Citation Nr: 21023309 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 18-11 949 DATE: April 20, 2021 ORDER Entitlement to service connection for a bilateral eye condition, claimed as macular degeneration, is denied. FINDING OF FACT The preponderance of the evidence is against finding that bilateral macular degeneration or dry eye condition began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for bilateral eye condition, claimed as macular degeneration, 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 November 1990 to April 1991. He served on active duty for training (ACDUTRA) from July 1984 to October 1984. He had additional service in the Army Reserves and the Army National Guard of Georgia. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a March 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In May 2019 the Veteran provided testimony before the undersigned Veterans Law Judge at a Travel Board hearing. A transcript of the hearing is of record. In November 2019 and again in January 2021, the Board remanded the case for further development, which has since been completed. Entitlement to service connection for bilateral eye condition The Veteran seeks service connection for a bilateral eye condition. 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). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Active military service includes any period of ACDUTRA during which the individual concerned was disabled from a disease or injury incurred or aggravated in line of duty and any period of inactive duty training (INACDUTRA) during which the individual concerned was disabled from an injury incurred or aggravated in line of duty. 38 U.S.C. § 101 (24); 38 C.F.R. § 3.6 (a). ACDUTRA is full-time duty in the Armed Forces performed by Reserves for training purposes. 38 U.S.C. § 101 (22); 38 C.F.R. § 3.6 (c). INACDUTRA is duty other than full-time duty prescribed for Reserves. 38 U.S.C. § 101 (23); 38 C.F.R. § 3.6 (d). 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. The Veteran contends that he has bilateral macular degeneration that resulted from exposure to UV light in service. He has stated, “[l]ow light conditions, operating in dark, working starlight scopes, working -- and when we got in the Bradley [Fighting Vehicle], we was in infrared sighting and stuff like that, so by the time I got out of the military, I was wearing glasses and -- and/or contacts, and my eyesight had degenerated.” The service treatment records do not show any eye complaints. On report of medical history completed by the Veteran in March 1991, he noted he wore glasses but denied “eye trouble.” The March 1991 separation examination did not note any eye abnormalities other than refractive error. On an April 2013 VA physical examination, the Veteran denied blurred or double vision, irritated eyes, or eye pain. He reported no light flashes or haloes around the eyes. A July 2013 VA treatment record noted macular changes vs. early macular degeneration. The Veteran submitted a statement dated in August 2019 from a VA Doctor of Optometry who noted the Veteran had macular degeneration that at least as likely as not was caused by his military service. The doctor did not provide a rationale for that conclusion. Thus, the Board accords it little weight. A VA examiner in December 2020 diagnosed dry eyes. The examiner stated that the Veteran did not have macular degeneration. The examiner checked the box for “the claimed condition was less likely than not incurred in or caused by inservice injury, event, or illness.” In the rationale section, the examiner merely stated, “no macula degeneration is present OU.” Since the December 2020 examiner did not address whether the macular degeneration diagnosed in 2019, or the dry eyes diagnosed on the December 2020 examination, were related to service, the Board remanded the case in January 2021 for another opinion. A VA examination was conducted in March 2021. The examining optometrist stated that there is absolutely no possibility of starlight scope use causing macula degeneration or dry eye syndrome. The examiner explained that both conditions are both age- and general health-related. Poorly controlled diabetes, a poor diet with limited green leafy vegetables, elevated cholesterol and obesity are the strongest contributors to macula changes, vision changes, and eye dryness. Therefore, it was his opinion that the Veteran’s macular degeneration of the left eye and dry eyes condition are less likely than not related to exposure of UV or infrared light in service, or from starlight scopes. The Board notes that, while refractive error was noted in service, for purposes of entitlement to benefits, the law provides that refractive errors of the eyes are developmental defects and not disease or injury within the meaning of applicable legislation. See 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. 38 C.F.R. §§ 3.303 (c), 4.9. Thus, VA regulations specifically prohibit service connection for refractory errors of the eyes unless such defect was subjected to a superimposed disease or injury during service which created additional disability. See VAOPGCPREC 82-90 (service connection may not be granted for defects of congenital, developmental or familial origin, unless the defect was subject to a superimposed disease or injury). The Board further concludes that, while the Veteran has current diagnoses of macular degeneration and dry eyes, and evidence shows that he was exposed to UV and/or infrared light in service, the preponderance of the competent and probative evidence weighs against finding that the current macular degeneration or dry eyes began during service or is otherwise related to an in-service injury, event, or disease. The March 2021 VA examiner opined that the Veteran’s macular degeneration and dry eye condition were not at least as likely as not related to an in-service injury, event, or disease, including his work with UV or infrared starlight scopes. The examiner, who is an optometrist, reviewed the service medical records and noted that the Veteran’s eye conditions were more likely related to age, general health, and diet. The examiner’s opinion is probative, because it is 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). The Veteran believes his eye condition is related to an in-service injury, event, or disease. Specifically, the Veteran contends his current eye disability is related to exposure to UV and/or infrared light during active service. The Veteran is not competent, however, to provide a nexus opinion regarding this issue. The issue is medically complex and requires knowledge of the internal pathology of the eye. Therefore, it is outside the competence of this Veteran because the record does not show that he has the medical training or education to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the VA examiner’s opinion, which concluded the Veteran’s eye conditions are not of service origin. There is no competent evidence or opinion to the contrary. Although the Veteran has a diagnosed macular degeneration eye condition and dry eyes, the preponderance of the evidence weighs against a finding that an eye condition is causally related to his service. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim, that doctrine is not applicable. Service connection for an eye disability is denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. G. Mazzucchelli, Counsel 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.