Symblepharon — VA Disability Rating Criteria (DC 6091)
Diagnostic Code 6091 · 38 CFR §4.79
What Is It?
Symblepharon is an adhesion between the conjunctiva of the eyelid and the conjunctiva of the eyeball. It occurs when scar tissue forms between these surfaces, typically after chemical burns, thermal burns, radiation exposure, or severe infections. For veterans, this condition most commonly results from chemical or thermal burns sustained during service. Symblepharon can restrict eye movement, cause chronic dryness, and impair vision depending on its location and extent.
Rating Criteria
| Rating | Criteria |
|---|---|
| 30% | Severe symblepharon with significant restriction of eye movement, corneal involvement affecting vision, and chronic surface disease. |
| 20% | Moderate symblepharon restricting eye movement and causing visual impairment through incomplete lid closure or corneal involvement. |
| 10% | Symblepharon causing limited eye movement or chronic irritation but not significantly affecting visual acuity. |
| 0% | Minimal adhesion with no functional limitation or visual impact. |
Evidence Needed
Ophthalmology examination documenting the location and extent of the adhesion, photographs showing the symblepharon, documentation of the causative injury (chemical burn, thermal burn), records of eye movement limitation, and visual acuity testing if the cornea is involved.
C&P Exam Tips
Request that the examiner photograph the adhesion and measure how it restricts lid movement and eye rotation. If it causes chronic dryness from poor tear distribution, ensure this is documented. Describe the injury event that caused the scarring and any surgeries attempted to correct it.
How to File
File under DC 6091 with documentation of the service-connected injury (burn, chemical exposure) that caused the scarring. If the symblepharon also causes restricted eye movement leading to diplopia, or chronic dry eye, claim these as secondary conditions for additional ratings.
Common Mistakes
Not claiming the secondary effects of symblepharon (dry eye, restricted movement, diplopia) as separate conditions. Not documenting the full extent of eye movement limitation. Failing to connect the adhesion to the specific burn or chemical exposure during service.
Frequently Asked Questions
Can symblepharon be surgically corrected?
Surgery can release the adhesion, but recurrence is common, especially after severe burns. Even if surgery is attempted, the scar tissue may reform. Document any surgical attempts and recurrences to support ongoing disability.
Is symblepharon from chemical burn exposure service-connectable?
Yes. Chemical burns during service are a direct cause of symblepharon. Document the exposure event, any immediate treatment received, and the subsequent development of the adhesion.