Causes for Concern Guidelines


InfantSEE has developed loose guidelines for normal, concerns, and problems in each of the five areas that are evaluated. These are guidelines only.

  1. Ocular Motility
    1. No Concern – ability to look at the target, follow and maintain for a brief period or until something else captures the attention
    2. Concern – Reduced ability to gain visual attention in the primary position
    3. Problem - Any limitation of movement in the cardinal meridian
  2. Binocular Function (Cover Test Data)
    1. No Concern – stereo response on gross targets
    2. Concern – no response on stereo targets
    3. Problem – obvious or subtle strabismus
  3. Refraction
    1. Hyperopia
      1. No Concern – Less than +3.50 - discuss risk, what to watch for, and usually seen at age 3.
      2. Concern – Between +3.50 and +5.00 - definite need to follow up within 6 to 12 months
      3. Problem – Over +5.00 - establish patient in an optometric office
    2. Myopia
      1. No Concern - Less than -1.00 - discuss risk, what to watch for, and usually seen at age 3.
      2. Concern – Slightly over -1.00 definite need to follow up within 6 to 12 months
      3. Problem – Well over -1.00 - establish patient in an optometric office
    3. Astigmatism
      1. No Concern – Less than 2.00 - discuss risk, what to watch for, and usually seen at age 3.
      2. Concern – 2.00 to 3.00 - Definite need to follow up within 6 to 12 months
      3. 3.00 – over 3.00 - Establish patient in an optometric office
    4. Anisometropia
      1. No Concern – Less than 1.00 - discuss risk, what to watch for, and usually seen at age 3.
      2. Concern – Between 1.00 and 2.00 - definite need to follow up within 6 to 12 months
      3. Problem – Over 2.00 - establish patient in an optometric office
  4. Looking Behavior
    1. No Concern
    2. Concern – Reduced ability to look/fixate
      1. Problem – Fixation preference for one eye or Failed Visual Acuity test
      2. Ocular Health
        1. No Concern
        2. Problem – any noted anomaly

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