Citation Nr: A20007332 Decision Date: 04/30/20 Archive Date: 04/30/20 DOCKET NO. 190724-14166 DATE: April 30, 2020 ORDER Entitlement to service connection for an eye disability (to include bilateral impaired vision, bilateral glaucoma, bilateral trace cataracts, and bilateral miosis) is denied. FINDING OF FACT The evidence of record demonstrates that the Veteran’s current vision loss is refractive in nature and therefore developmental and/or congenital; the Veteran does not have a diagnosis of glaucoma or any superimposed disease or injury of the eye related to active service. CONCLUSION OF LAW The criteria for service connection for an eye disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1985 to October 1988 and from March 1991 to July 1991. This case is before the Board of Veterans’ Appeals (Board) on appeal from a July 2018 rating decision. The Veteran’s Notice of Disagreement (NOD) was received in January 2019. The RO issued a Statement of the Case (SOC) in June 2019. In July 2019, the Veteran elected to opt-in to the modernized review system for the issues on appeal from the June 2019 SOC by submitting a VA Form 10182 (Notice of Disagreement) under the Appeals Modernization Act (AMA) and electing the Direct Review lane. See 84 Fed. Reg. 138, 177 (Jan. 18, 2019) (codified at 38 C.F.R. § 19.2 (d)). Accordingly, the Board is limited to review of the evidence in the record up and until the date of the Statement of the Case, June 4, 2019. 1. Entitlement to service connection for an eye disability. The Veteran seeks service connection for an eye disability. More specifically, he asserts that his vision became worse during service, to the extent that he required eyeglasses, and that he still suffers from impaired vision which began during service. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may also be granted on the basis of a post-service initial diagnosis of a disease, when “all of the evidence, including that pertinent to service, establishes that the disease was incurred during service.” See 38 C.F.R. § 3.303 (d). For purposes of entitlement to benefits, the law provides that refractive errors of the eyes are congenital or developmental defects and are not a disease or injury within the meaning of applicable legislation. 38 C.F.R. §§ 3.303(c), 4.9. In the absence of superimposed disease or injury, service connection may not be allowed for refractive error of the eyes, including myopia, presbyopia, and astigmatism, even if visual acuity decreased in service, as this is not a disease or injury within the meaning of applicable legislation relating to service connection. Id. Thus, VA regulations specifically prohibit service connection for refractive errors of the eyes unless such defect was subjected to a superimposed disease or injury which created additional disability. See VAOPGCPREC 82-90 (1990); 55 Fed. Reg. 45711 (1990). In analyzing the Veteran’s claim, the question for the Board is whether the Veteran has a current eye disability other than refractive error that is not congenital in nature; and, which began during service or is at least as likely as not related to an in-service injury, event, or disease. Service treatment records (STRs) show that the Veteran entered service with normal vision. See September 1985 entrance examination. In December 1986, the Veteran was treated for an upper respiratory infection. Examination revealed that the Veteran’s eyes were blood shot and irritated. The Veteran was prescribed eyeglasses in August 1987. STRs from October 1987 reflect that the Veteran’s eyes were watery and irritated, in conjunction with an upper respiratory infection. March 1988 service treatment records show the Veteran requested an eye exam due to experiencing headaches and blurry vision. It was also noted that the Veteran’s current prescription caused dizziness. Accordingly, the Veteran was referred to the optometry clinic for an eye examination. The eye exam conducted March 3, 1988 showed that the Veteran was noted to have refractive error corrected with lenses and possible glaucoma. A follow up treatment note from March 7, 1988 shows that it was determined that the Veteran did not have glaucoma. No other medical evidence of record shows a diagnosis of glaucoma during service. The Veteran’s separation examination report, dated in September 1988, shows that his eyes, ophthalmoscopic examination, pupils, and ocular motility were clinically evaluated as normal. Uncorrected distant vision was 20/50, bilaterally. A March 1991 eye exam conducted around the time of the Veteran’s entry into his second period of active duty shows that the Veteran marked that he had eye trouble; however, in the accompanying remarks section of the examination, it is noted only that the Veteran wore glasses. His uncorrected distant vision was 20/200 bilaterally. In April 1991, the Veteran’s eyes were noted to be irritated in conjunction with a runny nose. The assessment was allergic rhinitis. Additional service treatment records were reviewed for subsequent periods of Reserves service. During an August 1993 physical, the Veteran complained that his eyes were burning or watering. STRs show no other complaints, or treatment for eye trouble apart from new prescriptions for eyeglasses and worsening uncorrected distant vision. See e.g. September 1995 eye exam showing 20/200 uncorrected distant vision in the left eye and 20/100 uncorrected distant vision in the right eye. Additional examination reports from the Veteran’s Reserves service in September 1995 and in May 2000 were negative for eye disease or eye injury. Post-service private treatment records from May 2010 show that the Veteran’s eyes were found to be normal. A February 2015 physical also found the Veteran’s eyes to be normal, and the Veteran reported no eye symptoms. A May 2016 private treatment note similarly found the Veteran’s eyes to be normal. In the present case, the record contains a May 2018 VA examination. The examiner diagnosed the Veteran with bilateral miosis and bilateral trace cataracts but noted that the Veteran had no decrease in visual acuity or other visual impairment. In an addendum opinion, the examiner concluded that the Veteran’s trace cataracts were less likely than not related to service, stating that the “etiology of trace cataract is developmental and not related to any event in the Navy.” The Veteran’s uncorrected distant vision is 20/100 bilaterally. During the May 2018 examination, the examiner was aware of the Veteran’s in-service eye history, evidenced by a summarization on the examination report of all of the Veteran’s eye exams during service. The Veteran reported to the examiner that his “eye condition” began in 1987 when a Navy doctor told him he had glaucoma. However, as noted above, the follow up examination found that the Veteran did not have glaucoma and no other medical evidence of record shows a diagnosis of glaucoma or any other eye disability. The Veteran has also stated that his current vision impairment is a result of sleepless nights and late-night drills during service. See, e.g., January 2019 Legacy NOD. First, while the Veteran is certainly capable of reporting observable symptoms such as a decrease in visual acuity, he does not possess the requisite medical training or expertise to render an opinion as to causation of his decreased visual acuity. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Thus, his statements are not competent in that regard. Moreover, as noted above, refractive error of the eye is a congenital or developmental defect not capable of service connection, and there is no competent medical evidence showing that the Veteran incurred a superimposed eye injury as a result of service. In summary, the Veteran does not have a current disability of glaucoma, and the only in-service eye conditions other than refractive error were acute episodes of itchy, watery, and/or irritated eyes, all of which were noted in conjunction with allergies or acute upper respiratory infections. Moreover, the Veteran’s current trace cataracts and miosis were not shown during active duty or for many years following active duty. As noted above, the Veteran served in the Reserves following his last period of active duty in 1991. The May 2018 VA examiner did not find that the Veteran’s current trace cataracts and/or miosis were related to service, pointing out, in particular, that the etiology of the trace cataract was developmental and not related to any in-service event. The examiner also noted that the Veteran’s pupils were round and reactive to light, and that there was no afferent pupillary defect present. No functional impairment as a result of the miosis (constriction of pupils) was indicated. In essence, the examination report shows that the Veteran had only trace cataracts, developmental in nature, non-disabling miosis, and refractive error of the eye. There is no medical evidence to the contrary. Accordingly, and for the reasons set forth above, the Veteran does not have a current eye injury or disease related to service. The Veteran does not have glaucoma and his current eye conditions are developmental and/or congenital in nature and therefore service connection is not warranted. L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board V. Modesto 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.