VA Disability Rating for Lagophthalmos (DC 6022)
Diagnostic Code 6022 · 38 CFR §4.79
What Is It?
Lagophthalmos is the inability to fully close the eyelids, leaving the eye partially exposed even during sleep. This exposure can cause severe corneal drying, irritation, infections, and potentially vision-threatening corneal ulceration. In veterans, lagophthalmos most commonly results from facial nerve paralysis (Bell's palsy or trauma), eyelid scarring from burns, or after surgical procedures affecting the eyelid area. The condition requires constant management with lubricating drops, ointments, and sometimes taping the eye shut at night. The VA assigns a flat 20% for bilateral lagophthalmos and 10% for unilateral.
Rating Criteria
| Rating | Criteria |
|---|---|
| 20% | Bilateral lagophthalmos (affecting both eyes). |
| 10% | Unilateral lagophthalmos (affecting one eye). |
Evidence Needed
An ophthalmology examination measuring the gap between the eyelids during attempted closure is essential. Documentation of the cause (facial nerve palsy, burn scarring, surgical complication), corneal examination showing any exposure-related damage, treatment records for lubricants, taping, moisture chambers, or surgical correction, and photographs showing incomplete eyelid closure all strengthen your claim.
C&P Exam Tips
Have the examiner measure and document the gap during maximal lid closure. Show any nighttime protective devices you use (moisture chambers, tape). Describe the daily management routine required. Bring corneal examination results showing any exposure damage. Connect the lagophthalmos to the service-related nerve injury or scar.
How to File
File under DC 6022 with documentation of the incomplete lid closure and its cause. If corneal damage has occurred, file that as a secondary condition. Connect the lagophthalmos to the underlying facial nerve palsy, burn scar, or other service-related cause.
Common Mistakes
Not documenting the corneal exposure damage with staining during the exam is the most common mistake. Failing to describe the daily management burden (drops every 1-2 hours, taping at night), not connecting lagophthalmos to the underlying service-connected condition, and overlooking the need to claim corneal damage separately are other frequent errors.
Frequently Asked Questions
How does facial nerve damage cause lagophthalmos?
The facial nerve (cranial nerve VII) controls the muscle that closes the eyelid. When this nerve is damaged from TBI, skull fractures, or Bell's palsy, the eyelid cannot close fully. This is one of the most common causes in veterans with head or facial injuries.
What treatments are available through the VA?
The VA provides lubricating eye drops and ointments, moisture chamber goggles for sleep, and can perform surgical procedures like eyelid weight implants or tarsorrhaphy (partially stitching the eyelids together) to protect the cornea.