Table 1.
Definition of VIP Targeted Disorders by Hierarchy
| Group 1: Very important to detect and treat early |
| Amblyopia |
| Presumed unilateral: ≥3 line interocular difference, a unilateral amblyogenic factor, and worse eye VA ≤ 20/64 |
| Suspected bilateral: a bilateral amblyogenic factor, worse eye VA < 20/50 for 3-year-olds or < 20/40 for 4-year-olds, contralateral eye VA |
| worse than 20/40 for 3-year-olds or 20/30 for 4-year-olds |
| Strabismus: constant in primary gaze |
| Refractive error |
| Severe anisometropia (interocular difference > 2 D hyperopia, > 3 D astigmatism, or > 6 D myopia) |
| Hyperopia ≥ 5.0 D |
| Astigmatism ≥ 2.5 D |
| Myopia ≥ 6.0 D |
| Group 2: Important to detect early |
| Amblyopia |
| Suspected unilateral: 2-line interocular difference and a unilateral amblyogenic factor |
| Presumed unilateral: ≥3 line interocular difference, a unilateral amblyogenic factor, and worse eye VA > 20/64 |
| Strabismus: intermittent in primary gaze |
| Refractive error |
| Anisometropia (interocular difference > 1D hyperopia, > 1.5D astigmatism, or > 3D myopia)* |
| Hyperopia > 3.25 D and < 5.0 D AND interocular difference in SE ≥ 0.5 D |
| Astigmatism > 1.5 and < 2.5 D |
| Myopia ≥ 4.0 and < 6.0 D |
| Group 3: Detection clinically useful |
| Unexplained reduced VA |
| Bilateral: no bilateral amblyogenic factor, worse eye VA < 20/50 for 3-year-olds or < 20/40 for 4-year-olds, contralateral eye VA worse than 20/40 for 3-year-olds or 20/30 for 4-year-olds |
| Unilateral: no unilateral amblyogenic factor, worse eye VA < 20/50 for 3-year-olds or < 20/40 for 4-year-olds or ≥ 2 line difference between eyes (except 20/16 and 20/25) |
| Refractive error |
| Hyperopia > 3.25 and < 5.0 D AND interocular difference in SE < 0.5 D |
| Myopia > 2.0 and < 4.0 D |
Modified from Ophthalmology, 111, The Vision in Preschoolers Study Group, Comparison of preschool vision screening tests as administered by licensed eye care professionals in the Vision in Preschoolers Study, 637–650, Copyright 2004, with permission from American Academy of Ophthalmology.