Eye Conditions DBQ: Official VA Form

The public Eye Conditions Disability Benefits Questionnaire records medical information for VA evaluation. The form itself provides its current questions, definitions, examination and clinician requirements. A completed form is evidence; it does not establish service connection or guarantee an evaluation.

Related Diagnostic Code Subjects

45 code subjects are associated with this form in this educational directory. These editorial subject associations are not official VA assignments, and the form may not be appropriate for every examination or claim.

• DC 6000: Choroidopathy, including uveitis, iritis, cyclitis, or choroiditis
• DC 6001: Keratopathy
• DC 6002: Scleritis
• DC 6006: Retinopathy or maculopathy not otherwise specified
• DC 6007: Intraocular hemorrhage
• DC 6008: Detachment of retina
• DC 6009: Unhealed eye injury
• DC 6010: Tuberculosis of eye
• DC 6011: Retinal scars, atrophy, or irregularities
• DC 6012: Angle-closure glaucoma
• DC 6013: Open-angle glaucoma
• DC 6014: Malignant neoplasms of the eye, orbit, and adnexa (excluding skin)
• DC 6015: Benign neoplasms of the eye, orbit, and adnexa (excluding skin)
• DC 6016: Nystagmus, central
• DC 6017: Trachomatous conjunctivitis
• DC 6018: Chronic conjunctivitis (nontrachomatous)
• DC 6019: Ptosis, unilateral or bilateral
• DC 6020: Ectropion
• DC 6021: Entropion
• DC 6022: Lagophthalmos
• DC 6023: Loss of eyebrows, complete, unilateral or bilateral
• DC 6024: Loss of eyelashes, complete, unilateral or bilateral
• DC 6025: Disorders of the lacrimal apparatus (epiphora, dacryocystitis, etc.)
• DC 6026: Optic neuropathy
• DC 6027: Cataract
• DC 6029: Aphakia or dislocation of crystalline lens
• DC 6030: Paralysis of accommodation (due to neuropathy of the Oculomotor Nerve (cranial nerve III))
• DC 6032: Loss of eyelids, partial or complete
• DC 6034: Pterygium
• DC 6035: Keratoconus
• DC 6036: Status post corneal transplant
• DC 6037: Pinguecula
• DC 6040: Diabetic retinopathy
• DC 6042: Retinal dystrophy (including retinitis pigmentosa, wet or dry macular degeneration, early-onset macular degeneration, rod and/or cone dystrophy)
• DC 6046: Post-chiasmal disorders
• DC 6061: Anatomical loss of both eyes 1
• DC 6062: No more than light perception in both eyes 1
• DC 6063: Anatomical loss of one eye: 1
• DC 6064: No more than light perception in one eye: 1
• DC 6065: Vision in one eye 5/200 (1.5/60)
• DC 6066: Visual acuity in one eye 10/200 (3/60) or better
• DC 6080: Visual field defects
• DC 6081: Scotoma, unilateral
• DC 6090: Diplopia (double vision)
• DC 6091: Symblepharon

Read The Form Before Arranging An Examination

Review who may complete the form, which conditions it includes or excludes, and whether testing is required. VA can still request a claim examination. Report actual findings; this reference does not provide suggested answers.

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