Trauma or damage to the eye is considered to be an injury, and may result in temporary or permanent loss of vision. Unhealed eye injuries are those that have not returned to a normal state of functioning.

The causes of eye injuries include: domestic accidents; assaults; explosions; sports related activities; burns; and motorcycle or motor vehicle accidents. Unhealed eye injuries may appear as, but are not limited to: corneal injury; rupture of the eyeball; abrasions; lacerations; foreign bodies; chemical burns; thermal burns; or orbital fracture.

Signs and symptoms of the condition may include: photophobia; double vision; pain; partial or full loss of vision; hemorrhage; conjunctival laceration; corneal edema; hyphema; iritis; angle recession glaucoma; lens dislocation; and pupil dilation. Injury to the posterior structures may include: retinal hemorrhage, vitreal hemorrhage, or retinal detachment.

Tests that may be used to diagnose the condition include: visual fields; visual acuity; ophthalmoscopy; slit lamp examination; soft tissue x-ray; computed tomography (CT) scan; ultrasonography; and fluorescein staining.

Treatment will vary according to the type of injury, e.g., eye ointment and an eye patch for simple injuries, or surgical treatment for penetrating injuries, lacerations, or blowout fractures. Severe globe (eyeball) injury may result in removal of the eyeball (enucleation).

Late-onset glaucoma may occur months or years later. Long-term complications from chemical burns include: glaucoma, corneal scarring, and entropion (see diagnostic code: 6021 entropion). Excessive exposure to x-ray or nuclear radiation may produce cataract changes that will appear after many months. Rupture of the scleral wall may result in cataract development weeks after the injury.

• Consider entitlement to Auto and auto adaptive equipment under 38 CFR 3.308 if there is permanent impairment of vision in both eyes consisting of central visual acuity of 20/200 or less in the better eye, with corrective glasses, or central visual acuity of more than 20/200 if there is a field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends an angular distance no greater than 20° in the better eye.

• Consider entitlement to specially adapted housing under 38 U.S.C. 2101(a)(2)(A)(i) if there is visual impairment to the degree specified in 38 CFR 3.809(b)(2).

• Review for potential entitlement to special monthly compensation under 38 CFR 3.350 when there is loss/loss of use of one or both eyes, light perception only; visual acuity 5/200 or less; the vision field is reduced to 5 degree concentric contraction in both eyes; or blindness with no light perception in one or both eye.

• Evaluate on the basis of either visual impairment due to the particular condition or on incapacitating episodes, whichever results in a higher evaluation.

• For the purposes of evaluation under 38 CFR 4.79, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes.

• Examples of treatment may include but are not limited to: Systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions.

• For the purposes of evaluating visual impairment due to the particular condition, refer to 38 CFR 4.75, 38 CFR 4.76, 38 CFR 4.77, 38 CFR 4.78,  and  38 CFR 4.79, diagnostic codes 6061-6091.

• This code includes orbital trauma, as well as penetrating or non-penetrating eye injury.