Statement of Principles
concerning
BLEPHARITIS
No. 64 of 2010
for the purposes of the
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
Title
1. This Instrument may be cited as Statement of Principles concerning blepharitis No. 64 of 2010.
Determination
2. The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a) revokes Instrument No. 116 of 1995, as amended by Instrument No. 20 of 2004, concerning acute blepharitis; and
(b) revokes Instrument No. 118 of 1995, as amended by Instrument No. 22 of 2004, concerning chronic blepharitis; and
(c) determines in their place this Statement of Principles.
Kind of injury, disease or death
3. (a) This Statement of Principles is about blepharitis and death from blepharitis.
(b) For the purposes of this Statement of Principles, "blepharitis" means an inflammation of the eyelid margins. This definition includes chalazion and hordeolum.
Basis for determining the factors
4. On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that blepharitis and death from blepharitis can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).
Factors that must be related to service
5. Subject to clause 7, at least one of the factors set out in clause 6 must be related to the relevant service rendered by the person.
Factors
6. The factor that must exist before it can be said that, on the balance of probabilities, blepharitis or death from blepharitis is connected with the circumstances of a person’s relevant service is:
(a) having seborrhoeic dermatitis of the periocular region at the time of the clinical onset of blepharitis; or
(b) having ocular rosacea at the time of the clinical onset of blepharitis; or
(c) having an infection of the eyelid at the time of the clinical onset of blepharitis; or
(d) having an infestation of Phthirus pubis lice in the region of the eyelid at the time of the clinical onset of blepharitis; or
(e) having an infestation of Demodex folliculorum or Demodex brevis mites in the region of the eyelid, at the time of the clinical onset of blepharitis; or
(f) having vitamin A or vitamin B complex deficiency, at the time of the clinical onset of blepharitis; or
(g) having ocular or periocular exposure to an allergen within the 12 hours before the clinical onset of blepharitis; or
(h) having ocular or periocular exposure to an irritant substance at the time of the clinical onset of blepharitis; or
(i) being in an immunocompromised state at the time of the clinical onset of blepharitis; or
(j) having mustard gas exposure to the region of the eye at the time of the clinical onset of blepharitis; or
(k) undergoing a course of therapeutic radiation to the region of the eye at the time of the clinical onset of blepharitis; or
(l) having a neoplasm affecting the eyelid at the time of the clinical onset of blepharitis; or
(m) having xerophthalmia at the time of the clinical onset of blepharitis; or
(n) having diabetes mellitus at the time of the clinical onset of blepharitis; or
(o) having a smallpox immunisation within the two weeks before the clinical onset of blepharitis; or
(p) having treatment with an epidermal growth factor receptor inhibitor at the time of the clinical onset of blepharitis; or
(q) having treatment with hydroxyurea or indinavir at the time of the clinical onset of blepharitis; or
(r) having seborrhoeic dermatitis of the periocular region at the time of the clinical worsening of blepharitis; or
(s) having ocular rosacea at the time of the clinical worsening of blepharitis; or
(t) having an infection of the eyelid at the time of the clinical worsening of blepharitis; or
(u) having an infestation of Phthirus pubis lice in the region of the eyelid at the time of the clinical worsening of blepharitis; or
(v) having an infestation of Demodex folliculorum or Demodex brevis mites in the region of the eyelid, at the time of the clinical worsening of blepharitis; or
(w) having vitamin A or vitamin B complex deficiency, at the time of the clinical worsening of blepharitis; or
(x) having ocular or periocular exposure to an allergen within the 12 hours before the clinical worsening of blepharitis; or
(y) having ocular or periocular exposure to an irritant substance at the time of the clinical worsening of blepharitis; or
(z) being in an immunocompromised state at the time of the clinical worsening of blepharitis; or
(aa) having mustard gas exposure to the region of the eye at the time of the clinical worsening of blepharitis; or
(bb) undergoing a course of therapeutic radiation to the region of the eye at the time of the clinical worsening of blepharitis; or
(cc) having a neoplasm affecting the eyelid at the time of the clinical worsening of blepharitis; or
(dd) having xerophthalmia at the time of the clinical worsening of blepharitis; or
(ee) having diabetes mellitus at the time of the clinical worsening of blepharitis; or
(ff) inability to obtain appropriate clinical management for blepharitis.
Factors that apply only to material contribution or aggravation
7. Paragraphs 6(r) to 6(ff) apply only to material contribution to, or aggravation of, blepharitis where the person’s blepharitis was suffered or contracted before or during (but not arising out of) the person’s relevant service.
Inclusion of Statements of Principles
8. In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.
Other definitions
9. For the purposes of this Statement of Principles:
"a course of therapeutic radiation" means one or more fractions (treatment portions) of ionising radiation administered with the aim of achieving palliation or cure with gamma rays, x-rays, alpha particles or beta particles;
"an allergen" means an antigenic substance capable of producing an immune response;
"an immunocompromised state" means a state where the immune response has been attenuated by administration of immunosuppressive drugs, irradiation, malnutrition, a malignant disease process or certain types of infection;
"an infection of the eyelid" means a bacterial, viral, rickettsial, parasitic or fungal infection involving the skin, hair follicles or glands of the eyelid;
"an irritant substance" means a chemical which causes an inflammatory effect on living tissue by chemical action at the site of contact;
"death from blepharitis" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s blepharitis;
"ocular rosacea" means a chronic inflammatory dermatological condition of the eyelids and ocular surface;
"relevant service" means:
(a) eligible war service (other than operational service) under the VEA; or
(b) defence service (other than hazardous service) under the VEA; or
(c) peacetime service under the MRCA;
"terminal event" means the proximate or ultimate cause of death and includes:
(a) pneumonia;
(b) respiratory failure;
(c) cardiac arrest;
(d) circulatory failure; or
(e) cessation of brain function.
Application
10. This Instrument applies to all matters to which section 120B of the VEA or section 339 of the MRCA applies.
11. This Instrument takes effect from 1 September 2010.
Dated this eighteenth day of August 2010
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRPERSON
