Diagnostic Code 6022 · 38 CFR §4.79
Lagophthalmos is the inability to fully close the eyelids, leaving the eye partially exposed even during sleep. This exposure can cause severe corneal drying, irritation, infections, and potentially vision-threatening corneal ulceration. In veterans, lagophthalmos most commonly results from facial nerve paralysis (Bell's palsy or trauma), eyelid scarring from burns, or after surgical procedures affecting the eyelid area. The condition requires constant management with lubricating drops, ointments, and sometimes taping the eye shut at night. The VA assigns a flat 20% for bilateral lagophthalmos and 10% for unilateral.
| Rating | Criteria |
|---|---|
| 20% | Bilateral lagophthalmos (affecting both eyes). |
| 10% | Unilateral lagophthalmos (affecting one eye). |
An ophthalmology examination measuring the gap between the eyelids during attempted closure is essential. Documentation of the cause (facial nerve palsy, burn scarring, surgical complication), corneal examination showing any exposure-related damage, treatment records for lubricants, taping, moisture chambers, or surgical correction, and photographs showing incomplete eyelid closure all strengthen your claim.
The facial nerve (cranial nerve VII) controls the muscle that closes the eyelid. When this nerve is damaged from TBI, skull fractures, or Bell's palsy, the eyelid cannot close fully. This is one of the most common causes in veterans with head or facial injuries.
The VA provides lubricating eye drops and ointments, moisture chamber goggles for sleep, and can perform surgical procedures like eyelid weight implants or tarsorrhaphy (partially stitching the eyelids together) to protect the cornea.