Cataract is opacity of the lens of the eye. Traumatic is defined as caused by or related to an injury. Senile is defined as one that forms slowly, and proceeds as a progressive opacity of the lens of the eye. A senile cataract refers to the condition in the older adult. This is the most common type of cataract.

Possible trauma-related causes of cataracts are injuries from penetrating wounds such as gunshot, knife, machinery, or rocks. Other causes may include: electrical high voltage, radioactive exposure, or overexposure to heat.The senile cataract is usually the result of aging. Recently, ultraviolet radiation has been implicated in senile cataract formation. Other cataracts may occur in association with systemic disorders such as diabetes mellitus (see diagnostic code: 7913 diabetes mellitus), or secondary to intraocular diseases, such as severe, recurrent uveitis (see diagnostic code: 6000 choroidopathy, including uveitis, iritis, cyclitis, and choroiditis).

Cataracts occurring from high voltage are bilateral. Blurring of vision usually begins to develop within six months, but it ranges from a few weeks to three years. Cataract symptoms include: photophobia, distortion of night vision, and blurred vision. However, signs and symptoms of penetrating trauma may include: escaping aqueous humor or vitreous humor and a soft eye; opaque lens; and intraocular hemorrhage. In case of the senile cataract, there is no pain involved. Edema of the lens varies directly with the stage of cataract development. The pupil appears white in a fully-developed cataract.

Tests involving viewing of the lens through a dilated pupil usually include: ophthalmoscopy, slit lamp; visual acuity; hand flashlight, loupe; and gonioscopy.

The foreign body causing the penetrating trauma should be removed immediately. The cataract may be removed at the time of the foreign body or at a later time after the inflammation has subsided. Systemic and topical antibiotics, and topical corticosteroids are usually used to minimize infection and complications such as uveitis (see diagnostic code: 6000 choroidopathy, including uveitis, iritis, cyclitis, and choroiditis). Mydriatic drops are recommended to keep the pupil dilated and to prevent posterior synechia (adhesion of the iris to the cornea). Persons who experience a high voltage cataract will receive surgical correction after the cataract has formed and signs and symptoms are present. Lens extraction is the treatment used when visual impairment interferes with daily living. Placement of an intraocular lens is the desired procedure with the cataract removal. Over 90% of cataract surgery operations will have an intraocular lens implantation. If there are conditions that exclude lens implantation, then a contact lens or eyeglasses will be prescribed.

Complications following cataract surgery that may occur include: glaucoma (see diagnostic code: 6012 angle-closure glaucoma); uveitis; infection; or retinal detachment (see diagnostic code: 6008 detachment of retina). Contraindications to lens implantation include: recurrent uveitis; diabetic retinopathy; neovascular glaucoma; and rubeosis iridis.

• If posterior subcapsular cataracts is alleged as a result of exposure to ionizing radiation in service, follow the guidance for processing claims based on exposure to ionizing radiation.  (38 CFR 3.311).

• May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

• 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).

• The veteran, spouse, surviving spouse or parent will be considered in need of regular aid and attendance if he or she is blind or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or less (38 CFR 3.351(c)(1)).

• Consider entitlement to automobile allowance and/or automobile adaptive equipment if there is visual impairment to the degree specified in 38 CFR 3.808(b)(3).

• 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.

• Review for entitlement to special monthly compensation under 38 CFR 3.350.

• 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.