Body system: EyeRegulation: 38 CFR § 4.79DBQ: DBQ OPHTH Eyes
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: the VA rates visual acuity on corrected vision. For a corneal disorder such as keratoconus that causes severe irregular astigmatism, acuity is rated as corrected by contact lenses if you customarily wear them and they correct your vision better than eyeglasses.
Rating levels
- Note — DC 6035 keratoconus is rated under the General Rating Formula for Diseases of the Eye in 38 CFR § 4.79. PATH 1: visual impairment. The VA measures your visual acuity, visual field, or eye-muscle function and rates it under the vision codes (DCs 6061 to 6066 for visual acuity, DC 6080 for visual field defects, DC 6090 for double vision). PATH 2: the Incapacitating Episodes ladder shown below, which counts how many clinic visits your keratoconus required for treatment during the past 12 months. The VA assigns whichever path gives the higher evaluation. NOTE: visual acuity is rated on corrected distance vision. If your keratoconus causes severe irregular astigmatism that contact lenses correct better than eyeglasses, and you customarily wear contact lenses, your acuity is rated as corrected by the contact lenses (38 CFR § 4.76(b)).
- 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.