Or. Admin. Code § 436-035-0260 - Visual Loss
(1) Visual loss due
to a work-related illness or injury is rated for central visual acuity,
integrity of the peripheral visual fields, and ocular motility. For ocular
disturbances that cause visual impairment that is not reflected in visual
acuity, visual fields or ocular motility refer to section (5) of this rule.
Visual loss is measured with best correction, using the lenses recommended by
the worker's physician. For lacrimal system disturbances refer to OAR
436-035-0440.
(2) Ratings for loss in central visual acuity
are calculated for each eye as follows:
(a)
Reports for central visual acuity must be for distance and near
acuity.
(b) The ratings for loss of
distance acuity are as follows, reported in standard increments of Snellen
notation for English and Metric 6: [Ratings not included. See ED.
NOTE.]
(c) The ratings for loss of
near acuity are as follows: reported in standard increments of Snellen 14/14
notation, Revised Jaeger Standard, or American Point-type notation: [Ratings
not included. See ED. NOTE.]
(d)
Once the ratings for near and distance acuity are found, add them and divide by
two. The value which results is the rating for lost central visual
acuity.
(e) If a lens has been
removed and a prosthetic lens implanted, an additional 25%, is to be combined
(not added) with the percent loss for central visual acuity to determine total
central visual acuity, as shown in table (g).
(f) If a lens has been removed and there is
no prosthetic lens implanted, an additional 50% is to be combined (not added)
with the percent loss for central visual acuity to determine total central
visual acuity, as shown in table (g).
(g) The table below may be substituted for
combining central visual acuity and the loss of a lens for a total central
visual acuity. The table displays the percent loss of central vision for the
range of near and distance acuity combined with lens removal for a total
central visual acuity. The upper figure is to be used when the lens is present
(as found in (d)), the middle figure is to be used when the lens is absent and
a prosthetic lens has been implanted (as found in (e)), and the lower figure is
to be used when the lens is absent with no implant (as found in (f)). If near
acuity is reported in Revised Jaeger Standard or American Point-type, convert
these findings to Near Snellen for rating purposes under (2)(c) of this rule
when using this table.
(3) Ratings for loss of visual field are
based upon the results of field measurements of each eye separately using the
Goldmann perimeter with a III/4e stimulus. The results may be scored in either
one of the two following methods:
(a) Using
the monocular Esterman Grid, count all the printed dots outside or falling on
the line marking the extent of the visual field. The number of dots counted is
the percentage of visual field loss; or
(b) A perimetric chart may be used which
indicates the extent of retained vision for each of the eight standard 45°
meridians out to 90°. The directions and normal extent of each meridian are
as follows: [Ratings not included. See ED. NOTE.]
(A) Record the extent of retained peripheral
visual field along each of the eight meridians. Add (do not combine) these
eight figures. Find the corresponding percentage for the total retained degrees
by use of the table below.
(B) For
loss of a quarter or half field, first find half the sum of the normal extent
of the two boundary meridians. Then add to this figure the extent of each
meridian included within the retained field. This results in a figure which may
be applied in the chart below.
(C)
Visual field loss due to scotoma in areas other than the central visual field
is rated by adding the degrees lost within the scotoma along affected meridians
and subtracting that amount from the retained peripheral field. That figure is
then applied to the chart below.
(4) Ratings for ocular motility impairment
resulting in binocular diplopia are determined as follows:
(a) Determine the single highest value of
loss for diplopia noted on each of the standard 45° meridians as listed in
the following table.
(b) Add the
values obtained for each meridian to obtain the total impairment for loss of
ocular motility. A total of 100% or more is rated as 100% of the eye. As an
example: Diplopia on looking horizontally off center from 30 degrees in a left
direction is valued at 10%. Diplopia in the same eye when looking horizontally
off center from 21 to 30 degrees in a right direction is valued at 20%. The
impairments for diplopia in both ranges are added, so the impairment rating
would be 10% plus 20% resulting in a total loss of ocular motility of
30%.
(5) To the extent
that stereopsis (depth perception), glare disturbances or monocular diplopia
causes visual impairment are not reflected in visual acuity, visual field or
ocular motility, the losses for visual acuity, visual fields or ocular motility
will be combined with an additional 5% when in the opinion of the physician the
impairment is moderate, 10% if the impairment is severe.
(6) The total rating for monocular loss is
found by combining (not adding) the ratings for loss of central vision, loss of
visual field, and loss of ocular motility and loss for other conditions
specified in section (5) of this rule.
(7) The total rating for binocular loss is
figured as follows:
(a) Find the percent of
monocular loss for each eye.
(b)
Multiply the percent of loss in the better eye by three.
(c) Add to that result the percent of loss in
the other eye.
(d) Divide this sum
by four. The result is the total percentage of binocular loss.
(e) This method is expressed by the formula
3(A) + B 4
"A" is the percent of loss in the better eye;
"B" is the percent of loss in the other eye.
(8) Use the method (monocular or
binocular) which results in the greater impairment rating.
(9) Enucleation of an eye is rated at 100% of
an eye.
Notes
Formula & Ratings referenced are not included in rule text. Click here for PDF copy of formula(s) & rating(s).
Stat. Auth.: ORS 656.726
Stats. Implemented: ORS 656.005, 656.214, 656.268 & 656.726
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