Glaucoma and VA Disability

🧠 Episode Overview:

In this episode, we break down everything veterans need to know about glaucoma and VA disability benefits. Glaucoma is a serious eye condition that can cause permanent vision loss — and many veterans aren’t aware that it can be connected to their military service or service-connected conditions.

We’ll cover how the VA rates glaucoma, what kind of medical evidence you need, and how to establish service connection—whether it’s primary, secondary, or related to exposure or injury during service.

🔍 Topics Covered:

• What glaucoma is and how it affects veterans
• Common causes and risk factors (including diabetes, hypertension, and eye trauma)
• How to file a VA claim for glaucoma
• Understanding service connection for glaucoma
  • Primary service connection
  • Secondary to conditions like diabetes, traumatic brain injury (TBI), or hypertension
• How the VA rates vision loss and glaucoma
• What to expect during a C&P eye exam
• Importance of nexus letters and medical evidence
• Appealing a denied glaucoma VA claim

💡 Key Takeaways:

• Glaucoma can be a service-connected disability if properly documented.
• A strong nexus letter and thorough medical evaluation are crucial for approval.
• Veterans with existing service-connected conditions may qualify for secondary service connection.
• Don’t give up after a denial — appeals and medical rebuttals can turn your case around.

🎧 Tune In If You’re a Veteran Who:

• Has been diagnosed with glaucoma or other vision problems
• Is seeking VA compensation for vision loss
• Has had a claim denied for glaucoma or related eye conditions
• Wants to understand how secondary service connection works for eye conditions

Episode Transcript

Leah Bucholz (00:01):
Hey guys, it's Leah B from Prestige Veteran
Medical Consulting. I'm a USArmy veteran, physician
assistant, informer compensationand pension examiner. So today I
wanted to come on and discuss atopic that I think a lot of
people have been asking for,well specifically asking for eye
conditions. So the first kind ofthe most popular, one of the
most popular eye conditions Icould think of was glaucoma. So
I wanted to talk about glaucomatoday.

(00:23):
So for those of you guys thatdon't know us, we like to talk
about disability relatedbenefits and break down things
and give veterans the tools tohelp them take control of their
claims. Glaucoma, again, itdoesn't always get a spotlight
but a lot of you guys aresuffering from it. So it's a
serious eye condition that canlead to permanent vision loss.
But here's the thing, lot ofveterans don't know that they

(00:44):
can be service connected for iteither directly or indirectly.
If you've been diagnosed withglaucoma and you're already
rated for things like diabetes,TBI or eye trauma, then this
episode is probably for you andit may help you with that.
So what is glaucoma? So let'sstart off with the basics.
Glaucoma is a group of eyeconditions that damage the optic

(01:04):
nerve usually due to increasedpressure inside of the eye. If
untreated, it can lead topermanent vision loss or even
blindness in some cases. Sothere are a few different types.
So the main types that we seethe most frequently are open
angle glaucoma, that's the mostcommon and it is just sort of
slow developing. Angle closureglaucoma, that is more sudden

(01:27):
and painful. Secondary glaucomacan be caused by other medical
conditions or trauma. And thetricky thing is that glaucoma
often develops with no earlywarning signs and you might not
even notice anything until yourvision is already deteriorating.
So can glaucoma be serviceconnected?
So absolutely, on a primary orsecondary basis. And we're gonna

(01:48):
get into some of that. So the VAcan grant service connection for
glaucoma if it started during orright after your military
service, that would be like adirect service connection. If it
was caused or worsened by analready service connected
disability, and that is oftenreferred to as secondary service
connection. Or in rare cases, ifit's presumptively related to

(02:10):
some type of toxic exposure.
Most veterans who win claims forglaucoma do so by proving
secondary service connection,it's pretty common. Some of you
guys are diagnosed in servicewith it as well. It's not that
it's uncommon, it's justtypically not diagnosed while on
active duty. We're gonna getinto that a little bit later. So
for direct service connection.

(02:31):
So there's three main parts ofan element of any claim that
help establish a serviceconnection. So one is that you
have a current medicalcondition. Two is that you have
an event or incident in servicethat has basically led to that
disability. So it could even bea secondary service connection.

(02:53):
So let me break that down alittle further.
So you have a diagnosis, in thiscase it's glaucoma, then you
have an event from service,whether it's you got hit in the
eye in service or maybe youdevelop service connected
diabetes and now your conditionis related to that secondarily.
And then the third thing is thatnexus or that link between

(03:13):
number one and number two. Sodirect service connection for
glaucoma. So a direct serviceconnection means the condition
began during your militaryservice and there's medical
evidence to back that up. So, orit's related to something that
happened while on active duty.
So an example would be if youserved in dusty or sandy
environment like Iraq orAfghanistan, you went to sick

(03:36):
call a few times for eyeirritation or blurry vision.
Years later, you get diagnosedwith glaucoma. If your service
records reflect repeated eyeissues or trauma that may be a
potential direct link in somecases. Also you could have just
been diagnosed while on activeduty. Maybe your commands aren't
major and you're just getting alittle bit older and maybe

(03:59):
you're not, again, young peoplecan get it too.
You can have a traumaticglaucoma or you can have some
medical condition that leads toit, but maybe you're just
developing it as you get olderand while you're still in the
service. So another examplewould be as if you suffered
blunt trauma to the head or eyeduring a training accident, that
trauma can lead to a traumaticglaucoma which is probably gonna

(04:22):
be clearly service related. Soagain, what do you need? A
current diagnosis, evidence ofan in service onset or injury,
and then a nexus from a medicalprofessional tying it all
together. So does that nexushave to come from an outside
provider or your doctor?
No, not necessarily. The VA willorder you a compensation and

(04:42):
pension exam if there's enoughevidence that you've submitted
to warrant one. And that VA Cand P examiner is gonna review
your case, listen to you, reviewyour history and provide a
nexus. It might not be apositive nexus. They may say,
Hey, I do not think there's anexus here.
Or they may say there is clearlya link. So secondary service

(05:06):
connection, we touched on that alittle bit. So here's where it
gets interesting. Secondaryservice connection means that
your glaucoma was either causedby or worsened by another
condition that the VA alreadyrecognizes as service connected.
So what are some commonsecondary causes of glaucoma?
Diabetes, type two diabetes, bigtime. Traumatic brain injury,

(05:29):
hypertension or high bloodpressure can cause it, long term
steroid use like prednisone forasthma or arthritis, eye trauma
like an orbital fracture maybeyou got hit in the eye,
Autoimmune disorders like lupusor sarcoidosis, sleep apnea, you
can have medication side effectsthat cause glaucoma. So some

(05:52):
real world examples might bethings like you're being related
for type two diabetes from agentorange exposure. Later your
doctor tells you that thediabetes damaged the blood
vessels in your eyes leading toglaucoma. And that is a textbook
secondary claim.
Or say that you have a serviceconnected TBI. Studies show TBI
can increase intracranialpressure which can affect eye

(06:15):
pressure and optic nerve healthleading to glaucoma. Another
solid case for secondary serviceconnection. So you'll need
medical evidence linking theprimary condition to glaucoma
and your ophthalmologist mayhelp you or your optometrist or
your treating doctor. So let'stalk about some medical
literature because I always liketo give you guys some tools and

(06:35):
some medical literature toreview or to present to your
doctors.
So medical literature is yourally when you're, trying to
obtain VA disability. So backingyour case with peer reviewed
research can strengthen yourclaim in some cases, especially
if you're appealing or whatnot.Here's what the science says. So
when it comes to diabetes andglaucoma, studies show diabetics

(06:57):
are twice as likely to developglaucoma due to long term damage
to the eyes blood vessels andpressure regulation. TBI and
glaucoma neurologic studiesincluding some from military
medicine linked TBI to increasedrisk of glaucoma especially if
there's optic nerve damage orabnormal cerebrospinal fluid
pressure.
Steroid use in glaucomamedications like prednisone

(07:20):
often prescribed for arthritisor asthma have been shown to
cause steroid induced glaucomawith long term use. Sleep apnea
and glaucoma. Sleep apnearestricts oxygen to the optic
nerve and multiple studies havehave suggested that it raises
glaucoma risk. So these studies,can be helpful again if you ask

(07:40):
your doctor to reference them ifthey if they agree. So it's not
just their statement that thisis related it's actually backed
by medical literature andscience that says, hey this is
why my opinion is this way.
So how does the VA rateglaucoma? So glaucoma is rated
under 38 CFR 4.79, which coverseye conditions. The VA looks at

(08:02):
visual field loss, visualacuity, or how clearly you see,
optic nerve damage. Ratingstypically range from ten to 100%
depending on how much yourvision is actually impacted. In
severe cases like legalblindness, you may also qualify
for special monthlycompensation.
So when you file a claim forglaucoma, you're likely gonna be

(08:25):
scheduled for a C and P exam ora compensation and pension exam.
That examiner is probably gonnameasure your eye pressure,
assess your vision loss andperipheral vision. They are
gonna probably review yourmedical records, evaluate any
link to your service or existingconditions. And you may wanna
bring your own eye exam results.They should have them if you've

(08:47):
submitted them or if you've beenseen at the VA.
Honestly if you've been deniedbefore or if you have any
questions on how to file yourclaim or how to appeal your
claim or whatever, may want todiscuss that with an accredited
attorney or a VSO or a claimsagent. They can obviously
strategize with you and help younavigate the appeals process.

(09:09):
Things that can be helpful arethings like a diagnosis from
your treating doctor, yourophthalmologist, your
optometrist. If you're alreadyrated for something like
diabetes, TBI, or hypertension,you might want to look at that
secondary service connection ifit applies. Make sure you have
your treatment records, your eyeexams, any history of symptoms
from service.

(09:29):
And again, doctor may supportyou with the letter. It doesn't
have to be something like superlong either. It can just be
like, hey, I believe my patient,Mr. Smith, his service connected
diabetes has caused hisglaucoma. So I hope this has
been helpful for you guys.

(09:51):
Please drop some comments. Ialways appreciate the feedback
from y'all when you guys give meyour real world stories. If you
have any other eye conditions orany other eye related matters or
any other things that you'd liketo hear about or for me to add
to upcoming videos, I'm happy todo so. Please like and subscribe
and as always thank you forwatching.