archive Date: 04/04/19 DOCKET NO. 17-09 500 DATE: April 4, 2019 ORDER Service connection for a dry eye syndrome (and other residuals of in-service LASIK eye surgery) is denied. FINDING OF FACT The preponderance of evidence shows that the Veteran’s dry eye syndrome (and other residuals of in-service LASIK eye surgery) was not incurred due to a disease or injury during active service. CONCLUSION OF LAW The criteria for service connection for a dry eye syndrome have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran honorably served in the U.S. Navy from September 2010 to September 2015. This matter is before the Board of Veterans’ Appeals on appeal from a February 2016 decision of the Department of Veterans Affairs (VA) Regional Office in St. Paul, Minnesota. 1. Service connection for a dry eye syndrome is denied. Legal Criteria Service connection may be granted for disability caused by disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. To establish service connection for a claimed disability, there must be evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (“nexus”) between the claimed in-service disease or injury and the current disability. Hickson v. West, 12 Vet. App. 247 (1999). The usual effects of medical and surgical treatment in service, having the effect of ameliorating disease or other conditions incurred before enlistment will not be considered service connected unless the disease or injury is otherwise aggravated by service. 38 U.S.C. § 1153; 38 C.F.R. § 3.306 (a), (b). Pertinent to this case, refractive errors of the eyes (including hypermetropia, astigmatism, presbyopia, and refractive amblyopia) are not a disease or injury within the meaning of applicable regulations. See 38 C.F.R. §§ 3.303 (c), 4.9. Lay statements may serve to support a claim for service connection by establishing the occurrence of observable events or the presence of a disability or symptoms of disability subject to lay observation. See 38 U.S.C. § 1154 (a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). When all evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in “relative equipoise” (meaning that the evidence for and against the claim is evenly balanced), with the veteran prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which case the claim must be denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). Factual Background The Veteran is claiming service connection for dry eye syndrome and other residuals of in-service LASIK eye surgery. See March 2016 Notice of Disagreement. The Veteran’s November 2015 VA examination indicates he has experiences dry eye syndrome and other residuals of the surgery. See November 2015 VA examination. His service treatment records indicate that the Veteran had an astigmatism and refractive error. See August 2011 service treatment record. In 2014, he underwent LASIK eye surgery to correct this. See May 2014 operative plan. He was informed about the possible side effects that could result as a consequence of this surgery. See May 2014 surgery report. Later, the Veteran was diagnosed with dry eye syndrome. See March 2015 optometry report. The Veteran stated that the dry eye syndrome is a residual of the LASIK procedure performed in service. See March 2016 NOD. He said he also has recurring pain in both eyes, decreased night vision, and a higher than normal rate of aberrations (including starburst and halos). Id. In November 2015, VA conducted an examination concerning the Veteran’s dry eye syndrome. The examiner noted that the Veteran had LASIK surgery and has experienced visual issues since the surgery. The examiner also concluded that the Veteran experiences functional impairment due to his dry eye syndrome. Analysis The Veteran can establish a current disability of dry eye syndrome and associated residuals of in-service LASIK eye surgery. The question before the Board is whether these medical problems are “[t]he usual effects of medical and surgical treatment in service” (and therefore not eligible for disability compensation) or whether they were “otherwise aggravated by service” in any way. See 38 U.S.C. § 1153; 38 C.F.R. § 3.306 (a), (b). The Board acknowledges that the Veteran received LASIK eye surgery while on active duty. However, for service connection to be granted for an elective procedure, that procedure must be due to an in-service disease or injury. This procedure was performed due to the Veteran’s refractive error (including astigmatism), which is considered a developmental defect and not disease or injury within the meaning of applicable legislation. See 38 C.F.R. §§ 3.303 (c), 4.9. Therefore, the Veteran cannot establish an in-service disease or injury for the purposes of VA compensation. Furthermore, the Board acknowledges that the Veteran has experienced pain in both eyes as well as decreased vision as a result of his dry eye syndrome. However, the Veteran was informed about usual side effects of his elective LASIK surgery. The symptoms he is experiencing, while unfortunate, are considered a usual effect of the surgery and therefore not compensable. Without an in-service injury or disease, a causal link (“nexus”) between a current condition and military service cannot be established. Moreover, the VA examination does not indicate that the Veteran’s dry eye syndrome is at least as likely as not a result of service in any other way. Accordingly, the preponderance of the evidence is against finding that the Veteran’s current dry eye syndrome is related to an in-service disease or injury and service connection for dry eye syndrome (and other residuals of in-service LASIK eye surgery) must be denied. [CONTINUED ON NEXT PAGE] The Board is grateful for the Veteran’s honorable service and regrets that a more favorable outcome is not warranted. VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Bryant, Law Clerk