Statement of Principles concerning myopia, hypermetropia and astigmatism (Reasonable Hypothesis) (No. 9 of 2016) (Cth)

Statement of Principles concerning MYOPIA, HYPERMETROPIA AND ASTIGMATISM (Reasonable Hypothesis) (No. 9 of 2016) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

Dated 4 March 2016

The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:

Professor Nicholas Saunders AO Chairperson

Contents 1 Name 2 Commencement 3 Authority 4 Revocation 5 Application 6 Definitions 7 Kind of injury, disease or death to which this Statement of Principles relates 8 Basis for determining the factors 9 Factors that must exist 10 Relationship to service 11 Factors referring to an injury or disease covered by another Statement of Principles Schedule 1 - Dictionary 1 Definitions

1 Name This is the Statement of Principles concerning myopia, hypermetropia and astigmatism (Reasonable Hypothesis) (No. 9 of 2016). 2 Commencement This instrument commences on 4 April 2016. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Revocation The Statement of Principles concerning myopia, hypermetropia and astigmatism No. 69 of 2007 made under subsection 196B(2) of the VEA is revoked. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies. 6 Definitions The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument. 7 Kind of injury, disease or death to which this Statement of Principles relates (1) This Statement of Principles is about myopia, hypermetropia and astigmatism and death from myopia, hypermetropia and astigmatism. Meaning of myopia, hypermetropia and astigmatism (2) For the purposes of this Statement of Principles: (a) myopia means a refractive error in which rays of light entering the eye parallel to the visual axis come to focus in front of the retina in the unaccommodated eye; and (b) hypermetropia means a refractive error in which rays of light entering the eye parallel to the visual axis come to focus behind the retina in the unaccommodated eye; and (c) astigmatism means a refractive error in which eye refraction varies in different meridians, such that no two-dimensional object can be brought to focus on the retina, giving rise to blurred vision; and (d) excludes transient changes in refraction resulting from pharmacological agents. (3) While myopia attracts ICD‑10‑AM code H44.2 or H52.1, hypermetropia attracts ICD‑10‑AM code H52.0, and astigmatism attracts ICD‑10‑AM code H52.2, in applying this Statement of Principles the meaning of myopia, hypermetropia and astigmatism is that given in subsection (2). (4) For subsection (3), a reference to an ICD‑10‑AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD‑10‑AM), Ninth Edition, effective date of 1 July 2015, copyrighted by the Independent Hospital Pricing Authority, ISBN 978‑1‑76007‑020‑5. Death from myopia, hypermetropia and astigmatism (5) For the purposes of this Statement of Principles, myopia, hypermetropia or astigmatism, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's myopia, hypermetropia or astigmatism. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 Basis for determining the factors The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that myopia, hypermetropia or astigmatism and death from myopia, hypermetropia or astigmatism can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA. Note: relevant service is defined in the Schedule 1 – Dictionary. 9 Factors that must exist At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting myopia, hypermetropia or astigmatism or death from myopia, hypermetropia or astigmatism with the circumstances of a person's relevant service: (1) having decentration or tilting of the lens of the affected eye at the time of the clinical onset of myopia, hypermetropia or astigmatism; Note: decentration is defined in the Schedule 1 - Dictionary. (2) having corneal surgery of the affected eye, within the six months before the clinical onset of myopia, hypermetropia or astigmatism; Note: corneal surgery is defined in the Schedule 1 - Dictionary. (3) having surgery for cataract of the affected eye, within the six months before the clinical onset of myopia, hypermetropia or astigmatism; (4) having albinism at the time of the clinical onset of myopia, hypermetropia or astigmatism; (5) for myopia only: (a) having a nuclear cataract of the affected eye at the time of the clinical onset of myopia;