EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Strabismus
✓ VERIFIED AGAINST 38 C.F.R.§ 4.79 (Eye) · reviewed 2026-05-17 · ClaimRecon Editorial Team
Strabismus is rated by the U.S. Department of Veterans Affairs under DC 6090 of 38 CFR § 4.78, DC 6090 across 1 severity tier (0%). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.
OVERVIEW
Misalignment of the eyes where both eyes do not look at the same point simultaneously. Types include esotropia (inward turning), exotropia (outward turning), hypertropia (upward turning), and hypotropia (downward turning). May be caused by cranial nerve palsy, TBI, or orbital trauma.
RATING CRITERIA (1 LEVELS)
0%
Rate per the verbatim § 4.79 DC 6090 diplopia equivalent-visual-acuity lookup table. Strabismus causes diplopia when fusion fails — the looked-up cell yields an equivalent visual acuity applied per the § 4.79 combined-acuity table. Per § 4.31, occasional diplopia or diplopia correctable with spectacles or prism rates 0%.
VERBATIM § 4.79 EQUIVALENT VISUAL ACUITY TABLE
DC 6090 (Diplopia) — Equivalent Visual Acuity by Field of Gaze · text quoted verbatim from
eCFR § 4.79| Field of Gaze | Down | Lateral | Up |
|---|
| Central 20 degrees | 5/200 (1.5/60) |
| 21 to 30 degrees | 15/200 (4.5/60) | 20/100 (6/30) | 20/70 (6/21) |
| 31 to 40 degrees | 20/200 (6/60) | 20/70 (6/21) | 20/40 (6/12) |
APPLICATION RULE
Per 38 C.F.R. § 4.78(a), the examiner uses a Goldmann perimeter chart or the Tangent Screen method that identifies the four major quadrants and degree ranges. Per § 4.78(b), where diplopia exists in more than one quadrant or degree range, the rater uses the quadrant and degree range that provides the highest evaluation. The equivalent visual acuity value above is applied to the affected eye and combined with the corresponding unaffected eye under the § 4.79 visual-impairment combined-acuity table (DCs 6063-6066).
NOTES (verbatim § 4.79)
Note (1): In accordance with 38 CFR 4.31, diplopia that is occasional or that is correctable with spectacles is evaluated at 0 percent.
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
SOURCES & EDITORIAL
Rating criteria text quoted verbatim from 38 C.F.R. § 4.79 (Eye). Source verified 2026-05-17 by ClaimRecon Editorial Team during a regulation-text comparison against the Cornell Law CFR mirror; eCFR.gov is the authoritative government source.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026