Body system: EyeRegulation: 38 CFR § 4.79
Keratoconus is a condition where the cornea (the clear front layer of the eye) thins and bulges outward in a cone shape, causing blurred and distorted vision. The VA rates this condition under the General Rating Formula for Diseases of the Eye (38 CFR § 4.79), using whichever path yields the higher evaluation: visual impairment (acuity, field, or muscle function) OR the Incapacitating Episodes ladder (10% for 1-2 treatment visits per year, up to 60% for 7 or more visits). Note: refractive correction with contact lenses or glasses does not lower the rating, the VA rates the underlying corneal deformity.
Rating levels
- -1% — DC 6035 keratoconus is rated under 38 CFR § 4.79. PATH 1: visual impairment, the VA measures your visual acuity, visual field defects, or eye-muscle function and rates under the standard chart codes (DCs 6066-6081 acuity, DC 6080 field, DC 6090 muscle). PATH 2: the Incapacitating Episodes ladder shown below, which counts how many clinic visits your keratoconus required for treatment during the past 12 months. Whichever path yields the higher evaluation is what the VA assigns. NOTE: refractive correction (contact lenses or glasses) does NOT improve the rating, the VA rates the underlying corneal deformity, not the corrected vision.
- 60% — You qualify for 60% if your keratoconus required 7 or more clinic visits specifically for treatment during the past 12 months (intravitreal or periocular injections, laser treatments, systemic immunosuppressants or biologic agents, or other surgical interventions). This is the highest tier on the Incapacitating Episodes path of the General Rating Formula for Diseases of the Eye (38 CFR § 4.79). Visual impairment may yield a higher rating in some cases, in which case the higher value applies.
- 40% — You qualify for 40% if your keratoconus required at least 5 but fewer than 7 clinic visits specifically for treatment during the past 12 months. This rating applies under the Incapacitating Episodes path of the General Eye Formula when it yields a higher evaluation than the visual impairment path.
- 20% — You qualify for 20% if your keratoconus required at least 3 but fewer than 5 clinic visits specifically for treatment during the past 12 months. This rating applies under the Incapacitating Episodes path of the General Eye Formula when it yields a higher evaluation than the visual impairment path.
- 10% — You qualify for 10% if your keratoconus required at least 1 but fewer than 3 clinic visits specifically for treatment during the past 12 months. This rating applies under the Incapacitating Episodes path of the General Eye Formula when it yields a higher evaluation than the visual impairment path.