Diagnostic Code 6090 · 38 CFR §4.78
Diplopia (double vision) occurs when the eyes fail to align properly, causing you to see two overlapping images of a single object. The condition can be constant or intermittent, and may affect vision in certain directions of gaze more than others. In veterans, diplopia commonly results from traumatic brain injury affecting the cranial nerves that control eye movement, orbital fractures displacing the eye, nerve damage from blast injuries, or muscle damage from direct eye area trauma. The VA rates diplopia by converting the affected area of the visual field into an equivalent visual acuity impairment, with diplopia in central gaze rated more severely than peripheral gaze diplopia.
| Rating | Criteria |
|---|---|
| 30% | Diplopia affecting central vision (straight-ahead gaze) causing the equivalent of significant visual acuity loss. |
| 20% | Diplopia in a significant portion of the visual field including areas used for reading or walking. |
| 10% | Diplopia limited to peripheral gaze positions with minimal impact on central vision and daily activities. |
| 0% | Diplopia only in extreme gaze positions not used in normal daily activities, or fully corrected with prism glasses. |
An ophthalmology or neuro-ophthalmology examination documenting the diplopia is essential. Diplopia field mapping showing which gaze positions are affected, eye alignment measurements (prism cover test), documentation of the service-connected cause (TBI, orbital fracture, nerve injury), and records of treatment including prism glasses, patching, or surgery all strengthen your claim.
The VA maps the area of the visual field where double vision occurs and converts this into an equivalent visual acuity rating. Diplopia in the central visual field rates higher than peripheral diplopia because it has a greater impact on daily function.
Prism lenses can correct mild to moderate diplopia by bending light to align the two images. However, they do not fix the underlying muscle or nerve problem. If your diplopia requires prism correction, this supports a disability claim because it demonstrates an ongoing functional impairment.
Yes. TBI is one of the most common causes of diplopia in veterans, as it can damage the cranial nerves (III, IV, or VI) that control eye muscles. If your TBI is service-connected, diplopia is claimed as secondary to the brain injury.