Citation Nr: 21074979 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 18-53 283 DATE: December 16, 2021 ORDER Service connection for a bilateral eye disorder is denied. FINDING OF FACT The preponderance of the evidence is against finding that a bilateral eye disorder began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for a bilateral eye disorder 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, who is the appellant, served on active duty from January 1963 to August 1966. In June 2021, a videoconference board hearing was held before the undersigned. A transcript of the hearing is associated with the Veteran's claims file. The case was remanded by the Board in June 2021 for further development of the evidence. This has been accomplished and it has been returned to the Board for further appellate consideration. Service connection for a bilateral eye disorder The Veteran contends that service connection should be established a bilateral eye disorder, as he believes his current eye disabilities are the result of chemicals to which he was exposed while on active duty. During the Board hearing before the undersigned, the Veteran testified regarding the circumstances surrounding the injury that he received at that time. He stated that he has had eye problems since that time, which included blurred vision and the need to wear glasses. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. After review of the evidence, the Board concludes that, while the Veteran has a current diagnosis of cataracts, myopia, and presbyopia, and evidence shows that he sustained a chemical injury while on active duty, the preponderance of the evidence weighs against finding that the Veteran's eye diagnoses began during service or is otherwise related to an in-service injury, event, or disease, including the chemical injury he sustained in 1963. Review of the Veteran's service treatment records (STRs) shows that in November 1963 he was admitted to the hospital with a history of splashing disodium phosphate in his face and eyes. The conjunctiva was injected in both eyes with the right pupil showing atropinized on dilation. The left pupil was normal. Slit lamp examination showed an unhealed abrasion inferior to the pupillary area while the left eye showed multiple small punctate abrasions. During hospitalization, the Veteran's eyes were patched and eventually both cornea healed without difficulty. Visual acuity at discharge from the hospital was 20/30 in the right eye and 20/40 in the left eye. On examination at separation from service, clinical evaluation of the eyes was normal. Uncorrected visual acuity was noted to be 20/20 in both eyes. Post service medical evidence includes a February 1989 VA eye examination that showed uncorrected visual acuity of 20/20-1 in the right eye and 20/20+2 in the left eye. The impression was presbyopia. On VA examination in December 2016, the diagnoses were cataracts, myopia, and presbyopia of both eyes. The Veteran's history of chemical injury of the eyes in 1963 was noted. Corrected visual acuity was noted to be 20/40 or better in each eye. After examination, the examiner opined that the Veteran did not have any residuals of a chemical burn to the right eye that was at least as likely as not incurred in or caused by the chemical burn that occurred in November 1963. It was explained that after review of the claims folder and peer reviewed medical literature, it was noted that there was no scarring or physical evidence of a corneal burn or abrasion of the right eye. As such, there were no residuals, and the chemical burn was healed on current examination. Another medical opinion was obtained by VA in July 2021 pursuant to the Board's remand in June 2021. After review of the record the examiner rendered an opinion regarding the etiology of the Veteran's diagnosed eye disabilities, cataracts, myopia and presbyopia. After noting the opinion rendered in 2016, that the current right eye findings were not likely as not secondary to the current nuclear cataract seen, the examiner stated that the Veteran's cataracts were less likely than not due to the in-service injury. The rationale was that cataracts were a common age-related condition and the Veteran's cataracts were consistent with normal age-related cataracts. The examiner explained it would be very unlikely that a chemical exposure to the eyes would cause internal pathology without also causing significant and lasting external pathology. The examiner then noted how the Veteran's service separation examination was silent for ocular pathology and his visual acuity was noted to be normal. Regarding myopia and presbyopia, the examiner pointed out how these were refractive errors. The examiner explained that presbyopia progresses naturally due to aging and again emphasized how the Veteran's service separation examination was silent for ocular pathology and visual acuity was normal in each eye. The Veteran's postservice treatment records show he was not diagnosed with cataracts until many years after his separation from service. While the Veteran is competent to report having experienced symptoms of blurred vision since service, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of cataracts. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Taken together, the VA opinions of record establish that the Veteran's cataracts, myopia or presbyopia are not at least as likely as not related to an in-service injury, event, or disease, including the chemical injury that took place in service. The combined rationale was that myopia and presbyopia were refractive errors and age related, with a further notation that these were not noted at separation from service. Regarding cataracts, the examiner explained that these were related to the internal structure of the eyes and not related to the chemical burns that occurred on the outer structure of the corneas. The examiners' combined opinions are probative, because they are based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). There is no competent evidence to the contrary. Finally, VA regulations provide that refractive error of the eyes are not diseases or injuries within in the meaning of applicable legislation for disability compensation purposes. See 38 C.F.R. §§ 3.303(c), 4.9; see also Winn v. Brown, 8 Vet. App. 510, 516 (1996). Presbyopia is a visual condition that becomes apparent especially in middle age and in which loss of elasticity of the lens of the eye causes defective accommodation, and inability to focus sharply for near vision. McNeely v. Principi, 3 Vet. App. 357, 364 (1992). Presbyopia is "hyperopia and impairment of vision due to ... old age." Dorland's Illustrated Medical Dictionary 1349 (28th ed. 1994). Myopia is that error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina. Dorland's Illustrated Medical Dictionary 1094 (28th ed. 1994). For these reasons, the Board finds that a preponderance of the evidence is against the Veteran's claim for service connection for a bilateral eye disorder, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Joseph P. Gervasio 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.