Visual Refractive Error F076

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522

Last amended

Rulebase for astigmatism

<h5>Current RMA Instruments</h5><div class="tablesaw-bar tablesaw-mode-swipe tablesaw-all-cols-visible"><div class="tablesaw-advance minimap"> </div></div><div class="tablesaw-overflow"><table class="tablesaw tablesaw-swipe" border="0" cellpadding="0" cellspacing="0" width="0" data-tablesaw-mode="swipe" data-tablesaw-minimap="" id="tablesaw-4660"><thead><tr><th><h5><a class="external-processed" href="http://www.rma.gov.au/assets/SOP/2025/d7f28e0cb0/035.pdf&quot; target="_blank" rel="nofollow noopener"><u>Reasonable Hypothesis SOP</u></a><svg class="svg-inline--fa fa-arrow-up-right-from-square fa-sm mx-2" aria-labelledby="svg-inline--fa-title-SR6DG23iJgqA" data-prefix="fal" data-icon="arrow-up-right-from-square" role="img" xmlns="http://www.w3.org/2000/svg&quot; viewbox="0 0 512 512" data-fa-i2svg=""><path fill="currentColor" d="M336 0c-8.8 0-16 7.2-16 16s7.2 16 16 16H457.4L212.7 276.7c-6.2 6.2-6.2 16.4 0 22.6s16.4 6.2 22.6 0L480 54.6V176c0 8.8 7.2 16 16 16s16-7.2 16-16V16c0-8.8-7.2-16-16-16H336zM64 32C28.7 32 0 60.7 0 96V448c0 35.3 28.7 64 64 64H416c35.3 0 64-28.7 64-64V304c0-8.8-7.2-16-16-16s-16 7.2-16 16V448c0 17.7-14.3 32-32 32H64c-17.7 0-32-14.3-32-32V96c0-17.7 14.3-32 32-32H208c8.8 0 16-7.2 16-16s-7.2-16-16-16H64z"></path></svg></h5></th><th><h5>35 of 2025</h5></th></tr></thead><tbody><tr><td><h5><a class="external-processed" href="http://www.rma.gov.au/assets/SOP/2025/56a93ef0f0/036.pdf&quot; target="_blank" rel="nofollow noopener"><u>Balance of Probabilities SOP</u></a><svg class="svg-inline--fa fa-arrow-up-right-from-square fa-sm mx-2" aria-labelledby="svg-inline--fa-title-FTw3KWfPbB5b" data-prefix="fal" data-icon="arrow-up-right-from-square" role="img" xmlns="http://www.w3.org/2000/svg&quot; viewbox="0 0 512 512" data-fa-i2svg=""><path fill="currentColor" d="M336 0c-8.8 0-16 7.2-16 16s7.2 16 16 16H457.4L212.7 276.7c-6.2 6.2-6.2 16.4 0 22.6s16.4 6.2 22.6 0L480 54.6V176c0 8.8 7.2 16 16 16s16-7.2 16-16V16c0-8.8-7.2-16-16-16H336zM64 32C28.7 32 0 60.7 0 96V448c0 35.3 28.7 64 64 64H416c35.3 0 64-28.7 64-64V304c0-8.8-7.2-16-16-16s-16 7.2-16 16V448c0 17.7-14.3 32-32 32H64c-17.7 0-32-14.3-32-32V96c0-17.7 14.3-32 32-32H208c8.8 0 16-7.2 16-16s-7.2-16-16-16H64z"></path></svg></h5></td><td><h5>36 of 2025</h5></td></tr></tbody></table></div><h5>Changes from previous instruments</h5><drupal-media data-entity-type="media" data-entity-uuid="fd19f623-b278-40a8-8c49-73474c660209"> </drupal-media><h5>ICD Coding</h5><ul><li>ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3</li></ul><h5>Brief description</h5><p>Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:</p><ul><li>Myopia (nearsightedness): difficulty seeing distant objects clearly</li><li>Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly</li><li>Astigmatism: distorted or blurred vision due to an irregularly curved cornea</li><li>Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. </li></ul><p>If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.</p><p>Note: Myopia and hypermetropia cannot co-exist in the same eye.</p><h5>Confirming the diagnosis</h5><p>The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. </p><h5>Additional diagnoses covered by SOP</h5><ul><li>Nearsightedness</li><li>Farsightedness  </li><li>Hypermetropia</li><li>Myopia includes:<ul><li>benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia</li></ul></li><li>Hyperopia includes:<ul><li>curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia</li></ul></li><li><span>Astigmatism includes:</span><ul><li><span>myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, </span>oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism <span> </span></li></ul></li></ul><h5>Conditions excluded from SOP</h5><ul><li>Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. <span>It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. </span></li><li>Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself </li></ul><p>*another SOP applies</p><p>#non-SOP condition </p><h5>Clinical onset</h5><p>Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.</p><h5>Clinical worsening</h5><p>Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. <span>It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist.</span> In most cases, refractive errors can be effectively corrected with glasses or contact lenses. </p>

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/rulebase-astigmatism

A lid or limbal mass of the eye

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-astigmatism/lid-or-limbal-mass-eye

Last amended

Albinism

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-astigmatism/albinism

Last amended

Cataract surgery

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-astigmatism/cataract-surgery

Last amended

Corneal scarring

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-astigmatism/corneal-scarring

Last amended

Decentration or tilting of the lens

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-astigmatism/decentration-or-tilting-lens

Last amended

Keratoconus

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-astigmatism/keratoconus

Last amended

No appropriate clinical management for myopia or hypermetropia or astigmatism

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-astigmatism/no-appropriate-clinical-management-myopia-or-hypermetropia-or-astigmatism

Last amended

Pterygium

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-astigmatism/pterygium

Last amended

Surgery for retinal detachment

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/sop-information/sops-and-supporting-information-alphabetic-listing/m/myopia-hypermetropia-and-astigmatism-f076/rulebase-astigmatism/surgery-retinal-detachment

Surgery involving the cornea or sclera

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-astigmatism/surgery-involving-cornea-or-sclera

Last amended

Rulebase for hypermetropia

<h5>Current RMA Instruments</h5><div class="tablesaw-bar tablesaw-mode-swipe tablesaw-all-cols-visible"><div class="tablesaw-advance minimap"> </div></div><div class="tablesaw-overflow"><table class="tablesaw tablesaw-swipe" border="0" cellpadding="0" cellspacing="0" width="0" data-tablesaw-mode="swipe" data-tablesaw-minimap="" id="tablesaw-4660"><thead><tr><th><h5><a class="external-processed" href="http://www.rma.gov.au/assets/SOP/2025/d7f28e0cb0/035.pdf&quot; target="_blank" rel="nofollow noopener"><u>Reasonable Hypothesis SOP</u></a><svg class="svg-inline--fa fa-arrow-up-right-from-square fa-sm mx-2" aria-labelledby="svg-inline--fa-title-SR6DG23iJgqA" data-prefix="fal" data-icon="arrow-up-right-from-square" role="img" xmlns="http://www.w3.org/2000/svg&quot; viewbox="0 0 512 512" data-fa-i2svg=""><path fill="currentColor" d="M336 0c-8.8 0-16 7.2-16 16s7.2 16 16 16H457.4L212.7 276.7c-6.2 6.2-6.2 16.4 0 22.6s16.4 6.2 22.6 0L480 54.6V176c0 8.8 7.2 16 16 16s16-7.2 16-16V16c0-8.8-7.2-16-16-16H336zM64 32C28.7 32 0 60.7 0 96V448c0 35.3 28.7 64 64 64H416c35.3 0 64-28.7 64-64V304c0-8.8-7.2-16-16-16s-16 7.2-16 16V448c0 17.7-14.3 32-32 32H64c-17.7 0-32-14.3-32-32V96c0-17.7 14.3-32 32-32H208c8.8 0 16-7.2 16-16s-7.2-16-16-16H64z"></path></svg></h5></th><th><h5>35 of 2025</h5></th></tr></thead><tbody><tr><td><h5><a class="external-processed" href="http://www.rma.gov.au/assets/SOP/2025/56a93ef0f0/036.pdf&quot; target="_blank" rel="nofollow noopener"><u>Balance of Probabilities SOP</u></a><svg class="svg-inline--fa fa-arrow-up-right-from-square fa-sm mx-2" aria-labelledby="svg-inline--fa-title-FTw3KWfPbB5b" data-prefix="fal" data-icon="arrow-up-right-from-square" role="img" xmlns="http://www.w3.org/2000/svg&quot; viewbox="0 0 512 512" data-fa-i2svg=""><path fill="currentColor" d="M336 0c-8.8 0-16 7.2-16 16s7.2 16 16 16H457.4L212.7 276.7c-6.2 6.2-6.2 16.4 0 22.6s16.4 6.2 22.6 0L480 54.6V176c0 8.8 7.2 16 16 16s16-7.2 16-16V16c0-8.8-7.2-16-16-16H336zM64 32C28.7 32 0 60.7 0 96V448c0 35.3 28.7 64 64 64H416c35.3 0 64-28.7 64-64V304c0-8.8-7.2-16-16-16s-16 7.2-16 16V448c0 17.7-14.3 32-32 32H64c-17.7 0-32-14.3-32-32V96c0-17.7 14.3-32 32-32H208c8.8 0 16-7.2 16-16s-7.2-16-16-16H64z"></path></svg></h5></td><td><h5>36 of 2025</h5></td></tr></tbody></table></div><h5>Changes from previous instruments</h5><drupal-media data-entity-type="media" data-entity-uuid="fd19f623-b278-40a8-8c49-73474c660209"> </drupal-media><h5>ICD Coding</h5><ul><li>ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3</li></ul><h5>Brief description</h5><p>Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:</p><ul><li>Myopia (nearsightedness): difficulty seeing distant objects clearly</li><li>Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly</li><li>Astigmatism: distorted or blurred vision due to an irregularly curved cornea</li><li>Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. </li></ul><p>If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.</p><p>Note: Myopia and hypermetropia cannot co-exist in the same eye.</p><h5>Confirming the diagnosis</h5><p>The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. </p><h5>Additional diagnoses covered by SOP</h5><ul><li>Nearsightedness</li><li>Farsightedness  </li><li>Hypermetropia</li><li>Myopia includes:<ul><li>benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia</li></ul></li><li>Hyperopia includes:<ul><li>curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia</li></ul></li><li><span>Astigmatism includes:</span><ul><li><span>myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, </span>oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism <span> </span></li></ul></li></ul><h5>Conditions excluded from SOP</h5><ul><li>Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. <span>It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. </span></li><li>Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself </li></ul><p>*another SOP applies</p><p>#non-SOP condition </p><h5>Clinical onset</h5><p>Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.</p><h5>Clinical worsening</h5><p>Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. <span>It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist.</span> In most cases, refractive errors can be effectively corrected with glasses or contact lenses. </p>

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/rulebase-hypermetropia

Albinism

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-hypermetropia/albinism

Last amended

Anterior displacement of the retina

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-hypermetropia/anterior-displacement-retina

Last amended

Aphakia

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-hypermetropia/aphakia

Last amended

Cataract surgery

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-hypermetropia/cataract-surgery

Last amended

Corneal surgery

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-hypermetropia/corneal-surgery

Last amended

No appropriate clinical management for myopia or hypermetropia or astigmatism

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-hypermetropia/no-appropriate-clinical-management-myopia-or-hypermetropia-or-astigmatism

Last amended

Posterior displacement of the lens into the vitreous

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-hypermetropia/posterior-displacement-lens-vitreous

Last amended

Rulebase for myopia

<h5>Current RMA Instruments</h5><div class="tablesaw-bar tablesaw-mode-swipe tablesaw-all-cols-visible"><div class="tablesaw-advance minimap"> </div></div><div class="tablesaw-overflow"><table class="tablesaw tablesaw-swipe" border="0" cellpadding="0" cellspacing="0" width="0" data-tablesaw-mode="swipe" data-tablesaw-minimap="" id="tablesaw-4660"><thead><tr><th><h5><a class="external-processed" href="http://www.rma.gov.au/assets/SOP/2025/d7f28e0cb0/035.pdf&quot; target="_blank" rel="nofollow noopener"><u>Reasonable Hypothesis SOP</u></a><svg class="svg-inline--fa fa-arrow-up-right-from-square fa-sm mx-2" aria-labelledby="svg-inline--fa-title-SR6DG23iJgqA" data-prefix="fal" data-icon="arrow-up-right-from-square" role="img" xmlns="http://www.w3.org/2000/svg&quot; viewbox="0 0 512 512" data-fa-i2svg=""><path fill="currentColor" d="M336 0c-8.8 0-16 7.2-16 16s7.2 16 16 16H457.4L212.7 276.7c-6.2 6.2-6.2 16.4 0 22.6s16.4 6.2 22.6 0L480 54.6V176c0 8.8 7.2 16 16 16s16-7.2 16-16V16c0-8.8-7.2-16-16-16H336zM64 32C28.7 32 0 60.7 0 96V448c0 35.3 28.7 64 64 64H416c35.3 0 64-28.7 64-64V304c0-8.8-7.2-16-16-16s-16 7.2-16 16V448c0 17.7-14.3 32-32 32H64c-17.7 0-32-14.3-32-32V96c0-17.7 14.3-32 32-32H208c8.8 0 16-7.2 16-16s-7.2-16-16-16H64z"></path></svg></h5></th><th><h5>35 of 2025</h5></th></tr></thead><tbody><tr><td><h5><a class="external-processed" href="http://www.rma.gov.au/assets/SOP/2025/56a93ef0f0/036.pdf&quot; target="_blank" rel="nofollow noopener"><u>Balance of Probabilities SOP</u></a><svg class="svg-inline--fa fa-arrow-up-right-from-square fa-sm mx-2" aria-labelledby="svg-inline--fa-title-FTw3KWfPbB5b" data-prefix="fal" data-icon="arrow-up-right-from-square" role="img" xmlns="http://www.w3.org/2000/svg&quot; viewbox="0 0 512 512" data-fa-i2svg=""><path fill="currentColor" d="M336 0c-8.8 0-16 7.2-16 16s7.2 16 16 16H457.4L212.7 276.7c-6.2 6.2-6.2 16.4 0 22.6s16.4 6.2 22.6 0L480 54.6V176c0 8.8 7.2 16 16 16s16-7.2 16-16V16c0-8.8-7.2-16-16-16H336zM64 32C28.7 32 0 60.7 0 96V448c0 35.3 28.7 64 64 64H416c35.3 0 64-28.7 64-64V304c0-8.8-7.2-16-16-16s-16 7.2-16 16V448c0 17.7-14.3 32-32 32H64c-17.7 0-32-14.3-32-32V96c0-17.7 14.3-32 32-32H208c8.8 0 16-7.2 16-16s-7.2-16-16-16H64z"></path></svg></h5></td><td><h5>36 of 2025</h5></td></tr></tbody></table></div><h5>Changes from previous instruments</h5><drupal-media data-entity-type="media" data-entity-uuid="fd19f623-b278-40a8-8c49-73474c660209"> </drupal-media><h5>ICD Coding</h5><ul><li>ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3</li></ul><h5>Brief description</h5><p>Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:</p><ul><li>Myopia (nearsightedness): difficulty seeing distant objects clearly</li><li>Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly</li><li>Astigmatism: distorted or blurred vision due to an irregularly curved cornea</li><li>Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. </li></ul><p>If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.</p><p>Note: Myopia and hypermetropia cannot co-exist in the same eye.</p><h5>Confirming the diagnosis</h5><p>The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. </p><h5>Additional diagnoses covered by SOP</h5><ul><li>Nearsightedness</li><li>Farsightedness  </li><li>Hypermetropia</li><li>Myopia includes:<ul><li>benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia</li></ul></li><li>Hyperopia includes:<ul><li>curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia</li></ul></li><li><span>Astigmatism includes:</span><ul><li><span>myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, </span>oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism <span> </span></li></ul></li></ul><h5>Conditions excluded from SOP</h5><ul><li>Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. <span>It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. </span></li><li>Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself </li></ul><p>*another SOP applies</p><p>#non-SOP condition </p><h5>Clinical onset</h5><p>Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.</p><h5>Clinical worsening</h5><p>Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. <span>It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist.</span> In most cases, refractive errors can be effectively corrected with glasses or contact lenses. </p>

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/rulebase-myopia

Albinism

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-myopia/albinism

Last amended

Cataract surgery

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-myopia/cataract-surgery

Last amended

Corneal surgery

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-myopia/corneal-surgery

Last amended

Decentration or tilting of the lens

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-myopia/decentration-or-tilting-lens

Last amended

Keratoconus

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-myopia/keratoconus

Last amended

Lenticonus

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-myopia/lenticonus

Last amended

Marfan syndrome

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-myopia/marfan-syndrome

Last amended

No appropriate clinical management for myopia or hypermetropia or astigmatism

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-myopia/no-appropriate-clinical-management-myopia-or-hypermetropia-or-astigmatism

Last amended

Nuclear cataract

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-myopia/nuclear-cataract

Last amended

Surgery for retinal detachment

Current RMA Instruments
 
Reasonable Hypothesis SOP
35 of 2025
Balance of Probabilities SOP
36 of 2025
Changes from previous instruments
ICD Coding
  • ICD-10-AM Codes: H44.2, H52.0, H52.1, H52.2, H52.3
Brief description

Visual refractive errors occur when the eye is unable to clearly focus images, typically due to an abnormal shape of the cornea or lens, or an abnormal length of the eyeball. These irregularities prevent light from focusing properly on the retina, resulting in blurred vision and reduced visual acuity. The SoP covers a group of eye diseases which includes:

  • Myopia (nearsightedness): difficulty seeing distant objects clearly
  • Hyperopia (farsightedness or hypermetropia): difficulty seeing nearby objects clearly
  • Astigmatism: distorted or blurred vision due to an irregularly curved cornea
  • Anisometropia: a condition where there is a difference in refractive error of ≥1 diopter between the eyes, resulting in one eye having poorer vision than the other. It is therefore due to varying degrees of myopia, hyperopia or astigmatism in each eye. 

If more than one type of refractive error is present in an eye, each type may need to be separately identified and assessed, as they may have different underlying causes.

Note: Myopia and hypermetropia cannot co-exist in the same eye.

Confirming the diagnosis

The specific diagnosis is established by an ophthalmologist or optometrist based on a clinical eye assessment. 

Additional diagnoses covered by SOP
  • Nearsightedness
  • Farsightedness  
  • Hypermetropia
  • Myopia includes:
    • benign myopia, simple myopia, school myopia, physiological myopia, pathological myopia, non-pathological myopia, curvature myopia, index myopia, refractive myopia, axial myopia, progressive myopia, stationary myopia, degenerative myopia, low myopia, high myopia
  • Hyperopia includes:
    • curvature hyperopia, index hyperopia, axial hyperopia, low hyperopia, high hyperopia
  • Astigmatism includes:
    • myopic astigmatism, hyperopic astigmatism, mixed astigmatism, simple astigmatism, compound astigmatism, regular astigmatism, irregular astigmatism, with-the-rule astigmatism, against-the-rule astigmatism, oblique astigmatism, bioblique astigmatism, corneal astigmatism, lenticular astigmatism, retinal astigmatism  
Conditions excluded from SOP
  • Presbyopia * - All people over 50 and most people between 40 and 50 will have diminished near vision due to presbyopia as a result of age-related lens changes. It can be confused with hyperopia (hypermetropia), as both impair near vision. However, presbyopia results from reduced lens flexibility with age, while hyperopia is due to structural abnormalities of the eye, such as a shorter eyeball or irregular shape of the cornea or lens. 
  • Amblyopia # - potential consequence of untreated refractive conditions, not a refractive error itself 

*another SOP applies

#non-SOP condition 

Clinical onset

Clinical onset may differ between the eyes. It is defined as the point at which the refractive error was first documented by an optometrist or ophthalmologist, or when blurred or decreased vision- subsequently confirmed to be due to a refractive error- was first noted.

Clinical worsening

Refractive errors are generally stable in adults; however, changes can occur as part of the natural progression of conditions such as degenerative myopia, or as a result of ocular disease or trauma. It is important to determine whether any clinical worsening is consistent with the expected natural history of the condition. This assessment typically requires the opinion of an ophthalmologist. In most cases, refractive errors can be effectively corrected with glasses or contact lenses. 

Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/myopia-hypermetropia-and-astigmatism-f076-h442h520h521h522/rulebase-myopia/surgery-retinal-detachment

Last amended