38 CFR Part 4 — 38 CFR § 4.79

Diplopia (double vision) — VA Diagnostic Code 6090

Eye

Diagnostic code

6090

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38 CFR § 4.79, under Impairment of Muscle Function, lists Diagnostic Code 6090 as “Diplopia (double vision):”. The rating column is headed “Equivalent visual acuity,” with a line break after “Equivalent.” The rows give 5/200, 15/200, 20/100, 20/70, 20/200, 20/70, and 20/40. The note evaluates occasional diplopia, or diplopia correctable with spectacles, at 0 percent. Appendix B to Part 4 indexes the code as “Diplopia.” The index does not say “double vision.”

Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was up to date as of 2026-10-01 and last amended on 2026-08-27. The § 4.79 source note prints 73 FR 66550, Nov. 10, 2008, as amended at 83 FR 15321, Apr. 10, 2018. The § 4.75 source note prints 73 FR 66549, Nov. 10, 2008. The § 4.78 source note prints 73 FR 66550, Nov. 10, 2008, as amended at 83 FR 15321, Apr. 10, 2018.

The rating criteria at each level

6090 Diplopia (double vision) — equivalent visual acuity

Rating %: 5/200 (1.5/60)

Criteria (verbatim). (a) Central 20 degrees

Rating %: —

Criteria (verbatim). (b) 21 degrees to 30 degrees

Rating %: 15/200 (4.5/60)

Criteria (verbatim). (1) Down

Rating %: 20/100 (6/30)

Criteria (verbatim). (2) Lateral

Rating %: 20/70 (6/21)

Criteria (verbatim). (3) Up

Rating %: —

Criteria (verbatim). (c) 31 degrees to 40 degrees

Rating %: 20/200 (6/60)

Criteria (verbatim). (1) Down

Rating %: 20/70 (6/21)

Criteria (verbatim). (2) Lateral

Rating %: 20/40 (6/12)

Criteria (verbatim). (3) Up

Rating %	Criteria (verbatim)
5/200 (1.5/60)	(a) Central 20 degrees
—	(b) 21 degrees to 30 degrees
15/200 (4.5/60)	(1) Down
20/100 (6/30)	(2) Lateral
20/70 (6/21)	(3) Up
—	(c) 31 degrees to 40 degrees
20/200 (6/60)	(1) Down
20/70 (6/21)	(2) Lateral
20/40 (6/12)	(3) Up

The second column heading is “Equivalent visual acuity.” The XML breaks the line after “Equivalent.” The cells are acuity levels. They are not printed as the percentages 100, 90, or 30.

Note: In accordance with 38 CFR 4.31, diplopia that is occasional or that is correctable with spectacles is evaluated at 0 percent.

The (b) and (c) headings have empty acuity cells. The Down, Lateral, and Up rows under each heading carry the acuities.

Appendix B also prints “6092 Diplopia, limited muscle function.” The 2026-10-01 text of § 4.79 does not list diagnostic code 6092. The muscle-function table ends at DC 6091, symblepharon.

38 CFR § 4.78(a) says the examiner must use a Goldmann perimeter chart or the Tangent Screen method that identifies the four major quadrants (upward, downward, left, and right lateral) and the central field (20 degrees or less) (see Figure 2). The examiner must document the results of muscle function testing by identifying the quadrant(s) and range(s) of degrees in which diplopia exists. Paragraph (b)(1) says an evaluation for diplopia will be assigned to only one eye. When a claimant has both diplopia and decreased visual acuity or visual field defect, that paragraph assigns a level of corrected visual acuity for the poorer eye (or the affected eye, if disability of only one eye is service-connected) that is one step poorer if the DC 6090 evaluation is 20/70 or 20/100, two steps poorer if it is 20/200 or 15/200, or three steps poorer if it is 5/200. That adjusted level must not exceed 5/200. The paragraph then says to use diagnostic codes 6065 through 6066 for the percentage evaluation. Paragraph (b)(2) says that when diplopia extends beyond more than one quadrant or range of degrees, evaluate diplopia based on the quadrant and degree range that provides the highest evaluation. Paragraph (b)(3) says that when diplopia exists in two separate areas of the same eye, increase the equivalent visual acuity under diagnostic code 6090 to the next poorer level of visual acuity, not to exceed 5/200.

38 CFR § 4.75(a) includes muscle function in the evaluation of visual impairment. Paragraph (b) says examinations of muscle function will be conducted only when there is a medical indication of disease or injury that may be associated with visual field defect or impaired muscle function, and that the examination must be conducted by a licensed optometrist or a licensed ophthalmologist. 38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just. The DC 6090 note is the 0 percent sentence for occasional diplopia or diplopia correctable with spectacles. It cites 38 CFR 4.31.

Source: 38 CFR § 4.79, Diagnostic Code 6090, and 38 CFR § 4.78, eCFR full-text XML for 2026-10-01.

What the words mean in your records

Equivalent visual acuity

Central 20 degrees is 5/200 (1.5/60). From 21 to 30 degrees, Down is 15/200 (4.5/60), Lateral is 20/100 (6/30), and Up is 20/70 (6/21). From 31 to 40 degrees, Down is 20/200 (6/60), Lateral is 20/70 (6/21), and Up is 20/40 (6/12).

One eye

Section 4.78(b)(1) says an evaluation for diplopia will be assigned to only one eye. The percentage step after that assignment uses diagnostic codes 6065 through 6066.

Occasional, or correctable with spectacles

The note evaluates that diplopia at 0 percent, in accordance with 38 CFR 4.31. The equivalent-acuity rows are the other lines.

Evidence that speaks to each level

The quadrant and the degrees

What the rater needs to see. The quadrant and the range of degrees in which diplopia exists: central 20 degrees, 21 to 30 degrees, or 31 to 40 degrees, and Down, Lateral, or Up where those rows apply.

Where that usually lives. The muscle-function examination § 4.78(a) describes, using a Goldmann perimeter chart or the Tangent Screen method. Figure 2 is the chart that paragraph cites.

0 percent

What the rater needs to see. Diplopia that is occasional, or diplopia that is correctable with spectacles, when the note is the line being used.

Where that usually lives. The same examination.

Level	What the rater needs to see	Where that usually lives
The quadrant and the degrees	The quadrant and the range of degrees in which diplopia exists: central 20 degrees, 21 to 30 degrees, or 31 to 40 degrees, and Down, Lateral, or Up where those rows apply.	The muscle-function examination § 4.78(a) describes, using a Goldmann perimeter chart or the Tangent Screen method. Figure 2 is the chart that paragraph cites.
0 percent	Diplopia that is occasional, or diplopia that is correctable with spectacles, when the note is the line being used.	The same examination.

VA’s public DBQ list, checked October 5, 2026, names “Eye Conditions” under Ophthalmological. The file is Eye Conditions.

The exam form

DC 6090 prints equivalent visual acuities and a 0 percent note. Section 4.78(b)(1) sends the percentage evaluation to diagnostic codes 6065 through 6066 after the step adjustment. This page does not say the form replaces those sections.

Related codes and how they interact

The percentage table is 6065 through 6066.

Section 4.78(b)(1) names diagnostic codes 6065 through 6066 for the percentage evaluation after the diplopia step adjustment. DC 6090’s own column is equivalent visual acuity. DC 6091 is symblepharon. Appendix B’s 6092 is not a code in the 2026-10-01 rating table.

Secondary conditions and presumptions

The 2026-10-01 text of 38 CFR § 3.309 does not contain “diplopia.” DC 6090 is a rating-schedule line, not a § 3.309 name.

Short answers

What is the VA rating for diplopia?

Diagnostic Code 6090 in 38 CFR § 4.79 assigns an equivalent visual acuity by the degree and direction of diplopia. Occasional diplopia, or diplopia correctable with spectacles, is 0 percent under the note. Section 4.78(b)(1) uses diagnostic codes 6065 through 6066 for the percentage evaluation after its step adjustment. Education only. VA decides on the evidence.

Why does the index omit “double vision”?

Appendix B says “Diplopia.” The rating table says “Diplopia (double vision):”.

FAQ

What does DC 6090 print instead of a percentage?

Equivalent visual acuity. Central 20 degrees is 5/200 (1.5/60). The 21-to-30-degree rows are 15/200 down, 20/100 lateral, and 20/70 up. The 31-to-40-degree rows are 20/200 down, 20/70 lateral, and 20/40 up. The note evaluates occasional diplopia, or diplopia correctable with spectacles, at 0 percent. Education only.

Which eye is evaluated for diplopia?

Section 4.78(b)(1) says an evaluation for diplopia will be assigned to only one eye. When diplopia extends beyond more than one quadrant or range of degrees, paragraph (b)(2) uses the quadrant and degree range that provides the highest evaluation.

Is limited muscle function DC 6092?

Appendix B prints “6092 Diplopia, limited muscle function.” The 2026-10-01 text of § 4.79 does not list 6092. Muscle function in that section is DC 6090, and the next code is DC 6091.

Next steps

Read the decision for DC 6090, the quadrant and degrees it used, and any step adjustment under § 4.78.
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Other eye codes are on the eye diagnostic-code index.

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Other codes in this body system

Nearby catalog entries in Eye, ordered by diagnostic code number. All Eye codes

Also: DC code lookup (tools) lists the same index in a compact layout.

Source: 38 CFR Part 4, Diagnostic Code 6090 • va.gov

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