Citation Nr: 21075486 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 14-34 757A DATE: December 20, 2021 ORDER Service connection for a bilateral vision condition is denied. FINDING OF FACT The Veteran's bilateral visual condition did not have its onset during active service and is not otherwise etiologically related to such service, and it was not caused by or aggravated by service-connected posttraumatic stress disorder (PTSD), including required medications. CONCLUSION OF LAW The criteria for service connection for a bilateral vision condition are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1988 to August 1992. The claim is on appeal from a July 2011 rating decision. In March 2019, the Veteran testified at a Board hearing. Most recently, in March 2021, the Board remanded the matter for additional development. The Board has limited the discussion below to the relevant evidence required to support its finding of fact and conclusion of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Service connection for a bilateral vision condition. Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. See 38 C.F.R. § 3.310. Analysis The Veteran contends that he has vision disorder related to service or that is secondary to service-connected PTSD medications. He maintains that he operated M-16 service rifles without suppressors during service and was regularly subjected to a blinding flash and gas that burned his eyes. See March 2019 Board hearing testimony. The Veteran also asserts that he has blurry since taking medication for service-connected PTSD. Pursuant to the Board's March 2021 remand, the Veteran was afforded a VA eye examination in August 2021. The examination reflects the Veteran's history of decreased visual acuity beginning in 2014. The examiner stated that the Veteran's primary open angle glaucoma (POAG), affecting both eyes and causing decreased visual acuity in the left eye, is a hereditary condition and unrelated to service, to include firing an M-16 rifle without suppressors. In addition, and although a history of surgical intervention in both eyes to manage chronically elevated intraocular pressure (IOP) was noted, no visual loss due to PTSD medications was reported. The Board notes that the Veteran's service treatment records (STRs) are silent as to complaints or treatment for vision problems. In August 1991, his eyes were reactive to light, and good pupil constriction and dilation was reported. See September 1995 STRs. In addition, the separation examination report reflects vision was 20/20 in each eye. Id. Further, VA treatment records in July 2011 reflect that the Veteran denied blurred vision, and his pupils were equal, round, and reactive to light and accomodation. VA treatment records in September 2015 reflect that the Veteran was started on glaucoma medication in May 2014. In addition, September 2020 VA treatment records reflect the Veteran's history of having been diagnosed with glaucoma five to six years earlier. See August 2021 VA treatment records. In this case, although the Veteran has a current diagnosis of glaucoma, the evidence does not show a bilateral vision condition related to service or service-connected PTSD, including required medications. The Board notes that, although the Veteran is competent to report his symptoms, a determination as to whether his bilateral vision condition is related to service is a complex matter requiring related medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (holding that a lay person is not considered competent to testify regarding medically complex issues). As the Veteran has no known or reported medical expertise, he is not legally competent to establish a nexus between a bilateral vision condition and service; thus, his opinions as to causation lack probative value. (Continued on the next page) In this case, the Board has accorded the greatest probative value to the August 2021 VA opinion. A rationale for the opinion was provided, and the opinion with the evidence. There is no competent evidence to the contrary. In sum, the Board the evidence does not support the claim of service connection for a bilateral vision disorder. The preponderance of the evidence is against the claim; the benefit of the doubt doctrine is not applicable; and service connection for a bilateral vision disorder is therefore not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Taylor 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.