DI 26001.005 Evidence of Blindness

We need evidence from an acceptable medical source to establish a medically determinable visual impairment.

Licensed optometrists for impairments of visual disorders, or measurement of visual acuity and visual fields only, depending on the scope of practice in the State in which the optometrist practices.

For more information about who are acceptable medical sources to establish whether an individual has a medically determinable impairment(s), see DI 22505.003.

For additional information about evidence needed to evaluate visual disorders and statutory blindness under Title II, see “How do we evaluate visual disorders?” in DI 34001.012A.

B. Title XVI evidence of statutory blindness

For Title XVI claims:

We need an eye examination by a physician (medical or osteopathic doctor) skilled in diseases of the eye or by an optometrist.

For additional information about evidence needed to evaluate visual disorders and statutory blindness under Title XVI, see “How do we evaluate visual disorders?” in DI 34001.012A. and DI 34005.102A.

20 CFR 416.913(f) Evidence we need to establish statutory blindness

C. Measurement of visual acuity and visual fields – Title II and Title XVI

1. Measurement of visual acuity and visual fields in adults and children

For detailed information about how we measure visual acuity and visual fields for adults and children, refer to the following related adult and child references:

a. Adult

b. Child (under age 18)

c. Other related reference

DI 24535.005 Titles II and XVI: Evaluating Visual Field Loss Using Automated Static Threshold Perimetry – SSR 07-01p

2. Low vision visual acuity categories

The following low vision visual acuity categories indicate that no optical correction will improve the claimant’s visual acuity:

If the claimant’s central visual acuity in an eye is recorded as CF, HM, LP or LPO, or NLP, we will determine that the claimant’s best-corrected central visual acuity is 20/200 or less in that eye.

3. Conversion of visual acuity measurements

If the claimant’s visual acuity is measured for a distance other than 20 feet, we will convert it to a 20-foot measurement. For example, if visual acuity is measured at 10 feet and is reported as 10/40, we will convert this measurement to 20/80.

4. Pinhole or automated refraction acuity

We will not use the results of pinhole testing or automated refraction acuity to determine best-corrected central visual acuity. These tests provide an estimate of potential visual acuity but not an actual measurement of best-corrected central visual acuity.

D. Visual acuity test chart measurements for statutory blindness

1. Snellen methodology

When we measure the claimant’s best-corrected central visual acuity, we use visual acuity testing for distance using Snellen methodology or any other testing methodology that is comparable to Snellen methodology, such as the Bailey-Lovie and Early Treatment Diabetic Retinopathy Study (ETDRS).

2. Other test charts

Most test charts that use Snellen methodology do not have lines that measure visual acuity between 20/100 and 20/200. However, some newer test charts have lines that measure visual acuity between 20/100 and 20/200, such as the Bailey-Lovie and ETDRS.

If visual acuity is measured with one of these newer charts, and the claimant cannot read any of the letters on the 20/100 line, we will consider that the claimant has statutory blindness based on a visual acuity of 20/200 or less. For example, if best-corrected visual acuity for distance in the better eye is 20/160 using an ETDRS chart, we will find the claimant has statutory blindness.

A claimant does not have statutory blindness if he or she can read at least one letter on the 20/100 line. For example, the best-corrected visual acuity in the better eye is 20/125+1 using an ETDRS chart. The claimant does not have statutory blindness because he or she is able to read one letter on the 20/100 line.