What happens during a C&P exam for Eye Muscle Paralysis (Extraocular Muscle)?

Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation. Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.

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Eye Muscle Paralysis (Extraocular Muscle)

Q: What are the VA rating percentages for Eye Muscle Paralysis (Extraocular Muscle)?

Eye Muscle Paralysis (Extraocular Muscle) (DC 6090) is rated at 0% under 38 CFR § 4.78, DC 6090. Rate per the verbatim § 4.79 DC 6090 diplopia equivalent-visual-acuity lookup table. The looked-up cell yields an equivalent visual acuity (e.g. 5/200, 20/100) applied to the affected eye and combined per § 4.79 visual-impairment combined-acuity table. See the cross-table data attached to this entry.

Q: What rates 0% for Eye Muscle Paralysis (Extraocular Muscle) under 38 CFR § 4.78, DC 6090?

Under 38 CFR § 4.78, DC 6090 (DC 6090), a 0% rating for Eye Muscle Paralysis (Extraocular Muscle) requires: Rate per the verbatim § 4.79 DC 6090 diplopia equivalent-visual-acuity lookup table. The looked-up cell yields an equivalent visual acuity (e.g. 5/200, 20/100) applied to the affected eye and combined per § 4.79 visual-impairment combined-acuity table. See the cross-table data attached to this entry.

Q: What evidence do I need for a Eye Muscle Paralysis (Extraocular Muscle) VA claim?

Key evidence for a Eye Muscle Paralysis (Extraocular Muscle) claim includes: Service treatment records showing injury or complaints; Imaging (X-ray, MRI, CT); Range of motion measurements; Flare-up documentation per Sharp v. Shulkin; Buddy statements describing limitations. All evidence should document both the condition and its impact on daily functioning.

DC 609038 C.F.R. § 4.78

Diagnostic Code

DC 6090

38 C.F.R. § 4.78

Rating Range

0–0%

1 severity tier

Source

Verified

38 C.F.R. § 4.79

Eye Muscle Paralysis (Extraocular Muscle) is rated by the U.S. Department of Veterans Affairs under DC 6090 of 38 CFR § 4.78, DC 6090 across 1 severity tier (0%). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.

Educational tool only. Not legal or medical advice. Not affiliated with the VA.

Overview

Paralysis or paresis of one or more extraocular muscles controlling eye movement, typically due to cranial nerve damage (CN III, IV, or VI). CN III (oculomotor) palsy causes ptosis, outward eye deviation, and dilated pupil. CN IV (trochlear) palsy causes vertical diplopia. CN VI (abducens) palsy causes inward eye deviation. Common after TBI and blast injuries.

Rating Criteria

Rate per the verbatim § 4.79 DC 6090 diplopia equivalent-visual-acuity lookup table. The looked-up cell yields an equivalent visual acuity (e.g. 5/200, 20/100) applied to the affected eye and combined per § 4.79 visual-impairment combined-acuity table. See the cross-table data attached to this entry.

VERBATIM § 4.79 EQUIVALENT VISUAL ACUITY TABLE

DC 6090 (Diplopia) — Equivalent Visual Acuity by Field of Gaze · text quoted verbatim from eCFR § 4.79

Field of Gaze	Down	Lateral	Up
Central 20 degrees	5/200 (1.5/60)
21 to 30 degrees	15/200 (4.5/60)	20/100 (6/30)	20/70 (6/21)
31 to 40 degrees	20/200 (6/60)	20/70 (6/21)	20/40 (6/12)

APPLICATION RULE

Per 38 C.F.R. § 4.78(a), the examiner uses a Goldmann perimeter chart or the Tangent Screen method that identifies the four major quadrants and degree ranges. Per § 4.78(b), where diplopia exists in more than one quadrant or degree range, the rater uses the quadrant and degree range that provides the highest evaluation. The equivalent visual acuity value above is applied to the affected eye and combined with the corresponding unaffected eye under the § 4.79 visual-impairment combined-acuity table (DCs 6063-6066).

NOTES (verbatim § 4.79)

Note (1): In accordance with 38 CFR 4.31, diplopia that is occasional or that is correctable with spectacles is evaluated at 0 percent.

03Key Evidence

—Service treatment records showing injury or complaints

—Imaging (X-ray, MRI, CT)

—Range of motion measurements

—Flare-up documentation per Sharp v. Shulkin

—Buddy statements describing limitations

—Prescription history

—Physical therapy records

—Employment impact documentation

04C&P Exam Tips

1Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.

2Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.

3Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.

4Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).

5If you use assistive devices (brace, cane), bring them.

6Describe daily activity impact: work, sleep, household tasks.

Tools

Rating Calculator →Secondaries Explorer →C&P Exam Prep →PACT Act Scanner →2026 Rates →

Sources & Editorial

Rating criteria text quoted verbatim from 38 C.F.R. § 4.79 (Eye). Source verified 2026-05-17 by ClaimRecon Editorial Team against the Cornell Law CFR mirror; eCFR.gov is the authoritative government source.

View § 4.79 on eCFR →Cornell Law mirror →Editorial Standards →Suggest a correction →

EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026

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VERBATIM § 4.79 EQUIVALENT VISUAL ACUITY TABLE

DC 6090 (Diplopia) — Equivalent Visual Acuity by Field of Gaze · text quoted verbatim from eCFR § 4.79

Field of Gaze	Down	Lateral	Up
Central 20 degrees	5/200 (1.5/60)
21 to 30 degrees	15/200 (4.5/60)	20/100 (6/30)	20/70 (6/21)
31 to 40 degrees	20/200 (6/60)	20/70 (6/21)	20/40 (6/12)

APPLICATION RULE

NOTES (verbatim § 4.79)

Note (1): In accordance with 38 CFR 4.31, diplopia that is occasional or that is correctable with spectacles is evaluated at 0 percent.