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C&P Exam Prep: Eye Conditions

DC 6080 special-senses 38 CFR 4.79

DBQ Overview

Interview + Physical
Form Name
Eye_Conditions
Form Code
Eye_Conditions
Page Count
14
Examiner Type
Ophthalmologist or Optometrist
Estimated Duration
30-45 minutes
Exam Format
Interview + Physical

What to Expect During Your Exam

Exam Overview

To objectively document the nature, severity, and functional impact of visual field defects for VA disability rating purposes under 38 CFR - 4.79, DC 6080. The examiner will determine the extent of visual field loss bilaterally, identify the underlying pathology, assess corrected and uncorrected visual acuity in both eyes, evaluate for associated ocular conditions, and document how the condition impacts daily functioning and work.

What the examiner evaluates:

  • Visual field extent in each eye using Goldmann kinetic perimetry or automated perimetry (Humphrey Model 750, Octopus Model 101 or later with simulated kinetic Goldmann capability)
  • Corrected and uncorrected distance and near visual acuity in both eyes
  • Intraocular pressure in both eyes
  • Slit lamp examination of anterior and posterior segment
  • Fundus examination for retinal pathology, optic nerve appearance, macular health
  • Presence and type of visual field defect (scotoma, hemianopsia, constriction) and laterality
  • Underlying pathology causing the field defect (glaucoma, retinal disease, optic neuropathy, post-chiasmal disorder, TBI, etc.)
  • Diplopia, nystagmus, and ocular motility
  • Impact of incapacitating episodes on daily activities
  • Current treatments, medications, and surgical history
  • Functional impairment in occupational and daily activities

Exam will typically be conducted in a clinical ophthalmology or optometry setting with specialized equipment including a visual field testing machine (Goldmann or automated perimeter), slit lamp, tonometer, and visual acuity chart. Bring all current corrective lenses (glasses and/or contacts). If you have been told not to drive to the exam due to your condition, document this and arrange alternative transportation. Inform the scheduler if you cannot wear contact lenses for the exam.

Typical duration: 30-45 minutes

Visual Field Testing (Goldmann Kinetic Perimetry or Automated Perimetry)

The extent of peripheral and central vision in each eye, measured in degrees from fixation in multiple meridians. Under DC 6080, the remaining visual field (total degrees) directly determines the disability rating. A normal visual field subtends approximately 120 degrees horizontally and 90 degrees vertically in each eye.

What to expect:

You will sit with one eye covered and focus on a central target. A light stimulus (or moving light) will appear at various locations in your peripheral and central vision. You press a button or respond verbally each time you see the target. The test takes 5-15 minutes per eye. Automated perimetry uses computer-generated stimuli; Goldmann uses a moving target adjusted by the examiner. The examiner maps the area you can see and documents the remaining field in degrees.

Key thresholds:

  • Remaining field 46-60 degrees bilateral or equivalent visual acuity — 10% bilateral; 10% unilateral
  • Remaining field 31-45 degrees bilateral or equivalent visual acuity (20/70 each eye) — 30% bilateral; 10% unilateral
  • Remaining field 16-30 degrees bilateral or equivalent visual acuity (20/100 each eye) — 50% bilateral; 10% unilateral
  • Remaining field 6-15 degrees bilateral or equivalent visual acuity (20/200 each eye) — 70% bilateral; 20% unilateral
  • Remaining field 5 degrees or less bilateral or equivalent visual acuity (5/200 each eye) — 100% bilateral
  • Scotoma affecting at least 1/4 of visual field (centrally located) — Separately ratable; can affect overall visual acuity rating
  • Homonymous hemianopsia (loss of half visual field) — Significant bilateral functional loss; rated under visual field formula

Tips:

  • Be honest about what you can and cannot see - do not try to guess or perform better than your actual vision allows
  • The test measures your actual functional vision; fatigue, glare, and lighting conditions can affect results - inform the examiner if conditions are not optimal
  • If your vision fluctuates (worse at certain times of day, worse with fatigue, or worse during flare-ups), mention this before testing begins
  • Your worst-day visual field performance is what should be documented - inform the examiner if today is not representative of your worst functioning
  • If you experience pain, discomfort, or difficulty maintaining focus during testing, tell the examiner immediately
  • If you normally use corrective lenses for testing conditions, ensure they are worn during the exam
  • Inform the examiner if you have had recent changes in your visual field - expanding or contracting
  • For automated perimetry, the false-positive and false-negative rates matter - cooperate fully but do not over-respond

Pain considerations: Visual field testing itself is not typically painful, but if underlying conditions (such as glaucoma, uveitis, or optic neuritis) cause eye pain, pressure, or photophobia that affects your ability to cooperate with testing or that worsens during the exam, clearly communicate this to the examiner. Document any pain that occurs during or after the exam.

Best Corrected and Uncorrected Visual Acuity (Distance and Near)

Sharpness of vision at distance (typically 20 feet or 6 meters) and near (typically 14 inches or 36 cm), both with and without corrective lenses. Documented as a Snellen fraction (e.g., 20/20, 20/200) for each eye separately. Under the VA rating system, corrected visual acuity in each eye is cross-referenced on rating tables to determine combined disability ratings.

What to expect:

You will read letters on a standard eye chart (Snellen chart) at distance and a near card, first without glasses, then with your best corrective lenses. Each eye is tested separately. The examiner records the smallest line you can read accurately. For near vision, you may be asked to read standard print sizes.

Key thresholds:

  • 20/200 or worse (each eye, corrected) — Legal blindness threshold; significantly elevated bilateral rating
  • 20/100 corrected — Moderate visual impairment; rated on VA visual acuity table
  • 20/70 corrected — Mild-moderate impairment; entered into bilateral rating table
  • 5/200 or worse (each eye) — Maximum visual acuity impairment for rating purposes under DC 6080

Tips:

  • Wear your current, best corrective lenses to the exam
  • Inform the examiner if your prescription has recently changed
  • Do not memorize the eye chart before the exam - accurate results reflect your actual functional vision
  • If your vision fluctuates (e.g., worse in bright light, worse with fatigue, worse at the end of the day), communicate this
  • If one eye is significantly worse than the other, ensure both are thoroughly tested

Pain considerations: If bright light during visual acuity testing triggers photophobia or worsens your symptoms, inform the examiner. Photophobia is a separately documented symptom under the DBQ and should be noted as a functional limitation.

Intraocular Pressure (IOP) Measurement

Fluid pressure inside the eye, measured in millimeters of mercury (mmHg). Normal IOP is approximately 10-21 mmHg. Elevated IOP is associated with glaucoma, a common cause of visual field defects. The examiner will use either Goldmann applanation tonometry (gold standard) or non-contact tonometry.

What to expect:

A device will touch the front surface of your eye (after numbing drops for Goldmann applanation) or a puff of air will be directed at your eye (non-contact tonometry). The procedure takes only a few seconds per eye. Results are recorded in mmHg for right and left eyes separately.

Key thresholds:

  • IOP above 21 mmHg — Consistent with glaucoma; supports field defect etiology for rating
  • IOP controlled with medication — Documented treatment burden; relevant to rating and functional impact

Tips:

  • Inform the examiner of all glaucoma medications you take, including the names, doses, and how often you use them
  • If your IOP fluctuates and has been recorded as higher at other times, bring documentation from your treating eye doctor
  • If you are allergic to numbing drops used for Goldmann tonometry, inform the examiner beforehand

Pain considerations: Non-contact tonometry (air puff) is not painful but may be startling. Goldmann applanation tonometry requires topical anesthetic drops and is generally not painful. If you have significant dry eye or corneal sensitivity, inform the examiner.

Slit Lamp Examination (Anterior and Posterior Segment)

Detailed examination of the anterior segment (cornea, iris, lens) and posterior segment (retina, macula, optic nerve, vitreous) of each eye using a high-magnification biomicroscope with a narrow beam of light. Identifies structural pathology that may cause or contribute to visual field defects, including cataracts, corneal disease, glaucomatous optic nerve changes, retinal pathology, and macular disease.

What to expect:

You will rest your chin on a chin rest and forehead against a bar while the examiner uses a bright slit of light and magnification to examine the structures of your eye. Dilating drops may be used to enlarge the pupil for better posterior segment visualization. The exam takes approximately 5-10 minutes per eye. Dilation may temporarily blur your vision for 4-6 hours after the exam.

Key thresholds:

  • Optic nerve cupping (cup-to-disc ratio greater than 0.6) — Supports glaucomatous etiology for visual field loss
  • Retinal pathology (detachment scars, dystrophy, macular degeneration) — Documents structural basis for visual field defect
  • Cataract (pre- or post-operative) — May affect visual acuity separately from field defect

Tips:

  • If you were dilated recently, inform the examiner and note how long your vision was affected
  • Arrange transportation to the exam in case dilation is performed and you cannot drive afterward
  • If you have had prior eye surgery (cataract, LASIK, retinal, glaucoma surgery), bring a written summary from your surgeon
  • Mention any changes in floaters, flashes, or shadows in your vision - these are relevant to posterior segment findings

Pain considerations: Bright light during slit lamp examination may trigger photophobia or discomfort. Inform the examiner if you experience significant light sensitivity so it can be documented.

Estimate

Rating Criteria Breakdown

100% Bilateral visual field remaining 5 degrees or less, OR each ...

Bilateral visual field remaining 5 degrees or less, OR each affected eye evaluable as 5/200 (1.5/60) or worse. Total or near-total bilateral visual field loss - functional blindness.

Key Symptoms

  • Bilateral visual fields reduced to 5 degrees or less - essentially functional blindness
  • Visual acuity of 5/200 or worse in each eye even with best correction
  • Complete dependence on adaptive devices and personal assistance for all activities
  • Unable to read, navigate, or perform any visual tasks independently
  • Qualifies for blind rehabilitation services
  • Total occupational preclusion from all sighted work

CFR: Under DC 6080, the maximum rating of 100% (or the relevant bilateral combined rating approaching 100%) applies when the remaining bilateral visual field is 5 degrees or less, equivalent to visual acuity of 5/200 (1.5/60) in each eye under the VA visual acuity rating table. This is not to exceed 5/200 per DC 6090.

70% Bilateral visual field remaining 6-15 degrees, OR each affec ...

Bilateral visual field remaining 6-15 degrees, OR each affected eye evaluable as 20/200 (6/60). Represents extreme bilateral visual field loss - tunnel vision bilaterally at near-legal-blindness levels.

Key Symptoms

  • Bilateral tunnel vision with only 6-15 degrees of remaining field in each eye
  • Functional legal blindness bilaterally - cannot read standard print without magnification
  • Complete loss of peripheral vision - cannot detect movement or objects outside a narrow central window
  • Unable to independently perform most activities of daily living safely
  • Dependent on guide dogs, white cane, or personal assistance for mobility
  • Significant social isolation due to visual impairment
  • Cannot perform any occupation requiring visual awareness

CFR: Under DC 6080, a remaining bilateral visual field of 6-15 degrees is rated at 70%, or equivalently if each affected eye is evaluated as having visual acuity of 20/200.

60% Bilateral visual field remaining 16 degrees or less (approac ...

Bilateral visual field remaining 16 degrees or less (approaching 6-15 degree range), combined with near-equivalent visual acuity loss. This intermediate level represents the transition to the 70% criteria and is relevant when field loss and acuity loss combine to produce extreme functional impairment across both eyes.

Key Symptoms

  • Extremely constricted bilateral visual fields approaching tunnel vision
  • Functional legal blindness in both eyes
  • Dependent on magnification devices, guide assistance, or other adaptive technology
  • Unable to perform most occupational tasks requiring vision
  • Requires caregiver assistance for safe mobility

CFR: DC 6080 references a 60-degree remaining field category for bilateral field evaluation. This is distinct from the 70% and 50% levels and captures field loss producing significant impairment between those thresholds.

50% Bilateral visual field remaining 16-30 degrees, OR each affe ...

Bilateral visual field remaining 16-30 degrees, OR each affected eye evaluable as 20/100 (6/30). Represents severe bilateral visual field constriction with major impact on functional independence.

Key Symptoms

  • Severe bilateral tunnel vision - only central 16-30 degrees of vision remaining
  • Cannot safely drive or operate machinery
  • Major difficulty with reading and performing close work due to combined field and acuity loss
  • Requires significant assistance or adaptive devices for daily activities
  • Cannot safely walk in unfamiliar environments without assistance
  • Significant occupational impairment - most jobs requiring visual awareness are precluded
  • Frequent incapacitating episodes of visual disturbance

CFR: Under DC 6080, a remaining bilateral visual field of 16-30 degrees is rated at 50%, or equivalently if each affected eye is evaluated as having visual acuity of 20/100.

30% Bilateral visual field remaining 31-45 degrees, OR each affe ...

Bilateral visual field remaining 31-45 degrees, OR each affected eye evaluable as 20/70 (6/21). Represents moderate bilateral visual field constriction significantly impacting functional vision.

Key Symptoms

  • Tunnel vision bilaterally - significant loss of peripheral vision in both eyes
  • Difficulty navigating unfamiliar environments safely
  • Unable to safely operate a vehicle in many jurisdictions
  • Difficulty with activities of daily living requiring peripheral vision (cooking, descending stairs, crossing streets)
  • Frequent bumping into objects on both sides
  • Significant adaptation required at work and home

CFR: Under DC 6080, a remaining bilateral visual field of 31-45 degrees is rated at 30%, or equivalently if each affected eye is evaluated as having visual acuity of 20/70.

20% Unilateral visual field remaining 6-15 degrees, OR affected ...

Unilateral visual field remaining 6-15 degrees, OR affected eye evaluable as 20/200 (6/60). This rating level applies to significant unilateral field loss approaching legal blindness in one eye.

Key Symptoms

  • Severely constricted vision in one eye - effectively tunnel vision unilaterally
  • Inability to see objects to one side without turning head
  • Significant difficulty with depth perception
  • Dependence on the unaffected eye for most visual tasks
  • Frequent difficulty in dimly lit environments
  • Challenges reading or recognizing faces with affected eye alone

CFR: Under DC 6080, a remaining unilateral visual field of 6-15 degrees is rated at 20%, or equivalently if the affected eye is rated as having visual acuity of 20/200.

10% Bilateral visual field remaining 46-60 degrees, OR each affe ...

Bilateral visual field remaining 46-60 degrees, OR each affected eye evaluable as 20/50 (6/15). Unilateral visual field remaining 31-60 degrees, OR affected eye evaluable as 20/50-20/70.

Key Symptoms

  • Mild constriction of peripheral vision bilaterally
  • Difficulty with activities requiring peripheral awareness (driving, sports, navigating crowds)
  • Scotoma or field loss that does not significantly impact central vision
  • Minor difficulty in low-light conditions
  • Occasional trips or stumbles due to peripheral field loss

CFR: Under DC 6080, a remaining bilateral visual field of 46-60 degrees is rated at 10%. Alternatively, if each affected eye is evaluated as having visual acuity of 20/50, the bilateral combined rating yields 10%. For unilateral field loss, the range of 31-60 degrees of remaining field also produces a 10% rating.

How to Describe Your Symptoms

Visual Field Loss - Peripheral Vision

How to describe:

Describe specifically where in your visual field the loss occurs (above, below, to the left, to the right, or all around). Describe how far from center you lose vision. Use concrete examples: 'I cannot see cars approaching from my left side without turning my head' or 'I frequently walk into door frames on my right side because I cannot see them peripherally.' Specify whether the loss is the same in both eyes or worse in one eye.

Worst-day example:

“On my worst days, my vision feels like looking through a narrow tube - I can only see directly in front of me for a small area, maybe the width of a coffee mug held at arm's length. I cannot see the curb below me when I'm walking, and I've stumbled on steps multiple times this week. I could not safely cross a street because I couldn't detect traffic from the sides.”

What the examiner listens for:

Specific descriptions of functional limitations tied to peripheral vision loss, frequency and consistency of the defect, bilateral versus unilateral involvement, any progressive worsening, and impact on work and daily activities.

Understatements to avoid:

Avoid saying 'my vision is okay' when you mean only your central vision is intact. Do not minimize peripheral vision loss because you can still read. Peripheral field loss is the primary rating factor under DC 6080 - it must be clearly communicated even if central acuity seems acceptable.

Scotoma (Blind Spot within the Visual Field)

How to describe:

Describe a scotoma as a 'blind spot' or 'dark spot' in your vision that does not move when you look around. Specify whether it is in the center of your vision (central scotoma - most disabling) or off to the side (paracentral). Describe its size - does it block words when reading? Does it obscure faces? Is it always present or does it come and go? Specify which eye or eyes are affected.

Worst-day example:

“When I try to read, there is a dark oval spot in the center of my right eye's vision that blots out the word I'm trying to focus on. I have to look slightly to the side of a person's face to see their features because their nose and mouth disappear into the blind spot when I look directly at them. This happens every time I use my right eye alone.”

What the examiner listens for:

Location of the scotoma relative to fixation, size as reported by the patient, impact on reading and fine visual tasks, monocular versus binocular presence, and whether it is absolute (complete loss) or relative (reduced sensitivity).

Understatements to avoid:

Do not describe a central scotoma as 'slight blurriness' - a scotoma is a distinct blind spot, not blur. Do not suggest it only bothers you occasionally if it is consistently present when using the affected eye.

Hemianopsia (Loss of Half the Visual Field)

How to describe:

Describe it as 'I cannot see anything on the right (or left) side of my vision' - specify whether this is in both eyes simultaneously (homonymous - meaning both eyes lose the same side, indicating a brain/post-chiasmal cause) or in one eye only (monocular). Describe real-world impacts: 'I've driven past exits because I don't see road signs on that side' or 'I walked into a display in a store because I didn't see it on my left.'

Worst-day example:

“I woke up and the entire left half of everything I see was simply gone - like someone pulled a curtain across the left side of both eyes. I could not eat breakfast without turning my head completely to the left to find my coffee cup, which I'd placed directly in front of me. Getting dressed was dangerous because I kept reaching for things that were in my lost visual field without knowing it.”

What the examiner listens for:

Whether the hemianopsia is homonymous (both eyes lose the same side - post-chiasmal lesion) or monocular (one eye - ocular or optic nerve cause), completeness of the field loss, associated neurological symptoms, and etiology (TBI, CVA, intracranial tumor, demyelinating disease).

Understatements to avoid:

Do not describe hemianopsia as 'trouble seeing to the side.' It is a loss of half the visual field - communicate the severity and bilateral nature accurately. Do not omit the neurological context (TBI, stroke) if present, as this affects the examiner's diagnostic coding.

Photophobia and Glare Sensitivity

How to describe:

Describe photophobia as pain, extreme discomfort, or forced eye closure in response to light. Specify triggers (sunlight, fluorescent lighting, oncoming headlights at night). Describe how it limits activity: 'I cannot be outdoors during daytime without wraparound sunglasses and still experience pain' or 'I have to leave stores with bright overhead lighting because the glare is incapacitating.' Glare sensitivity specifically refers to difficulty seeing in high-contrast lighting (e.g., driving at night with oncoming headlights).

Worst-day example:

“On a bright day, even with dark sunglasses, I have to shield my eyes with my hand to see anything. Yesterday I was unable to drive home in the afternoon because the sunlight through the windshield created so much glare and pain that I pulled over. I had to call someone for a ride.”

What the examiner listens for:

Documented photophobia as a separate symptom (checkbox in DBQ), its severity, triggers, and direct functional impact on the veteran's daily activities and occupational functioning.

Understatements to avoid:

Do not minimize photophobia by saying 'bright light bothers me a little.' If photophobia is forcing behavioral changes (wearing sunglasses indoors, avoiding outdoor activity, limiting driving), say so explicitly. This is a separately documented symptom in the DBQ.

Incapacitating Episodes

How to describe:

Under 38 CFR - 4.79, Notes 1 and 2, incapacitating episodes of eye conditions (those requiring bed rest or treatment) can justify higher ratings. Describe episodes where your visual condition was so severe it required you to stop activity, see a doctor emergently, or stay home from work. Document frequency (how many per week or month), duration (how many days each), and what treatment was required.

Worst-day example:

“Last month I had three episodes where my vision deteriorated so severely I could not leave my home - I spent two days in bed with eye pain and near-total visual field loss in my right eye, and I had to go to the VA emergency clinic twice in one month. Each episode kept me out of work for at least two days.”

What the examiner listens for:

Frequency and duration of episodes per month, whether they required bed rest or treatment, which specific eye conditions caused the episodes, and their impact on the veteran's ability to work and perform daily activities.

Understatements to avoid:

Do not say your condition 'flares up sometimes' without providing specific frequency and duration data. Incapacitating episodes have defined rating criteria - two or more per year requiring treatment = 10%, four or more per year = 20% under the General Rating Formula.

Impact on Occupational Functioning

How to describe:

Be specific about which job tasks you can no longer perform due to your visual field defects. 'I cannot safely operate a forklift because I cannot see objects approaching from the sides.' 'I can no longer read documents without assistive technology.' 'I have been moved to a desk role because my employer determined I was a safety risk on the production floor.' If you have had to change jobs, reduce hours, or leave employment, state this clearly.

Worst-day example:

“My supervisor told me last year that I was a safety liability on the warehouse floor because I kept missing cues from the sides and nearly caused two accidents. I was transferred to an office role, but even there I struggle to read the computer screen without enlarged text, and I frequently miss things in my peripheral vision that cause errors. My performance reviews have declined since my vision worsened.”

What the examiner listens for:

Specific occupational tasks precluded by the visual field defect, whether the veteran has had to change roles or reduce workload, and concrete evidence of how vision loss translates to functional employment limitations.

Understatements to avoid:

Do not say 'I manage okay at work' if you have made significant accommodations or if your performance has been affected. Accurately describe any accommodations made (enlarged monitors, assistance from coworkers, job changes) as evidence of functional limitation.

Common Mistakes to Avoid

Prep Checklist

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Before Your Exam

Day Of

During the Exam

After the Exam

Your Rights During a C&P Exam

  • You have the right to request a copy of the completed Disability Benefits Questionnaire (DBQ) and examination report - contact your VA Regional Office or VSO to obtain it.
  • You have the right to submit your own private ophthalmology examination report and DBQ, which must be considered alongside the VA examination per 38 CFR - 3.303 and Caluza v. Brown.
  • You have the right to record your C&P examination in states that permit one-party consent recording - check your state's laws before the exam and inform the examiner if you are recording.
  • You have the right to request a new or supplemental examination if the original examination was inadequate - for example, if required visual field testing per M21-1 IV.i.3.B.1.a was not performed.
  • You have the right to submit buddy statements (lay evidence) from people who have witnessed your visual limitations - these must be considered as evidence under 38 CFR - 3.303.
  • You have the right to challenge an examination report that contains errors, omissions, or conclusions that are contrary to the medical evidence - work with a VSO or accredited VA claims agent to file a supplemental claim or Notice of Disagreement.
  • You have the right to an examination that uses proper equipment per M21-1: visual field testing must be performed using Goldmann kinetic perimetry or approved automated perimetry (Humphrey Model 750, Octopus Model 101, or later versions with simulated kinetic Goldmann capability).
  • You have the right to a complete examination - the examiner must evaluate all conditions for which you are claiming service connection and document all relevant findings, not just the primary complaint.
  • You have the right to submit additional evidence at any time before the VA issues a final decision on your claim.
  • You have the right to a VA fiduciary or VSO representative at no cost - contact your state's veterans service organization (DAV, VFW, AMVETS, American Legion) or the VA's Office of General Counsel for accredited claims agents.
  • You have the right to appeal any rating decision - options include Supplemental Claim (new and relevant evidence), Higher-Level Review (de novo review), or Board of Veterans' Appeals appeal within one year of the decision.
  • Under 38 CFR - 3.102, the benefit of the doubt standard applies - when evidence is in approximate balance, VA must resolve it in your favor.

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This C&P exam preparation guide is for educational purposes only and does not constitute legal, medical, or claims advice. Always consult with a qualified Veterans Service Organization (VSO) representative or VA-accredited attorney for guidance specific to your claim. Never exaggerate, minimize, or fabricate symptoms during a C&P examination.