1Statement of Principles concerning accommodation disorder (Balance of Probabilities) (No. 22 of 2026)

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RMA Australian Government Coat of Arms

 

Statement of Principles

concerning

ACCOMMODATION DISORDER (Balance of Probabilities)

(No. 22 of 2026)

The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.

 

Dated 20 February 2026

 

 

 

 

 

 

 

 

 

 

Professor Terence Campbell AM

Chairperson

by and on behalf of

The Repatriation Medical Authority

 

 

Contents

1 Name

2 Commencement

3 Authority

4 Repeal

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 accommodation disorder (Balance of Probabilities) (No. 22 of 2026).

1.                Commencement

              This instrument commences on 23 March 2026.

1.                Authority

This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.

1.                Repeal

The Statement of Principles concerning accommodation disorder (Balance of Probabilities) (No. 39 of 2017) (Federal Register of Legislation No. F2017L00889) made under subsection 196B(3) of the VEA is repealed.

1.                Application

This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.

1.                Definitions

The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.

1.                Kind of injury, disease or death to which this Statement of Principles relates
2.           This Statement of Principles is about accommodation disorder and death from accommodation disorder.

Meaning of accommodation disorder

1.           For the purposes of this Statement of Principles, accommodation disorder:
2.           means the inability to adjust the lens of the eye to various distances or an inability to sustain such an adjustment; and
3.           excludes: 1.             accommodative excess; and 2.          processes primarily affecting the lens (presbyopia and cataract) or shape of the eyeball (myopia, hypermetropia, astigmatism); and 3.        reversible paralysis of ciliary muscle function by means of pharmacological agents, except where such agents cannot be ceased or substituted.
4.           While accommodation disorder attracts ICD‑10‑AM code H52.5, in applying this Statement of Principles the meaning of accommodation disorder is that given in subsection (2).
5.           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), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.

Death from accommodation disorder

1.           For the purposes of this Statement of Principles, accommodation disorder, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's accommodation disorder.

Note: terminal event is defined in the Schedule 1 – Dictionary.

1.                Basis for determining the factors

On the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that accommodation disorder and death from accommodation disorder can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.

Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.

1.                Factors that must exist

At least one of the following factors must exist before it can be said that, on the balance of probabilities, accommodation disorder or death from accommodation disorder is connected with the circumstances of a person's relevant service:

1.           having an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle of the affected eye, at the time of clinical onset or clinical worsening;

Note: an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle is defined in the Schedule 1 – Dictionary.

1.           having concussion at the time of clinical onset or clinical worsening;
2.           having moderate to severe traumatic brain injury at the time of clinical onset or clinical worsening;
3.           taking atropine or an atropine-like medication, where the medication cannot be ceased or substituted, at the time of clinical onset or clinical worsening;

Note: atropine-like medication is defined in the Schedule 1 - Dictionary.

1.           taking a medication from the specified list, where the medication cannot be ceased or substituted, at the time of clinical onset or clinical worsening;

Note: medication from the specified list is defined in the Schedule 1 – Dictionary.

1.           taking a medication at the time of clinical onset or clinical worsening which is associated with:

2.           the development of accommodation disorder during medication therapy; and

3.           the cessation of accommodation disorder upon discontinuing medication therapy;

4.           inability to obtain appropriate clinical management for accommodation disorder before clinical worsening.

5.            Relationship to service

6.           The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.

7.           The clinical worsening aspect of factors set out in section 9 apply only to material contribution to, or aggravation of, accommodation disorder where the person's accommodation disorder was suffered or contracted before or during (but did not arise out of) the person's relevant service.

8.            Factors referring to an injury or disease covered by another Statement of Principles

In this Statement of Principles:

1.           if a factor referred to in section 9 applies in relation to a person; and
2.           that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;

then the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.

 

 

Schedule 1 - Dictionary  

Note:               See Section 6

1               Definitions

In this instrument:

                               accommodation disorder—see subsection 7(2).

                               an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle means any pathological process affecting:

(a)          the brain stem or the oculomotor nerve anywhere along its course (including the oculomotor nucleus, fascicles, subarachnoid space, cavernous sinus or orbit) that leads to a disturbance in the oculomotor nerve function; or

(b)          ciliary muscle function;

                               and causing impairment of accommodation.

                                atropine-like medication means a medication having properties similar to atropine (that is, antagonising the effects of acetylcholine at parasympathetic nerve endings).

Note 1: Examples of atropine-like drugs include antispasmodic agents (for example, scopolamine), drugs used to treat overactive bladder (for example, oxybutynin), eye drops used to facilitate examination of the fundus of the eye (for example, cyclopentolate), antipsychotic agents (for example, chlorpromazine, haloperidol, clozapine), tricyclic antidepressants (for example, amitriptyline, doxepin), sedative antihistamines (for example, clemastine, diphenhydramine), the anti-depressant maprotiline, and the anti-Parkinson medications benzatropine, biperiden, procyclidine and trihexyphenidyl.

Note 2: Typical symptoms and signs of atropine-like drugs are dry mouth, blurred vision, sensitivity to light, dilated pupils, lack of sweating, and rapid heartbeat.

                               medication from the specified list means:

(a)          amfepramone;

(b)          beclomethasone dipropionate;

(c)          benzylpenicillin;

(d)          betamethasone dipropionate;

(e)          biperiden;

(f)           budesonide;

(g)          carbachol;

(h)          carbamazepine;

(i)            chloramphenicol;

(j)            chloroquine;

(k)          chlorpromazine hydrochloride;

(l)            cortisone acetate;

(m)        cyclopentolate hydrochloride;

(n)          dexamethasone;

(o)          diacetylmorphine;

(p)          disopyramide phosphate;

(q)          dronabinol;

(r)           emetine (ipecac);

(s)           ethanechol;

(t)            fesoterodine fumarate;

(u)          fludrocortisone acetate;  

(v)          fluorometholone;

(w)        fluphenazine hydrochloride;

(x)          fluticasone propionate;

(y)          hydrocortisone;

(z)          hydromorphone hydrochloride;

(aa)       hydroxyamphetamine;

(bb)      hydroxychloroquine;

(cc)       hyoscine butylbromide;

(dd)      hyoscine hydrobromide;

(ee)       hyoscine methobromide;

(ff)        ipratropium;

(gg)      isoniazid;

(hh)      lithium;

(ii)         lysergic acid diethylamide;

(jj)         mescaline;

(kk)      methacholine (systemic administration only);

(ll)         methylprednisolone;

(mm) morphine sulfate;

(nn)      oxcarbazepine;

(oo)      oxybutynin chloride;

(pp)      oxymorphone hydrochloride;

(qq)      perphenazine;

(rr)        pilocarpine;

(ss)        pimozide;

(tt)         pralidoxime chloride;

(uu)      prednisolone;

(vv)      prednisone;

(ww)  primidone;

(xx)      prochlorperazine;

(yy)      procyclidine hydrochloride;

(zz)       promethazine hydrochloride;

(aaa)   psilocybin;

(bbb)  rimexolone;

(ccc)   solifenacin succinate;

(ddd)  telithromycin;

(eee)   thiethylperazine;

(fff)      tioridazine hydrochloride;

(ggg)  topiramate;

(hhh)  triamcinolone acetonide;

                               MRCA means the Military Rehabilitation and Compensation Act 2004.

                               relevant service means:

(a)          operational service under the VEA;

(b)          peacekeeping service under the VEA;

(c)          hazardous service under the VEA;

(d)          British nuclear test defence service under the VEA;

(e)          warlike service under the MRCA; or

(f)           non-warlike service under the MRCA.

Note: MRCA and VEA are defined in the Schedule 1 - Dictionary

                               terminal event means the proximate or ultimate cause of death and includes the following:

(a)           pneumonia;

(b)           respiratory failure;

(c)           cardiac arrest;

(d)           circulatory failure; or

(e)           cessation of brain function.

                               VEA means the Veterans' Entitlements Act 1986.