Pterygium

Pterygium — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Pterygium. DVA can only accept a claim for Pterygium if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

RH No. 33 of 2025 · BoP No. 34 of 20256 factors

Meaning of pterygium: For the purposes of this Statement of Principles, pterygium: (a) means a triangular or wedge-shaped expanse of fibrovascular tissue which grows horizontally in the interpalpebral fissure, extending from the conjunctiva to the cornea, being immovably united to the cornea at its apex, firmly attached to the sclera throughout its middle portion, and merged with the conjunctiva at its base; and (b) excludes: (i) pseudo-pterygium; (ii) pinguecula; (iii) pterygium of the nails; (iv) pterygium colli; (v) antecubital pterygium; and (vi) popliteal pterygium. (3) While pterygium attracts ICD-10-AM code H11.0, in applying this Statement of Principles the meaning of pterygium is that given in subsection (2). (4) 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.

Reasonable Hypothesis (RH) — Statement of Principles No. 33 of 2025

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 pterygium or death from pterygium with the circumstances of a person's relevant service:

(1)
having sunlight exposure to the eye which is not protected by clothing, ultraviolet-blocking sunglasses, or other physical barrier, for a cumulative period of at least 2,250 latitude equivalent hours before clinical onset;
Note: latitude equivalent hours and unprotected eye are defined in the Schedule 1 - Dictionary.
(2)
having exposure of the affected eye to electric arc welding light, while welding without appropriate eye protection, such as a welding helmet or welding mask, for an average of at least 20 hours per week, for at least the 2 years before clinical onset;
(3)
having heavy exposure of the unprotected eye to sawdust, in an environment where the person is covered in sawdust, for an average of at least 20 hours per week, for at least the one year before clinical onset;
(4)
inability to obtain appropriate clinical management for pterygium before clinical worsening;

Aggravation-only factors: the factors in subsection 9(4) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 34 of 2025

2 factors

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

(1)
having sunlight exposure to the eye which is not protected by clothing, ultraviolet-blocking sunglasses, or other physical barrier, for a cumulative period of at least 4,500 latitude equivalent hours before clinical onset;
Note: latitude equivalent hours is defined in the Schedule 1 - Dictionary.
(2)
inability to obtain appropriate clinical management for pterygium before clinical worsening;

Aggravation-only factors: the factors in subsection 9(2) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Accepted — what is it worth?

A Statement of Principles decides one thing only: whether DVA accepts liability for pterygium. It says nothing about how much you are paid. Compensation is worked out separately, from impairment points under the GARP — so a condition can be accepted and still rate few points, or rate more than you expect once it is combined with everything else on your file.

Pterygium may be accepted without proving the link to service

Pterygium is listed in Part 2 of the determination as attributable to defence service, provided the criteria below are met.

Qualifying service: peacetime service for at least 56 weeks; or warlike service or non-warlike service for at least 29 weeks.

A diagnosis is still required, and the presumption may not apply where there is clear evidence of a cause other than service. "Onset" means when an injury was sustained, or when all the signs and symptoms of a disease were first present — not the date of diagnosis. Applies to claims made on or after 1 July 2026.