Citation Nr: 21003757 Decision Date: 01/22/21 Archive Date: 01/22/21 DOCKET NO. 16-22 169 DATE: January 22, 2021 ORDER Entitlement to service connection for a detached retina of the left eye is denied. FINDING OF FACT A detached retina of the left eye did not have its onset during the Veteran’s active service, and is not otherwise etiologically related to such service. CONCLUSION OF LAW The criteria for service connection for a detached retina of the left eye are not met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from March 1997 to November 2006. The Veteran’s awards and decorations for his service include a Purple Heart Medal and a Combat Action Ribbon. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2015 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran testified at a hearing before the undersigned Veterans Law Judge in August 2018. A transcript of that hearing has been associated with the claims file. This case was previously before the Board in March 2019, at which time the issue on appeal was remanded for additional development. The case has now been returned to the Board for further appellate action. Service Connection – Detached Retina of the Left Eye The Veteran asserts that his detached retina of left eye, is related to his active service. Specifically, the Veteran testified at the August 2018 hearing that he was involved in an improvised explosive device (IED) explosion in June 2004 that resulted in a traumatic brain injury (TBI) The Veteran has reported that he believes that his eye was likely injured at the time of the TBI, which ultimately led to the detachment of his left retina. Service treatment records (STRs) show that the Veteran was indeed involved in an IED explosion in June 2004. Treatment records from that time show that the Veteran sustained a right shoulder injury requiring surgical wound debridement and closure, and that he had shrapnel removed from his right jaw. There are no records showing the Veteran to have reported any ocular complaints related to either eye at the time of the IED explosion resulting in injury, or subsequent treatment for such. In August 2006, the Veteran was afforded a separation examination. There is no indication from the examination report that the Veteran reported any ocular complaints at that time. In fact, the Veteran specifically denied any loss of vision in either eye in his Report of Medical History. The Veteran was noted to wear glasses or contacts at separation; however, STRs from as early as January 2000 show the Veteran to require correction for refractive error with an astigmatism. Physical examination of the eyes, pupils, and ocular motility at separation was clinically normal. Further, ophthalmoscopic examination was clinically normal. There is no other indication from the separation examination report that the Veteran was noted to have any eye disability at the time of his septation from active service. Post-service medical evidence of record shows that the Veteran was seen by outside providers for a routine eye examination by his optometrist, at which time the Veteran was referred to an ophthalmologist for follow-up of a suspected detached left retina. In September 2014, the Veteran was seen by an ophthalmologist, at which time he reported that he had a history of head trauma, and described his June 2004 IED blast injury. The Veteran denied any ocular effect at the time of the TBI. The Veteran was diagnosed with retinoschisis and detached left retina. The Veteran underwent laser retinopexy for his retinoschisis-related retinal detachment. A February 2015 VA examination, the Veteran reported his history of TBI in 2004. He denied any further head or eye trauma between the time of his 2004 TBI and his left eye retinal detachment. determined that the IED/TBI was not the cause of the detached retina. The examiner opined that were the two conditions related the detached retina would have occurred within weeks or months following the TBI. The TBI occurred in June 2004 with the detached retina first diagnosed in September 2014 more than ten years after the TBI. Therefore, the examiner found it less likely than not that the detached retina was related to the TBI. The examiner opined that the left eye retina detachment was not due to the Veteran’s in-service TBI. In so finding, the examiner noted that there was a 10 year duration between the TBI and the occurrence of retinal detachment. The examiner noted that a retinal detachment resulting from trauma would have been seen in the first few weeks or months after the TBI. In July 2019, an addendum VA medical opinion was obtained. At that time, the VA examiner opined that it was less likely as not that the Veteran’s retinoschisis and related retinal detachment were related to the Veteran’s active service. In so finding the examiner noted that retinoschisis was a common age related degeneration of the retina which was noted in up to seven percent of normal people, and was seen in approximately four percent of people over the age of 40. The examiner noted that retinoschisis occurred in the peripheral retina and usually caused no symptoms, and was often not seen or noted on routine ophthalmologic or optometric examination. The examiner noted that as the Veteran was not noted to have retinoschisis until he was diagnosed as having a retinal detachment in 2014, at which time the Veteran was about 40 years of age, he would have been in the range when about four percent of the population is noted to have retinoschisis. The Board finds that the February 2015 and July 2019 VA medical opinions are adequate, especially when read in conjunction with one another. In this regard, the examiner reviewed and discussed the relevant evidence, considered the contentions of the Veteran, and provided a supporting rationale for the conclusions reached. Barr v. Nicholson, 21 Vet. App. 303 (2007); Stefl v. Nicholson, 21 Vet. App. 120 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Additionally, the examiner’s conclusions are well-supported by the documented treatment that the Veteran has received for his detached retina since 2014. Further, there is no medical opinion of record to the contrary. As such, the VA medical opinions are the most probative evidence of record. While the laypersons are competent to report observable symptoms, the Veteran is not competent to provide a medical opinion linking his current retinoschisis or detached retina to his active service, as that would require medical knowledge, training, and expertise and is simply outside the realm of common knowledge of a lay person. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Therefore, the Veteran is not competent to provide an etiology opinion in this case. In sum, the Board notes that the Veteran did sustain a TBI while in active service in June 2004. However, the Veteran did not have any ocular complaints at that time, or at his separation examination in August 2006. The Veteran was not found to have retinoschisis and detached retina until 2014. The VA medical opinions of record are against the claim, and highly probative. Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to service connection for left eye detached retina is not warranted. 38 U.S.C. § 5107 (b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Andrew Ledman II 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.