1Statement of Principles concerning cataract (Reasonable Hypothesis) (No. 15 of 2026)

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RMA Australian Government Coat of Arms

 

Statement of Principles

concerning

CATARACT (Reasonable Hypothesis)

(No. 15 of 2026)

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

 

 

1.                Name

This is the Statement of Principles concerning cataract (Reasonable Hypothesis) (No. 15 of 2026).

1.                Commencement

              This instrument commences on 23 March 2026.

1.                Authority

This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.

1.                Repeal

The Statement of Principles concerning acquired cataract (Reasonable Hypothesis) (No. 87 of 2016) (Federal Register of Legislation No. F2016L01694) made under subsections 196B(2) of the VEA is repealed.

1.                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.

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 cataract and death from cataract.

Meaning of cataract

1.           For the purposes of this Statement of Principles, cataract:
2.           means partial or complete opacification of the lens or lens capsule of the eye, which causes visual impairment; and
3.           excludes congenital or infantile cataract and lens malformation.
4.           While cataract attracts ICD‑10‑AM code H25, H26.1-H26.9, H28.1 or H28.2, in applying this Statement of Principles the meaning of cataract 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 cataract

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

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

1.                Basis for determining the factors

The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that cataract and death from cataract 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.

1.                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 cataract or death from cataract with the circumstances of a person's relevant service:

1.           having sunlight exposure to the unprotected eye for a cumulative period of at least 2,250 latitude equivalent hours before clinical onset or clinical worsening;

Note: latitude equivalent hours and unprotected eye are defined in the Schedule 1 dictionary.

1.           having received a cumulative equivalent dose of at least 0.2 sievert of ionising radiation to the affected eye before clinical onset or clinical worsening;

Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.

1.           having penetrating trauma to the affected eye within the 20 years before clinical onset or clinical worsening;

Note: Penetrating trauma to the affected eye includes having a foreign body embedded in the affected eye.

1.           having blunt trauma to the affected eye, eye orbit or head, resulting in symptoms and signs lasting at least 3 days, within the 20 years before clinical onset or clinical worsening;

Note: Symptoms and signs that are associated with blunt trauma to the eye include, but are not limited to, blurry vision, ocular pain, orbital fracture, blood in the anterior chamber of the eye and decreased visual acuity.

1.           having intraocular surgery to the affected eye within the 2 years immediately preceding clinical onset or clinical worsening;
2.           having a severe thermal or chemical burn to the affected eye, involving at least one of the following clinical features:
3.           corneal anaesthesia;
4.           corneal opacification;
5.           symptoms and signs lasting at least 3 days and requiring medical attention;
6.           for chemical burns only, penetration of the chemical into the anterior chamber;

within the 6 months immediately preceding clinical onset or clinical worsening;

1.           being exposed to an explosive blast within the 3 months immediately preceding clinical onset or clinical worsening;
2.           having an electrical injury within the 5 years immediately preceding clinical onset or clinical worsening;

Note: electrical injury includes, but is not limited to, low-voltage electrical injury to the head or neck and high-voltage electrical injury to the body.

1.           having one of the following inflammatory conditions involving the affected eye before clinical onset or clinical worsening:
2.           uveitis;
3.           scleritis or episcleritis, where there is anterior chamber inflammation;
4.       having a Body Mass Index (BMI) of 25 or greater for at least the 5 years immediately preceding clinical onset or clinical worsening;

Note: Body Mass Index (BMI) is calculated as W/H2 where:

1.      W is the person's weight in kilograms; and
2.      H is the person's height in metres.
3.       having diabetes mellitus for at least the 5 years immediately preceding clinical onset or clinical worsening;
4.       having chronic hypoparathyroidism with hypocalcaemia for at least 3 months before clinical onset or clinical worsening of cortical or subcapsular cataract;
5.       being exposed to corticosteroids in any of the following circumstances within the 10 years before clinical onset or clinical worsening: 1.           applying a topical corticosteroid to the cornea of the affected eye equivalent to a cumulative dose of at least 100 drops of 0.1% dexamethasone; 1.           having an intravitreal corticosteroid implant in the affected eye for at least 6 months; 2.           taking an oral corticosteroid equivalent to a cumulative dose of at least 450 milligrams of prednisone; 3.           using an inhalational corticosteroid equivalent to a cumulative dose of at least 1,000 milligrams of budesonide;
6.       being treated with one of the following medications before clinical onset or clinical worsening: 1.           for anterior subcapsular cataract only, receiving a cumulative dose of at least 750 grams of a phenothiazine; 1.           receiving a cumulative dose of at least 15 grams of tamoxifen;
7.       having smoked at least 10 pack-years before clinical onset or clinical worsening;

Note: one pack-year is defined in the Schedule 1 – Dictionary.

1.       when aged under 60 years only, having chronic renal failure at the time of clinical onset or clinical worsening as indicated by:

2.           a glomerular filtration rate of less than 15 mL/min/1.73 m2 for a period of at least 3 months; or

3.           undergoing chronic dialysis for renal failure.

4.       inhaling or having cutaneous contact with 2,4,6-trinitrotoluene (TNT) on more days than not, for at least 10 years before clinical onset or clinical worsening;

5.       inability to obtain appropriate clinical management for cataract before clinical worsening.

6.            Relationship to service

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

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

9.            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(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:

                               cataract—see subsection 7(2).

                               cumulative equivalent dose means the total dose of ionising radiation received by the particular organ or tissue from external exposure, internal exposure or both, apart from normal background radiation exposure in Australia, calculated in accordance with the methodology set out in Guide to calculation of 'cumulative equivalent dose' for the purpose of applying ionising radiation factors contained in Statements of Principles determined under Part XIA of the Veterans' Entitlements Act 1986 (Cth), Australian Radiation Protection and Nuclear Safety Agency, as in force on 2 August 2017.

Note 1: Examples of circumstances that might lead to exposure to ionising radiation include being present during or subsequent to the testing or use of nuclear weapons, undergoing diagnostic or therapeutic medical procedures involving ionising radiation, and being a member of an aircrew, leading to increased levels of exposure to cosmic radiation.

Note 2: For the purpose of dose reconstruction, dose is calculated as an average over the mass of a specific tissue or organ. If a tissue is exposed to multiple sources of ionising radiation, the various dose estimates for each type of radiation must be combined.

                                latitude equivalent hours means hours of sunlight exposure multiplied by the appropriate latitude weighting factor as follows:

(a)          For tropical latitudes (23.5° South to 23.5° North) multiply by 1.0;

(b)          For subtropical latitudes (23.6° - 35°) multiply by 0.75;

(c)          For warm temperate latitudes (35.1° - 45°) multiply by 0.5;

(d)          For cool temperate latitudes (45.1° - 65°) multiply by 0.25.

Note: Sunlight exposure is calculated as the sum of sunlight exposure in each separate latitude, accounting for the different sunlight intensity in each latitude (weighting factor).

Sum of sunlight exposure = (hours spent in tropical latitude x tropical latitude weighting factor) + (hours spent in subtropical latitude x subtropical latitude weighting factor) + (hours spent in warm temperate latitude x warm temperate latitude weighting factor) + (hours spent in cool temperate latitude x cool temperate latitude weighting factor).

                               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.

                               one pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.

Note 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.

Note 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.

                               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.

                               unprotected eye means an eye that is directly exposed to the sun and is not protected by sunglasses with lenses that provide good ultraviolet radiation protection such as lens category 2 or above, a brimmed hat or other physical barrier.

                               VEA means the Veterans' Entitlements Act 1986.