Eyes: vision, glaucoma, visual fields and the exam

Two ways VA rates eye conditions

38 CFR 4.79

Most eye diseases are rated under one General Rating Formula, and VA uses whichever gives the higher result:

• Visual impairment from the condition (acuity, visual fields, or double vision, see the sections below), or
• Incapacitating episodes, counted by treatment visits in the past 12 months.

The regulation defines an incapacitating episode as an eye condition severe enough to require a clinic visit to a provider specifically for treatment. Examples of treatment named in the regulation include systemic immunosuppressants or biologic agents, injections in or around the eye, laser treatment, and other surgery.

For benefits such as VA eye care and low-vision services, see vision and eye benefits.

Incapacitating episodes

38 CFR 4.79, General Rating Formula

• 60%: documented episodes requiring 7 or more treatment visits in the past 12 months.
• 40%: at least 5 but fewer than 7 treatment visits.
• 20%: at least 3 but fewer than 5 treatment visits.
• 10%: at least 1 but fewer than 3 treatment visits.

The formula is used for conditions listed under it, including uveitis and other choroidopathy (6000), keratopathy (6001), scleritis (6002), retinopathy or maculopathy (6006), intraocular hemorrhage (6007), retinal detachment (6008), unhealed eye injury (6009, which includes orbital trauma), glaucoma, and pterygium findings, among others. Active tuberculosis of the eye (6010) is 100%.

Glaucoma, cataracts and related codes

38 CFR 4.79, DC 6012, 6013, 6027, 6029, 6036

• Angle-closure (6012) and open-angle (6013) glaucoma: rated under the General Rating Formula, with a minimum of 10% if continuous medication is required.
• Cataract (6027): before surgery, rated under the General Rating Formula. After surgery with a replacement lens (pseudophakia), also under the General Rating Formula. With no replacement lens, rate as aphakia.
• Aphakia or dislocated lens (6029): rate the visual impairment and raise the result one step, with a minimum of 30%.
• Corneal transplant (6036): General Rating Formula, with a minimum of 10% if there is pain, photophobia and glare sensitivity.
• Retinal scars, atrophy or irregularities (6011): 10% if centrally located and they cause an irregular, duplicated, enlarged or diminished image, or the General Rating Formula if that is higher.
• Diabetic retinopathy (6040), retinal dystrophy including macular degeneration (6042), optic neuropathy (6026), keratoconus (6035) and post-chiasmal disorders (6046) are listed codes rated by their visual impairment.

Diabetes and its eye effects are on diabetes, thyroid and adrenal ratings.

Central visual acuity

38 CFR 4.76 and 4.79, DC 6061 to 6066

Vision in each eye is measured, and the rating comes from the pair of results in a table. A few rules from the regulation:

• The exam must record uncorrected and corrected acuity, for distance and near, using Snellen’s test type or its equivalent.
• Acuity is rated on corrected distance vision. There is an exception when the lens needed in the poorer eye differs by more than three diopters from the better eye, not due to congenital or developmental refractive error, and the poorer or both eyes are service connected.
• If a reported acuity falls between two listed levels, VA uses the one that gives the higher rating.
• If near vision is worse than corrected distance vision by two or more steps, the report needs at least two recordings and an explanation, and the rating uses distance vision one step poorer.

Examples from the table: both eyes no more than light perception, or loss of both eyes, is 100%. Loss of one eye with 20/40 in the other is 40%. 20/200 in one eye with 20/200 in the other is 70%. 20/40 in both eyes is 0%. Several of these levels carry a footnote to review for special monthly compensation.

Visual field loss and scotoma

38 CFR 4.79, DC 6080 and 6081

• Homonymous hemianopsia: 30%.
• Loss of the temporal half: bilateral 30%, unilateral 10%. Loss of the inferior half: bilateral 30%, unilateral 10%. Loss of the nasal or superior half: 10%.
• Concentric contraction, remaining field of: 5 degrees, bilateral 100% and unilateral 30%; 6 to 15 degrees, bilateral 70% and unilateral 20%; 16 to 30 degrees, bilateral 50% and unilateral 10%; 31 to 45 degrees, bilateral 30% and unilateral 10%; 46 to 60 degrees, 10% either way.
• Scotoma (6081), one eye: a minimum of 10% if it affects at least a quarter of the visual field or is centrally located at any size, or higher if the visual impairment rates higher.

Each field entry also allows rating each affected eye at an equivalent acuity instead. The 5-degree bilateral level carries a note to review for special monthly compensation.

Diplopia and eyelid and surface conditions

38 CFR 4.79, DC 6090 and others

• Diplopia (6090) is converted to an equivalent acuity by where it occurs. Central 20 degrees is 5/200. At 21 to 30 degrees it is 15/200 looking down, 20/100 lateral and 20/70 up. At 31 to 40 degrees it is 20/200 down, 20/70 lateral and 20/40 up. Diplopia that is occasional or correctable with spectacles is rated 0%.
• Ectropion, entropion, lagophthalmos and tear-duct disorders: 20% both sides, 10% one side.
• Complete loss of eyebrows or eyelashes: 10% each. Central nystagmus: 10%. Paralysis of accommodation: 20%.
• Active chronic conjunctivitis: minimum 10%. Active trachomatous conjunctivitis: minimum 30%.
• Ptosis, eyelid loss and pinguecula are rated on visual impairment or disfigurement (DC 7800), as the regulation directs for each. See skin conditions for scars and disfigurement.
• Eye cancers: 100% when treatment is comparable to systemic cancer treatment, continuing beyond treatment, with a mandatory exam six months after it stops. Otherwise visual and nonvisual effects are rated separately and combined.

What VA’s eye exam form covers

VA Eye Conditions DBQ (version marked 2025-10-01)

• Diagnosis and a short history of the eye condition.
• Visual acuity, uncorrected and corrected, for distance and near in each eye, plus pupils, tonometry, slit lamp and fundus findings.
• Anatomical loss, light-perception-only vision and blindness; astigmatism and contact lens use.
• Diplopia, with the field areas, frequency and whether it is correctable.
• Visual field testing, including contraction by meridian, field loss and scotomas.
• A section for glaucoma and 11 other condition categories, including whether glaucoma needs continuous medication.
• Incapacitating episodes in the past 12 months, with the number of treatment visits in bands matching the rating levels, plus the type of treatment.
• Functional impact on work, and scarring or disfigurement.

Keep records of each treatment visit and its date. See Preparing for Your C&P Exam.

What I could not verify

• Rating levels come from the eCFR text of 38 CFR 4.79 and 4.76, current as of October 16, 2026. eCFR is unofficial, and the official text wins over me.
• I did not read 38 CFR 4.75, 4.77 or 4.78 (examination rules for fields and muscle function), so this page does not restate them.
• I checked the exam form through a text reader, not line by line. The form itself is the authority.
• This page covers rating levels only. It does not cover refractive error rules or which eye conditions may be service connected. Ask an accredited representative about those.