e. Considering The effects of uncomplicated refractive errors must be in excluded SC for considering impairment of vision from the standpoint of service connection Refractive (SC) and evaluation. Errors Myopia may progress rapidly during the periods of service and Exception: lead to destructive changes, such as changes in the choroid retinal hemorrhage, and retinal detachment. Notes: Children are usually hyperopic at birth and subsequently become less so, or they become emmetropic, or even myopic. In adults, refractive errors are generally stationary or change slowly until the stage of presbyopia, also a developmental condition. When dealing with refractive error only, if the best corrected vision on any examination by the Department of Veterans Affairs (VA) is better than prior determinations, view these prior determinations to be erroneous or at least as not representing best correction. For more information on considering SC for refractive error of Reference: the eye, see . Evaluate central visual acuity on the basis of corrected distance vision with f. Evaluation of Visual Acuity central fixation, even if a central scotoma is present. Evaluate the visual acuity of the poorer eye using either its Exception: uncorrected or corrected visual acuity, whichever results in better combined visual acuity, when the lens required to correct distance vision in the poorer eye differs by more than three diopters from the lens required to correct distance vision in the better eye the difference is not due to congenital or developmental refractive error, and either the poorer eye or both eyes are SC. For more information on evaluating based on visual acuity, see . Reference: g. Evaluating When the evidence shows anatomical loss of one eye together with inability Anatomical to wear a prosthesis, increase the evaluation for visual acuity under by 10 Loss of One percent. Eye With Inability to Notes: Wear a The maximum evaluation for visual impairment of both eyes will not exceed Prosthesis 100 percent. Assignment of the 10 percent increase under precludes an evaluation under based on gross distortion or asymmetry of an eye. A separate evaluation
e. Considering SC for Refractive Errors The effects of uncomplicated refractive errors must be excluded in considering impairment of vision from the standpoint of service connection (SC) and evaluation. Exception: Myopia may progress rapidly during the periods of service and lead to destructive changes, such as changes in the choroid retinal hemorrhage, and retinal detachment. Notes: Children are usually hyperopic at birth and subsequently become less so, or they become emmetropic, or even myopic. In adults, refractive errors are generally stationary or change slowly until the stage of presbyopia, also a developmental condition. When dealing with refractive error only, if the best corrected vision on any examination by the Department of Veterans Affairs (VA) is better than prior determinations, view these prior determinations to be erroneous or at least as not representing best correction. Reference: For more information on considering SC for refractive error of the eye, see . f. Evaluation of Visual Acuity Evaluate central visual acuity on the basis of corrected distance vision with central fixation, even if a central scotoma is present. Exception: Evaluate the visual acuity of the poorer eye using either its uncorrected or corrected visual acuity, whichever results in better combined visual acuity, when the lens required to correct distance vision in the poorer eye differs by more than three diopters from the lens required to correct distance vision in the better eye the difference is not due to congenital or developmental refractive error, and either the poorer eye or both eyes are SC. Reference: For more information on evaluating based on visual acuity, see . g. Evaluating Anatomical Loss of One Eye With Inability to Wear a Prosthesis When the evidence shows anatomical loss of one eye together with inability to wear a prosthesis, increase the evaluation for visual acuity under by 10 percent. Notes: The maximum evaluation for visual impairment of both eyes will not exceed 100 percent. Assignment of the 10 percent increase under precludes an evaluation under based on gross distortion or asymmetry of an eye. A separate evaluation