Statement of Principles concerning accommodation disorder (Reasonable Hypothesis) (No. 21 of 2026)
1Statement of Principles concerning accommodation disorder (Reasonable Hypothesis) (No. 21 of 2026)
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The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) 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
Name
This is the Statement of Principles concerning accommodation disorder (Reasonable Hypothesis) (No. 21 of 2026).
Commencement
This instrument commences on 23 March 2026.
Authority
This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.
Repeal
The Statement of Principles concerning accommodation disorder (Reasonable Hypothesis) (No. 38 of 2017) (Federal Register of Legislation No. F2017L00888) made under subsection 196B(2) of the VEA is repealed.
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.
Section 1 - Statement of Principles concerning accommodation disorder (Reasonable Hypothesis) (No. 21 of 2026) - Statement of Principles concerning accommodation disorder (Reasonable Hypothesis) (No. 21 of 2026) | Zoe
Definitions
The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.
Kind of injury, disease or death to which this Statement of Principles relates
This Statement of Principles is about accommodation disorder and death from accommodation disorder.
Meaning of accommodation disorder
For the purposes of this Statement of Principles, accommodation disorder:
means the inability to adjust the lens of the eye to various distances or an inability to sustain such an adjustment; and
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.
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).
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
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.
Basis for determining the factors
The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that accommodation disorder and death from accommodation disorder 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: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.
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 accommodation disorder or death from accommodation disorder with the circumstances of a person's relevant service:
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.
having concussion at the time of clinical onset or clinical worsening;
having moderate to severe traumatic brain injury at the time of clinical onset or clinical worsening;
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.
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.
taking a medication at the time of clinical onset or clinical worsening which is associated with:
the development of accommodation disorder during medication therapy; and
the cessation of accommodation disorder upon discontinuing medication therapy;
inability to obtain appropriate clinical management for accommodation disorder before clinical worsening.
Relationship to service
The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.
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.
Factors referring to an injury or disease covered by another Statement of Principles
In this Statement of Principles:
if a factor referred to in section 9 applies in relation to a person; and
that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(2) 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: