Can amblyopia be viewed as a disability
In the area of “visual organ”, for which a GdS is awarded, visual impairments are predominantly mentioned. However, impairments of vision after a corneal transplant are also listed.
The following impairments of the visual organ are mentioned:
- the loss of an eye
- Loss of the lens
- Visual acuity
- Eye muscle paralysis, strabismus
- Paralysis of the upper eyelid
- Misalignment of the eyelids, obstruction of the tear ducts with tears
- Loss of field of vision and narrowing of the field of vision
- Failure of the sense of color
- remaining eyesight after corneal transplant
- Removal of a malignant eye tumor
The Loss of an eye leads to a GdS of 40 if permanent, untreatable suppuration of the eye socket occurs.
At a Lens loss the GdS depends on the visual acuity and on whether one eye or both eyes are affected. The GdS also depends on whether intraocular artificial lenses, contact lenses or cataract glasses are necessary.
Depending on Visual acuity the GdS is up to 100. The visual acuity is determined with the use of visual aids, e.g. glasses. There is a DIN standard for determining visual acuity; the GdS is determined using a table from the German Ophthalmological Society (DOG). This table is listed below in the Health Care Ordinance (VersMedV).
In the sub-item Eye muscle paralysis Strabismus (double vision), paralyzed mouth of the upper eyelid, misalignment of the eyelids and the obstruction of the tear ducts are also assigned.
Loss of field of vision and narrowing of the field of vision are measured and rated with a GdS depending on the proportion of the lost field of vision.
At a Failure of the sense of color GdS is only assessed if there is night blindness or impairment of twilight vision.
To Corneal transplants A GdS is assessed depending on the remaining eyesight. This includes visual acuity in particular, but theoretically all of the aforementioned visual impairments are meant.
If in a row one malignant eye tumor An eyeball had to be removed, a GdS of 50 is awarded for the duration of the so-called healing test (5 years). If the tumor has metastasized, the GdS is 80.
The determination of the degree of disability is based on the health disorders stipulated in the Health Care Ordinance (VersMedV).
There indications are laid down according to which certain health disorders are assigned to a measure for the impairment of participation in life in the community. This measure is called the degree of damage (GdB), in the VersMedV the degree of damage (GdS) is used.
In the following, the health disorders named in the Health Care Ordinance with the date of issue December 10, 2008 with the GdS in the area of "visual organ" are listed as an unchanged reproduction of the text of the ordinance from the Federal Ministry of Justice and Consumer Protection.
4. Organ of vision
Visual impairment includes all visual impairments. The corrected visual acuity is primarily decisive for the assessment; in addition, among others Defects in the field of view and the field of view must be taken into account.
The visual acuity must always be determined according to the recommendations of the German Ophthalmological Society (DOG) according to DIN 58220; Deviations from this are only permitted in exceptional cases (e.g. bedridden or small children). The other partial functions of the eyesight can only be tested with devices or methods which, in accordance with the recommendations of the DOG, allow a flawless assessment relevant to the expert opinion.
With regard to the visual field determination, this means that only results of manual kinetic perimetry according to the Goldmann III / 4e brand may be used to determine visual field defects.
When assessing impaired vision, it is important to ensure that the morphological findings explain the visual impairment.
The "MdE table of the DOG" forms the basis for the GdS assessment in the event of a reduction in visual acuity.
|4.1 Loss of an eye with permanent suppuration of the eye socket that cannot be treated||40|
|4.2 Loss of Lens|
|Lens loss corrected by intraocular artificial lens or contact lens|
|Loss of lens in one eye|
|Visual acuity 0.4 and more||10|
|Visual acuity 0.1 to less than 0.4||20|
|Visual acuity less than 0.1||25-30|
Loss of lenses in both eyes
If the GdS resulting from the visual acuity for both eyes is not more than 60, this must be increased by 10.
The GdS values assume that the lenses are compatible. The objective finding is decisive.
In the case of cataract glasses, the GdS resulting from the visual acuity for both eyes must be increased by 10, in the case of blindness or loss of the other eye by 20.
If it cannot be corrected, the GdS is based on the residual visual acuity.
4.3 The ophthalmological examination includes the examination of one-eyed and two-eyed visual acuity. If the results of the two types of examination are different, the two-eyed visual acuity is to be used as the visual acuity value of the better eye.
RA 1,0 0,8 0,63 0,5 0,4 0,32 0,25 0,2 0,16 0,1 0,08 0,05 0,02 0 Visual acuity 5/5 5/6 5/8 5/10 5/12 5/15 5/20 5/25 5/30 5/50 1/12 1/20 1/50 0 LA 1,0 5/5 0 0 0 5 5 10 10 10 15 20 20 25 25 *25 0,8 5/6 0 0 5 5 10 10 10 15 20 20 25 30 30 30 0,63 5/8 0 5 10 10 10 10 15 20 20 25 30 30 30 40 0,5 5/10 5 5 10 10 10 15 20 20 25 30 30 35 40 40 0,4 5/12 5 10 10 10 20 20 25 25 30 30 35 40 50 50 0,32 5/15 10 10 10 15 20 30 30 30 40 40 40 50 50 50 0,25 5/20 10 10 15 20 25 30 40 40 40 50 50 50 60 60 0,2 5/25 10 15 20 20 25 30 40 50 50 50 60 60 70 70 0,16 5/30 15 20 20 25 30 40 40 50 60 60 60 70 80 80 0,1 5/50 20 20 25 30 30 40 50 50 60 70 70 80 90 90 0,08 1/12 20 25 30 30 35 40 50 60 60 70 80 90 90 90 0,05 1/20 25 30 30 35 40 50 50 60 70 80 90 100 100 100 0,02 1/50 25 30 30 40 50 50 60 70 80 90 90 100 100 100 0 0 *25 30 40 40 50 50 60 70 80 90 90 100 100 100
|4.4 Eye muscle paralysis, strabismus|
|when one eye has to be excluded from seeing because of the double vision||30|
|In the case of double images only in some areas of the field of vision with otherwise normal binocular vision, the GdS results from the following scheme by Haase and Steinhorst:|
|Link to the scheme by Haase and Steinhorst|
|in the case of one-sided image suppression through habituation (exclusion) and the corresponding disappearance of the double images||10|
|Limitations in visual acuity (e.g. amblyopia) or a significantly disfiguring effect may also have to be taken into account.|
|Paralysis of the upper eyelid with uncorrectable, complete|
|Closure of the eye||30|
|Misalignment of the eyelids, obstruction of the tear ducts with tears|
|4.5 Loss of visual field|
|Complete half-side and quadrant failures|
|with binocular vision||10|
|with loss of binocular vision||30|
|Homonymous quadrant above||20|
|Homonymous quadrant below||30|
|Complete loss of both lower halves of the field of vision||60|
|Loss of one half of the visual field due to loss or blindness of the other eye|
|In the case of incomplete half-side and quadrant failures, the GdS is to be set correspondingly lower.|
|Narrowing of the visual field|
|All-round narrowing with the normal field of view of the other eye|
|at a distance of 10 ° from the center||10|
|at 5 ° from the center||25|
|Binocular narrowing on all sides|
|at 50 ° from the center||10|
|at a distance of 30 ° from the center||30|
|at a distance of 10 ° from the center||70|
|at 5 ° from the center||100|
|All-round narrowing in the absence of the other eye|
|at 50 ° from the center||40|
|at a distance of 30 ° from the center||60|
|at a distance of 10 ° from the center||90|
|at 5 ° from the center||100|
|Irregular visual field deficits, scotomas in the 50 ° field of view below the horizontal meridian, binocular|
|at least 1/3 of the failed area||20|
|at least 2/3 of the failed area||50|
|In the absence of one eye, the scotomas are to be rated correspondingly higher.|
|4.6 Failure of color sense||0|
|Limitation of dark adaptation (night blindness) or twilight vision||0-10|
|4.7 After corneal transplants, the GdS is based solely on eyesight.|
|4.8 After a malignant eye tumor has been removed, the first five years of healing must be awaited; GdS during this time|
|when the tumor is limited to the eyeball (also when the eyeball is removed)||50|
|otherwise||at least 80|
Source: https://www.gesetze-im-internet.de/, as of November 3rd, 2020
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