Citation Nr: 21070826 Decision Date: 11/26/21 Archive Date: 11/26/21 DOCKET NO. 19-33 340 DATE: November 26, 2021 ORDER A 20 percent rating for dry eye syndrome is granted beginning the earlier date of February 20, 2018 (so not just as of May 6, 2019). A higher 10 percent rating is granted for pinguecula with corneal scarring. Prior to November 23, 2020, a 10 percent rating is granted for infiltrative keratitis and open angle glaucoma. Also, as of November 23, 2020, a higher 30 percent rating is granted for the infiltrative keratitis and open angle glaucoma. FINDINGS OF FACT 1. The Veteran has had dry eye syndrome for the entirety of the review period. 2. His pinguecula with corneal scarring has resulted in eye pain. 3. Prior to November 23, 2020, he experienced visual field defects with average concentric contraction measuring 56 degrees of visual field preserved in his right eye, and 57 degrees of visual field preserved in his left eye. His visual acuity measured 20/40 or better with no incapacitating episodes. 4. Since November 23, 2020, he has experienced visual field defects with average concentric contraction measuring 34 degrees of visual field preserved in his right eye, and 37 degrees of visual field preserved in his left eye. His visual acuity has measured 20/40 or better with no incapacitating episodes. CONCLUSIONS OF LAW 1. The criteria are met for entitlement to a 20 percent rating for dry eye syndrome as of an earlier effective date namely, as of February 20, 2018 rather than just since May 6, 2019. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. § 3.102, 3.159, 4.1, 4.3, 4.7, 4.79, Diagnostic Code (DC) 6099-6025. 2. The criteria also are met for entitlement to a 10 percent rating for pinguecula with corneal scarring. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.79, 4.118, DC 6037-7800. 3. As well, prior to November 23, 2020, the criteria are met for entitlement to a 10 percent rating for infiltrative keratitis and open angle glaucoma. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.75-4.79, DC 6013. 4. Also, since November 23, 2020, the criteria are met for entitlement to a 30 percent rating for the infiltrative keratitis and open angle glaucoma. Id. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U. S. Marines Corps from September 1991 to March 1999. This appeal to the Board of Veterans' Appeals (Board) is from a December 2018 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2020, the Board remanded these claims back to the RO (Agency of Original Jurisdiction (AOJ)) for further development and consideration. At the time, the Veteran had a 0 percent (so noncompensable) collective rating for pinguecula with dry eye syndrome and open-angle glaucoma. However, in a December 2020 decision since issued, on remand, the RO granted a separate 20 percent rating for the dry eye syndrome as of May 6, 2019. The Veteran since has continued to appeal. See AB v. Brown, 6 Vet. App. 35, 38-39 (1993) (explaining that receipt of a higher rating, but less than maximum possible rating and for all periods at issue, does not abrogate an appeal). 1. The 20 percent rating for the dry eye syndrome is granted as of an earlier effective date namely, as of February 20, 2018 rather than just since May 6, 2019. The Veteran's dry eye syndrome is rated as 20-percent disabling under 38 C.F.R. § 4.79, DC 6099-6025, for disorders of the lacrimal apparatus (epiphora, dacryocystitis, etc.). According to DC 6025, a 20 percent rating is warranted for bilateral (both eye) involvement and a 10 percent rating is warranted for unilateral (one eye) involvement. During the pendency of this appeal, VA issued a final rule revising the portion of the VA Schedule for Rating Disabilities that addresses the organs of special sense and schedule of ratings-eye. 89 Fed. Reg. 15316 (Apr. 10, 2018). The final rule went into effect May 13, 2018. There was no amendment to DC 6025. The Veteran is currently assigned his 20 percent rating beginning May 6, 2019 because this was the date determined by the RO on which his condition had worsened. The Board observes, however, that he has had a diagnosis of bilateral dry eye syndrome for the entirety of the review period. In fact, the earlier May 2018 VA examiner noted that the Veteran had had a diagnosis of bilateral dry eye syndrome since 1995. Thus, a 20 percent rating is warranted for dry eye syndrome since there has been bilateral (left and right eye) involvement, rather than a worsening of symptoms. The Veteran has reported experiencing symptoms of dryness, itching, and tingling throughout the review period. Consequently, the Board finds his 20 percent rating is warranted beginning the earlier date of February 20, 2018. 2. Entitlement to a rating of 10 percent for pinguecula and corneal scarring is granted. The Veteran's pinguecula with corneal scarring is currently rated 0-percent disabling (noncompensable) under 38 C.F.R. § 4.79, DC 6037. DC 6037 instructs to evaluate pinguecula based on disfigurement (DC 7800). And, for the following reasons and bases, the Board finds that a higher 10 percent rating warranted. As already alluded to, during the pendency of this appeal, VA issued a final rule revising the portion of the VA Schedule for Rating Disabilities that addresses the organs of special sense and schedule of ratings-eye. 89 Fed. Reg. 15316 (Apr. 10, 2018). The final rule went into effect May 13, 2018. There was no amendment to DC 6037. VA also amended the criteria for rating skin disabilities, effective August 13, 2018. However, DC 7800 and 7804 (unstable or painful scars) were not changed by the August 13, 2018, amendments. According to DC 7800, one characteristic of disfigurement warrants a 10 percent rating. A scar with visible or palpable tissue loss and either gross distortion or asymmetry of one feature or paired set of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with two or three characteristics of disfigurement warrants a 30 percent rating. A scar with visible or palpable tissue loss and either gross distortion or asymmetry of two features or paired sets of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with four or five characteristics of disfigurement warrants a 50 percent rating. A scar with visible or palpable tissue loss and either gross distortion of three or more features or paired sets of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with six or more characteristics of disfigurement warrants an 80 percent rating. 38 C.F.R. § 4.118. For purposes of evaluation of under 38 C.F.R. § 4.118, the eight characteristics of disfigurement are: a scar that is five or more inches, or thirteen centimeters, in length; a scar that is at least one-quarter of an inch, or 0.6 centimeters, wide at the widest part; surface contour of the scar that is elevated or depressed on palpation; a scar that is adherent to underlying tissue; skin that is hypo- or hyper-pigmented in an area exceeding six square inches, or 39 square centimeters; skin texture that is abnormal (irregular, atrophic, shiny, scaly, etc.) in an area exceeding six square inches, or 39 square centimeters; underlying soft tissue that is missing in an area exceeding six square inches, or 39 square centimeters; and skin that is indurated and inflexible in an area exceeding six square inches, or 39 square centimeters. 38 C.F.R. § 4.118, Diagnostic Code 7800, Note (1). While the Veteran's corneal scarring is considered noncompensable under DC 7800, Note (4) to DC 7800 instructs to separately evaluate disabling effects other than disfigurement that are associated with individual scars. Here, the Board notes that DC 7804 instructs to evaluate a painful scar as 10-percent disabling. Under DC 7804, one or two scars that are unstable or painful warrants a 10 percent rating. Three or four scars that are unstable or painful warrants a 20 percent rating. Five or more scars that are unstable or painful warrants a 30 percent rating. 38 C.F.R. § 4.118. The Board finds that the evidence is in favor of the assignment of a rating of 10 percent under DC 7804 because the Veteran reported a history of intermittent, chronic eye pain and photophobia owing to his service-connected eye conditions. For example, according to a March 2020 VA treatment note, he complained of constant chronic eye pain. Treatment notes also indicate he was seen for eye pain in November 2019 and reported a history of eye pain to the VA examiner in November 2020. In January 2019, he similarly reported experiencing photophobia because of his service-connected eye conditions, including his corneal scarring, which, as the December 2020 examiner explained, make it difficult, if not impossible, for tear film to evenly coat the surface of the eye, thus resulting in frequent styes and multiple therapies. Thus, the Board finds that the evidence supports assignment of a 10 percent rating under DC 7800 due to the Veteran's eye pain. He does not report, and the evidence of record does not otherwise support additionally finding that he has visible or palpable tissue loss and either gross distortion or asymmetry of one feature or paired set of features or two or three characteristics of disfigurement. Accordingly, the Board finds that a rating of 10 percent, at most, is warranted for his painful bilateral pinguecula with corneal scarring. 3. Prior to November 23, 2020, entitlement to a rating of 10 percent for infiltrative keratitis and open angle glaucoma is granted. 4. After November 23, 2020, however, entitlement to a higher 30 percent rating for the infiltrative keratitis and open angle glaucoma is granted. The Veteran's glaucoma was previously rated noncompensable under DC 6037-7800 along with his pinguecula. But, for the following reasons and bases, the Board finds that a separate 10 percent rating is warranted for this condition prior to November 23, 2020 and a higher 30 percent rating since. Of note, the November 2020 VA examiner added recurrent keratitis. Thus, in addition to the Veteran's dry eye syndrome and painful corneal scarring, the Board also considers a separate rating for his keratitis and glaucoma. The Veteran's open-angle glaucoma and keratitis are being assigned a 10 percent rating prior to November 23, 2020 and a 30 percent rating thereafter under 38 C.F.R. § 4.79, DC 6013. The assignment of a particular DC is "completely dependent on the facts of a particular case." See Butts v. Brown, 5 Vet. App. 532, 538 (1993). One DC may be more appropriate than another based on such factors as an individual's relevant medical history, the diagnosis, and demonstrated symptomatology. Any change in DC by a VA adjudicator must be specifically explained. See Pernorio v. Derwinski, 2 Vet. App. 625, 629 (1992). During the pendency of this appeal, VA issued a final rule revising the portion of the VA Schedule for Rating Disabilities that addresses the organs of special sense and schedule of ratings-eye. 89 Fed. Reg. 15316 (Apr. 10, 2018). The final rule went into effect May 13, 2018. Where there is a change in the rating criteria during the appeal period, the Board will consider the claim in light of both the former and revised schedular rating criteria, although an increased evaluation based on the revised criteria cannot predate the effective date of the amendments. See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). Both the former and revised criteria indicate that a minimum 10 percent rating is warranted if continuous medication is required. Under the former criteria, DC 6013 instructed to evaluate based on visual impairment due to open-angle glaucoma. Under the revised criteria, DC 6013 instructs to evaluate pursuant to the General Rating Formula for Diseases of the Eye. This General Rating Formula for Diseases of the Eye instructs to evaluate a condition based on visual impairment or its rating criteria for incapacitating episodes. Thus, the primary difference between the former and revised criteria is consideration of incapacitating episodes. Regarding visual impairment, the amendments made no substantive changes to how visual acuity is rated. Concerning visual field and muscle function examinations, the use of a Goldmann's chart is no longer required. There are otherwise no substantive changes to how those types of visual impairment are rated. The General Rating Formal for Diseases of the Eye instructs to evaluate based on either visual impairment due to a particular condition or on incapacitating episodes, whichever results in a higher evaluation. Incapacitating Episodes Where 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 10 percent rating is warranted. Where there are documented incapacitating episodes requiring at least 3 but less than 5 treatment visits for an eye condition during the past 12 months, a 20 percent rating is warranted. Where there are documented incapacitating episodes requiring at least 5 but less than 7 treatment visits for an eye condition during the past 12 months, a 40 percent rating is warranted. Where there are documented incapacitating episodes requiring 7 or more treatment visits for an eye condition during the past 12 months, a 60 percent rating is warranted. Note (1) indicates that, for the purposes of evaluations under 38 C.F.R. § 4.79, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes. Note (2) indicates 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. Note (3) indicates that, for the purposes of evaluating visual impairment due to a particular condition, refer to 38 C.F.R. § 4.75-4.78 and to § 4.79, DCs 6061-6091. With regards to incapacitating episodes, the Board acknowledges the Veteran's November 2020 VA examination indicates the Veteran experienced over 7 incapacitating episodes over the prior 12 months which required, among other medications, Restasis (cyclosporine ophthalmic), which is a type of immunosuppressant. Indeed, the Veteran was seen for a variety of eye issues stemming from his service-connected eye conditions over the review period, including recurrent styes, blepharitis, chalazions and other infections resulting in pain and ocular discomfort. VA records indicate these conditions have been treated by warm compresses, prescription eye drops, and lid scrubs. To this end, he has, at various points during the review period been prescribed topical corticosteroids, antibiotics, and immunosuppressants to treat his eye conditions. The Board must therefore consider whether these episodes qualify as "treatment" under the specific definition of § 4.79. The Board finds that they do not. The treatment records reflect that the Veteran was prescribed eye drops to be used as directed and instructed to return regularly for future monitoring and instructed to perform at-home treatments such as hot compresses. The examples listed under § 4.79 suggest an implicit requirement that a qualifying "treatment" must require administration by a physician or otherwise implicate a certain severity of potential side effect: "systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions." 38 C.F.R. § 4.79. While the Veteran was prescribed a type of immunosuppressant in the form of an eye drop, it is not considered a "systemic immunosuppressant." See, e.g., Johnson v. Shulkin, 862 F. 3d 1351 (Fed. Cir. 2017) (holding "systemic therapy" did not include topical therapy that affects only the area to which it is applied). The Board therefore finds that the eye drops prescribed for the Veteran to be used as directed on an outpatient basis do not qualify as the type of "treatment" contemplated by § 4.79 that would suggest entitlement to any higher rating. Thus, there is no basis under the General Rating Formula for a higher rating for his eye conditions based on incapacitating episodes under either the former or current criteria of this VA regulation. Visual Impairment The evaluation 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). Examinations of visual impairment must be conducted by a licensed optometrist or ophthalmologist, and the examiner must identify the disease, injury, or other pathologic process for any visual impairment found. Id. § 4.75(b). Examinations of visual field or muscle function will be conducted only when medically indicated. Id. Evaluation 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. Generally, the table is divided into steps corresponding to different levels of visual acuity for one eye, and each step is further divided into subsections of visual acuity for the other eye, with corresponding ratings. The rater will first locate the step that matches the visual acuity of the poorer eye. Within that step, the rater will then locate the subsection that matches the visual acuity of the better eye, which will produce the corresponding rating. Where a reported visual acuity is between two sequentially listed visual acuities, the visual acuity which permits the higher evaluation will be used. 38 C.F.R. § 4.76(c). TABLE FOR VISUAL ACUITY The table of Impairment of Central Visual Acuity encompasses DCs 6061-66. Under DC 6061, a 100 percent rating is warranted for anatomical loss of both eyes. Under DC 6062, a 100 percent rating is warranted for no more than light perception in both eyes. DC 6063 provides ratings where there is anatomical loss of one eye (the poorer eye). A 40 percent rating is warranted where visual acuity of the other eye is 20/40. A 50 percent rating is warranted where visual acuity of the other eye is 20/50. A 60 percent rating is warranted where visual acuity of the other eye is 20/100 or 20/70. A 70 percent rating is warranted where visual acuity of the other eye is 20/200. An 80 percent rating is warranted where visual acuity of the other eye is 15/200. A 90 percent rating is warranted where visual acuity of the other eye is 10/200. A 100 percent rating is warranted where visual acuity of the other eye is 5/200. DC 6064 provides ratings where there is no more than light perception in one eye (the poorer eye). A 30 percent rating is warranted where visual acuity in the other eye is 20/40. A 40 percent rating is warranted where visual acuity in the other eye is 20/50. A 50 percent rating is warranted where visual acuity in the other eye is 20/70. A 60 percent rating is warranted where visual acuity in the other eye is 20/100. A 70 percent rating is warranted where visual acuity in the other eye is 20/200. An 80 percent rating is warranted where visual acuity in the other eye is 15/200. A 90 percent rating is warranted where visual acuity in the other eye is 10/200. A 100 percent rating is warranted where visual acuity in the other eye is 5/200. DC 6065 provides ratings where vision in one eye (the poorer eye) is 5/200. A 30 percent rating is warranted where vision in the other eye is 20/40. A 40 percent rating is warranted where vision in the other eye is 20/50. A 50 percent rating is warranted where vision in the other eye is20/70. A 60 percent rating is warranted where vision in the other eye is 20/100. A 70 percent rating is warranted where vision in the other eye is 20/200. An 80 percent rating is warranted where vision in the other eye is 15/200. A 90 percent rating is warranted where vision in the other eye is 10/200. A 100 percent rating is warranted where vision in the other eye is also 5/200. DC 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 rating is warranted. Where the visual acuity in one eye (the poorer eye) is 20/50, the following ratings apply. A 10 percent rating is warranted where vision in the other eye is either 20/50 or 20/40. Where the visual acuity in one eye (the poorer eye) is 20/70, the following ratings apply. A 30 percent rating is warranted where vision in the other eye is also 20/70. A 20 percent rating is warranted where vision in the other eye is 20/50. A 10 percent rating is warranted where vision in the other eye is 20/40. Where the visual acuity in one eye (the poorer eye) is 20/100, the following ratings apply. A 50 percent rating is warranted where vision in the other eye is also 20/100. A 30 percent rating is warranted where vision in the other eye is 20/70. A 20 percent rating is warranted where vision in the other eye is 20/50. A 10 percent rating is warranted where vision in the other eye is 20/40. Where visual acuity in one eye (the poorer eye) is 20/200, the following ratings apply. A 70 percent rating is warranted where vision in the other eye is also 20/200. A 60 percent rating is warranted where vision in the other eye is 20/100. A 40 percent rating is warranted where vision in the other eye is 20/70. A 30 percent rating is warranted where vision in the other eye is 20/50. A 20 percent rating is warranted where vision in the other eye is 20/40. Where visual acuity in one eye (the poorer eye) is 15/200, the following ratings apply. An 80 percent rating is warranted where vision in the other eye is also 15/200. A 70 percent rating is warranted where vision in the other eye is 20/200. A 60 percent rating is warranted where vision in the other eye is 20/100. A 40 percent rating is warranted where vision in the other eye is 20/70. A 30 percent rating is warranted where vision in the other eye is 20/50. A 20 percent rating is warranted where vision in the other eye is 20/40. Where visual acuity in one eye (the poorer eye) is 10/200, the following ratings apply. A 90 percent rating is warranted where vision in the other eye is also 10/200. An 80 percent rating is warranted where vision in the other eye is 15/200. A 70 percent rating is warranted where vision in the other eye is 20/200. A 60 percent rating is warranted where vision in the other eye is 20/100. A 50 percent rating is warranted where vision in the other eye is 20/70. A 40 percent rating is warranted where vision in the other eye is 20/50. A 30 percent rating is warranted where vision in the other eye is 20/40. Here, the Veteran's visual acuity has ranged between 20/40 and 20/20 bilaterally for the duration of the review period. Consequently, a noncompensable rating is warranted for visual acuity. As explained in the following section, however, both the November 2020 and the May 2018 examiners noted impairment to the Veteran's visual field this is considered compensable. IMPAIRMENT OF VISUAL FIELD Evaluation of visual field is based on the remaining field of vision in each eye. The examiner must record the remaining visual field of at least 16 meridians 2212 degrees apart for each eye, even though only the visual field at eight principal meridians 45 degrees apart will be used for rating purposes. Id. The table of Ratings for Impairment of Visual Fields provides ratings for visual field loss. The first half of the table provides ratings based on loss of an entire half of field of vision in an eye. The second half of the table provides ratings based on the average concentric contraction of the visual field of each eye. To calculate average concentric contraction, the rater should add the remaining visual field (in degrees) at each of eight principal meridians 45 degrees apart and divide the sum by eight. 38 C.F.R. § 4.77(b). 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, separately evaluate the visual acuity and visual field defect (expressed as a level of visual acuity), and combine them under the provisions of § 4.25. 38 C.F.R. § 4.77(c). TABLE FOR VISUAL FIELD The table of Ratings for Impairment of Visual Fields encompasses DCs 6080 6081. Homonymous hemianopsia is rated 30 percent. Loss of temporal half of visual field warrants a 30 percent rating is it is bilateral and a 10 percent rating if it is unilateral. Alternatively, this equates to 20/70 vision in each affected eye. Loss of nasal half of visual field warrants a 10 percent rating, whether or not the effect is bilateral or unilateral. Alternatively, this equates to 20/50 vision in each affected eye. Loss of inferior half of visual field warrants a 30 percent rating is it is bilateral and a 10 percent rating if it is unilateral. Alternatively, this equates to 20/70 vision in each affected eye. Loss of superior half of visual field warrants a 10 percent rating, whether or not the effect is bilateral or unilateral. Alternatively, this equates to 20/50 vision in each affected eye. Ratings are also provided for concentric contraction of visual field. Where there is a remaining field of 46 to 60 degrees, a 10 percent rating is warranted for either bilateral or unilateral involvement. Alternatively, this equates to 20/50 vision in each affected eye. Where there is a remaining field of 31 to 45 degrees, a 30 percent rating is warranted for bilateral involvement and a 10 percent rating is warranted for unilateral involvement. Alternatively, this equates to 20/70 vision in each eye. Where there is a remaining field of 16 to 30 degrees, a 50 percent rating is warranted for bilateral involvement and a 10 percent rating is warranted for unilateral involvement. Alternatively, this equates to 20/100 vision in each affected eye. Where there is a remaining field of 6 to 15 degrees, a 70 percent rating is warranted for bilateral involvement and a 20 percent rating is warranted for unilateral involvement. Alternatively, this equates to 20/200 vision in each affected eye. Where there is a remaining field of 5 degrees, a 100 percent rating is warranted for bilateral involvement and a 30 percent rating is warranted for unilateral involvement. Alternatively, this equates to 5/200 vision in each affected eye. Analysis Turning to the case at hand, the Board notes that the Veteran was afforded VA examinations in both May 2018 and November 2020. His visual acuity was measured at 20/40 or better bilaterally. However, each examiner noted that the Veteran experienced visual field defects. Entitlement to 10 percent Prior to November 23, 2020 In May 2018, visual field testing revealed contraction of the right visual field to 52 degrees down (65 normal, for a loss of 13), 50 degrees down nasally (50 normal, for a loss of 0), 50 degrees nasally (60 normal, for a loss of 10), 46 degrees up nasally (55 normal, for a loss of 9), 40 degrees up (45 normal, for a loss of 5), 55 degrees up temporally (55 normal, for a loss of 0), 85 degrees temporally (85 normal, for a loss of 0), and 70 degrees down temporally (85 normal, for a loss of 15). The total loss of degrees of visual fields of the right eye was 52 degrees. 500 minus 52 total degrees lost equals 448 total remaining degrees of visual field divided by 8 that resulted in an average concentric contraction of 56 degrees of visual field preserved in the right eye. Visual field testing revealed contraction of the left visual field to 54 degrees down (65 normal, for a loss of 11), 50 degrees down nasally (50 normal, for a loss of 0), 56 degrees nasally (60 normal, for a loss of 4), 55 degrees up nasally (55 normal, for a loss of 0), 40 degrees up (45 normal, for a loss of 5), 49 degrees up temporally (55 normal, for a loss of 6), 85 degrees temporally (85 normal, for a loss of 0), and 70 degrees down temporally (85 normal, for a loss of 15). The total loss of degrees of visual fields of the left eye was 41 degrees. 500 minus 41 total degrees lost equals 459 total remaining degrees of visual field divided by 8 that resulted in an average concentric contraction of 57.375 rounded down to 57 degrees of visual field preserved in the left eye. At this juncture, the Veteran's worst corrected visual acuity was 20/40 or better, bilaterally. Thus, a compensable rating based on impairment of visual acuity is not warranted. 38 C.F.R. § 4.84a. His worst average concentric contraction was 56 degrees of visual field preserved in the right eye, and 57 degrees of visual field preserved in the left eye. Bilateral concentric contraction with remaining field of 46 to 60 degrees warrants a 10 percent evaluation. As the Veteran's visual acuity warranted a noncompensable evaluation, but his visual field defect warranted a 10 percent evaluation based on the results of his May 2018, VA eye examination, a 10 percent evaluation is warranted during this time period prior to his November 23, 2020 VA examination. Entitlement to 30 percent since November 23, 2020 In November 2020, visual field testing revealed contraction of the right visual field to 40 degrees down (65 normal, for a loss of 25), 30 degrees down nasally (50 normal, for a loss of 20), 28 degrees nasally (60 normal, for a loss of 32), 22 degrees up nasally (55 normal, for a loss of 33), 18 degrees up (45 normal, for a loss of 27), 21 degrees up temporally (55 normal, for a loss of 34), 39 degrees temporally (85 normal, for a loss of 46), and 34 degrees down temporally (85 normal, for a loss of 51). The total loss of degrees of visual fields of the right eye was 232 degrees. 500 minus 232 total degrees lost equals 448 total remaining degrees of visual field divided by 8 that resulted in an average concentric contraction of 33.5 rounded up to 34 degrees of visual field preserved in the right eye. Visual field testing revealed contraction of the left visual field to 37 degrees down (65 normal, for a loss of 28), 38 degrees down nasally (50 normal, for a loss of 12), 34 degrees nasally (60 normal, for a loss of 26), 34 degrees up nasally (55 normal, for a loss of 21), 40 degrees up (45 normal, for a loss of 5), 38 degrees up temporally (55 normal, for a loss of 17), 49 degrees temporally (85 normal, for a loss of 36), and 42 degrees down temporally (85 normal, for a loss of 43). The total loss of degrees of visual fields of the left eye was 207 degrees. 500 minus 207 total degrees lost equals 293 total remaining degrees of visual field divided by 8 that resulted in an average concentric contraction of 36.625 rounded up to 37 degrees of visual field preserved in the left eye. At this juncture, the Veteran's worst corrected visual acuity remains 20/40 or better, bilaterally. Thus, a compensable rating based on impairment of visual acuity continues to be unwarranted. 38 C.F.R. § 4.84a. His worst average concentric contraction was 34 degrees of visual field preserved in the right eye, and 37 degrees of visual field preserved in the left eye. Bilateral concentric contraction with remaining field of 31 to 45 degrees warrants a 30 percent evaluation. As the Veteran's visual acuity warranted a noncompensable evaluation, but his visual field defect warranted a 30 percent evaluation based on the results of his November 2018, VA eye examination, a 30 percent evaluation is warranted after November 23, 2020. The evidence of record, including the Veteran's May 2018 and November 2020 VA examinations, indicates the Veteran has neither experienced incapacitating episodes nor decreased visual acuity; meaning, his eye condition is considered noncompensable under both the former rating criteria as well as the post-2018 rating criteria. However, because the Veteran has been found to have visual defects to include bilateral concentric contraction with remaining field between 46 and 60 degrees prior to November 23, 2020 and between 31 and 45 degrees thereafter, the Board finds an additional evaluation for visual field defect is warranted. Thus, the Board finds that a 10 percent evaluation is warranted prior to November 23, 2020 and a 30 percent evaluation since. The Board has considered whether a higher rating or any additional ratings are warranted under an alternative DC but finds that there is no indication that the Veteran has impairment of muscle function or incapacitating episodes to warrant any higher or additional ratings. In conclusion, as the Board finds that the evidence supports the Veteran's claim for a compensable rating for his infiltrative keratitis and open angle glaucoma based on visual field defect, a 10 percent rating is warranted prior to November 23, 2020 and a higher 30 percent rating since. KEITH W. ALLEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. B. Kucera 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.