Table 1.
Hierarchy of VIP Targeted Disorders
| Group 1: Very Important to Detect and Treat Early |
| Amblyopia |
| Presumed unilateral: ≥3 lines' 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- and 5-year-olds, contralateral eye VA worse than 20/40 for 3-year-olds or 20/30 for 4- and 5-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: >1 D hyperopia, >1.5 D astigmatism, or >3 D myopia) |
| Hyperopia >3.25 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 Is Clinically Useful |
| Unexplained Reduced VA |
| Bilateral: no bilateral amblyogenic factor, worse eye VA <20/50 for 3-year-olds or <20/40 for 4- and 5-year olds, contralateral eye VA worse than 20/40 for 3-year-olds or 20/30 for 4- and 5-year-olds |
| Unilateral: no unilateral amblyogenic factor, worse eye VA <20/50 for 3-year-olds or <20/40 for 4- and 5-year-olds or ≥2 line difference between eyes (except 20/16 and 20/25) |
| Refractive Error |
| Hyperopia >3.25 D and <5.0 D AND interocular difference in SE <0.5 D |
| Myopia >2.0 D and <4.0 D |