Table 1.

Screening models for the low-middle-income countries.

	Binocular indirect ophthalmoscopy by ophthalmologists	Tele-imaging37,40,76 hub and spoke model	Neonatology lead model77
Team	Ophthalmologists work in their respective SNCUs, and they are linked with the nodal centre	Imaging technicians and program co-ordinator work alongside remotely located Ophthalmologist	NICU nurses/paediatricians work alongside remotely located Ophthalmologist
Program coverage	Only to their respective SNCUs	One team can cover up to 5–6 districts in the current model	Respective SNCU/NICU
Technique	Direct examination of the retina using Binocular Indirect Ophthalmoscopy	Fundus images are taken by certified technicians	Fundus images are taken by certified nursing staff/doctors
Training	Done by qualified paediatric ophthalmologists	Level 1–3 technicians	Neonatal nursing or medical staff
Pros	Cost effective	Possible to screen large number of at-risk infants and possible to integrate with AI in the future	‘Neonatal team owns the responsibility’ to screen all eligible infants and possible to integrate with AI in the future
Cons	There is a shortage of ophthalmologists trained to manage ROP and to meet the demand. Private NICU’s may not be able to access the service. No stored images for longitudinal viewing.	Requirement for an administrative framework, including credentialing, to safeguard the imaging staff	Each neonatal unit requires a designated leader, imaging staff and imaging camera. Need high level of multidisciplinary coordination.

SNCU; special newborn care unit, NICU, neonatal intensive care unit, AI: artificial intelligence.