• IRIS7: Amblyopia: Interocular visual acuity

    Updated January 2018.

    Reporting Option: 

    • IRIS Registry QCDR manual data entry: groups and individuals

    Measure Type: Outcome

    Description:  Percentage of newly diagnosed amblyopic patients with one or more of the following:

    1. A corrected interocular (or if not reported, the uncorrected) visual acuity difference < 0.23 logMAR 6-12 months after first diagnosis of amblyopia
    2. An improvement in the corrected visual acuity of the amblyopic eye greater or equal to 0.30 logMAR 6-12 months after first diagnosis of amblyopia 
    3. A final visual acuity in the amblyopic eye equal to 20/30 or better (less than or equal to 0.18 logMar) 6-12 months after first diagnosis of amblyopia 

    To Which Patients Does the Measure Apply?

    Denominator: All patients aged between 3 to 7 years with newly diagnosed amblyopia with recognition visual acuity difference of > 0.29 logMAR between right and left eye (IOD criterion is to exclude bilateral ametropic amblyopia).

    There are two criteria for inclusion of a patient into the denominator.

    1. Patient characteristics: Description located in “Denominator” (see above).
    2. Diagnosis codes (ICD-10-CM): Codes located in “Diagnosis Codes.”

    The quality measure also has exclusions for the denominator.

    Diagnosis Codes

    • Amblyopia (ICD-10: H53.001, H53.002, H53.003, H53.009, H53.021, H53.022, H53.023, H53.029, H53.031, H53.032, H53.033, H53.039)

    How to Report the Measure

    Numerator: Patients with interocular visual acuity difference of < 0.23 logMAR* or an improvement of three or more Snellen lines (> or = 0.30 logMAR)** in the amblyopic eye or a final visual acuity in the amblyopic eye of 20/30 or better (< or = 0.18 logMAR)*** recorded between 6 and 12 months after first use of amblyopia diagnosis code

    *Difference in visual acuity values between right and left eye (inter-eye)

    **Difference between baseline and visual acuity at 6-18 months in the amblyopic eye (intra-eye)

    ***Absolute visual acuity, not a difference

    Denominator Exclusions: Patients with diagnosis of deprivation amblyopia (ICD 10: H53.01), cataract (ICD –10: H26.01, H26.06, H26.09), aphakia (ICD-10: H27.00, H27.01, H27.02, H27.03), or pseudophakia (ICD-10: Z96.1)


    • No scoring benchmark currently exists for this QCDR measure.
    • If 19 or fewer physicians each report the measure or 20 physicians do not report the measure on at least 60 percent of qualifying patients, and a minimum of 20 patients, you will earn 3 out of 10 points toward your total quality score. Choose measures assuming you’ll only earn 3 points per QCDR measure.
    • If at least 20 physicians report the measure on at least 60 percent of qualifying patients and at least 20 patients, CMS will develop a scoring benchmark using data collected during the 2018 reporting year.


    This measure has been developed by the H. Dunbar Hoskins Jr. MD Center for Quality Eye Care of the American Academy of Ophthalmology. The measure is not a clinical guideline and does not establish a medical standard. It has not been tested in all possible applications.

    The measure, while copyrighted, can be reproduced and distributed with appropriate credit, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. The American Academy of Ophthalmology encourages use of the measure by other health care professionals, where applicable.

    Commercial use is defined as the sale, license or distribution of the measures for commercial gain, or incorporation of some or all of a measure into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the measures require a license agreement between the user and the American Academy of Ophthalmology. Neither the Academy nor its members shall be responsible for any use of the measures. 


    © 2017 American Academy of Ophthalmology. All rights reserved. Limited proprietary coding from Current Procedural Terminology (CPT®) is contained in the measure specifications. Users of this code set should obtain all necessary licenses. The Academy disclaims all liability for use or accuracy of the coding contained in these measure specifications. CPT® contained in the measures specifications is copyright 2004-2017 American Medical Association.