Statement of Principles

concerning

PTERYGIUM
(Reasonable Hypothesis)

(No. 33 of 2025)

The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

Dated    18 February 2025.

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 pterygium (Reasonable Hypothesis) (No. 33 of 2025).

1.                Commencement

              This instrument commences on 25 March 2025.

1.                Authority

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

1.                Repeal

The Statement of Principles concerning pterygium No. 116 of 2015 (Federal Register of Legislation No. F2015L01671) made under subsection 196B(2)  of the VEA is repealed.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
   1.           This Statement of Principles is about pterygium and death from pterygium.

Meaning of pterygium

1.           For the purposes of this Statement of Principles, pterygium:
   1.           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
   2.           excludes:
      1.             pseudo-pterygium;
      2.          pinguecula;
      3.        pterygium of the nails;
      4.         pterygium colli;
      5.           antecubital pterygium; and
      6.         popliteal pterygium.
2.           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).
3.           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 pterygium

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

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 pterygium and death from pterygium 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 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.

1.           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;
2.           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;
3.           inability to obtain appropriate clinical management for pterygium before clinical worsening.

1.            Relationship to service
   1.           The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.
   2.           The factor set out in subsection 9(4) applies only to material contribution to, or aggravation of, pterygium where the person's pterygium was suffered or contracted before or during (but did not arise out of) the person's relevant service.
2.            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:

                                 latitude equivalent hours means hours of 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 1: 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).

Note 2: sum of sunlight exposure = (sunlight hours spent in tropical latitude x tropical latitude weighting factor) + (sunlight hours spent in subtropical latitude x subtropical latitude weighting factor) + (sunlight hours spent in warm temperate latitude x warm temperate latitude weighting factor) + (sunlight hours spent in cool temperate latitude x cool temperate latitude weighting factor).

                               MRCA means the Military Rehabilitation and Compensation Act 2004.

                               pterygium—see subsection 7(2).

                               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:

(a)           pneumonia;

(b)           respiratory failure;

(c)           cardiac arrest;

(d)           circulatory failure; or

(e)           cessation of brain function.

                               VEA means the Veterans' Entitlements Act 1986.