Aniseikonia Induced by Cataract Surgery and Its Effect on Binocular Vision

Rutstein, Robert P.; Fullard, Roderick J.; Wilson, Jason; Gordon, Adam

doi:10.1097/opx.0000000000000491

Cited by 37 publications

(34 citation statements)

References 20 publications

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“…However, Rutstein et al. () used the same methodology as Kramer et al. and did not find any correlation between aniseikonia specific symptoms and anisometropia in a prospective study of patients undergoing bilateral cataract operation.…”

Section: Discussionmentioning

confidence: 99%

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The tolerance of anisometropia

Krarup

Nisted²,

Christensen

et al. 2019

Acta Ophthalmologica

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Purpose: This study examines aniseikonia, Aniseikonia tolerance range (ATR), anisometropia and patient-reported outcomes (PRO) in an anisometropic population compared with a non-anisometropic population. The relationship between anisometropia and aniseikonia is determined, and the correlations between aniseikonia, anisometropia and ATR versus PRO are described. Methods: One hundred and twenty-three patients with IOL-induced anisometropia ≥1 dioptre (D) (the anisometropic group) and 17 patients who had IOL-induced anisometropia <1 D (the control group) were included. Best corrected visual acuity, aniseikonia, ATR and stereoacuity were examined, and two questionnaires were completed: convergence insufficiency symptom survey (CISS) and Visual Function Questionnaire (VFQ-39). Results: One hundred and thirteen patients had anisometropia >1 and <3 D, and 10 patients had anisometropia >3 D. There was no difference in PRO between the control group and the anisometropic group (Mann-Whitney, p-values VFQ: 0.96, CISS: 0.06). There was no correlation between anisometropia and PRO (Spearman's rank correlation test p-values: VFQ: 0.54, CISS: 0.57). Patients with low ATR were more sensitive towards anisometropia and had lower PRO than patients with high ATR (Mann-Whitney, p-values: VFQ: 0.0008, CISS: 0.11). A large tolerance of aniseikonia was observed. Conclusion: No correlation between PRO and anisometropia or aniseikonia was found. Patients with low ATR are at risk of visual complaints if they are exposed to IOL-induced anisometropia. ATR might be a future screening tool in cataract patients.

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Section: Discussionmentioning

confidence: 99%

“…They reported that 9/10 symptoms decreased from preoperative to in between surgeries where the anisometropia was most pronounced (Rutstein et al. ). Moreover, we did not find any correlation between aniseikonia and PRO (Fig.…”

Section: Discussionmentioning

confidence: 99%

The tolerance of anisometropia

Krarup

Nisted²,

Christensen

et al. 2019

Acta Ophthalmologica

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“…The goals of this study were to validate a new stereopsis test for iPad and to assess its reproducibility in comparison with TNO at near and HD at distance. The stereopsis at near is widely used in clinical practice in order to improve paediatric vision screening programs, to provide an overall indication of binocularity, and to monitor binocularity after vision therapy or after monovision (Fricke et al 1997;Rutstein et al 2015). On the other hand, the measurement of distance stereopsis is uncommon in clinical practice even though it has been suggested that may be more effective than near stereopsis testing in screening for binocular vision disorders, reduced visual acuity, and uncorrected refractive errors (Rutstein and Corliss 2000).…”

Section: Discussionmentioning

confidence: 99%

“…One of the strengths of ST is the possibility to measure stereopsis at multiple distances maintaining the same sensitivity of stereoacuity. This makes the app especially useful to measure stereopsis at near, intermediate and distance vision with multifocal contact lenses or after cataract surgery with multifocal refractive intraocular lenses (Rutstein et al 2015), even though an understimation with diffractive intraocular lenses might be found due to be a wavelength-based stereotest (Varón et al 2014).…”

Section: Discussionmentioning

confidence: 99%

Stereopsis assessment at multiple distances with an iPad application

et al. 2017

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“…Although much research was conducted from the mid‐1930s to the 1980s, aniseikonia has largely been ignored in clinical practice. Recently, there has been a renaissance of aniseikonia research following advancements in multifocal lens designs in cataract surgery, retinal surgeries such as epiretinal membrane peels, and refractive surgeries, which have resulted in an increase in the number of reported cases …”

mentioning

confidence: 99%

Aniseikonia and anisometropia: implications for suppression and amblyopia

South

Gao

Collins

et al. 2019

Clinical and Experimental Optometry

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Aniseikonia is a difference in the perceived size or shape of images between eyes, and can arise from a variety of physiological, neurological, retinal, and optical causes. Aniseikonia is associated with anisometropia, as both anisometropia itself and the optical correction for anisometropia can cause aniseikonia. Image size differences above one to three per cent can be clinically symptomatic. Common symptoms include asthenopia, headache and diplopia in vertical gaze. Size differences of three and more impair binocular visual functions such as binocular summation and stereopsis. Above five per cent of aniseikonia, binocular inhibition or suppression tend to occur to prevent diplopia and confusion. Aniseikonia can be measured using a range of techniques and can be corrected or reduced by prescribing contact lenses or specially designed spectacle lenses. Subjective testing of aniseikonia is the only way to accurately measure the overall perceived amount of aniseikonia. However, currently it is not routinely assessed in most clinical settings. At least two-thirds of patients with amblyopia have anisometropia, thus we may expect aniseikonia to be common in patients with anisometropic amblyopia. However, aniseikonia may not be experienced by the patient under normal binocular viewing conditions if the image from the amblyopic eye is of poor quality or is too strongly suppressed for image size differences to be recognised. This lack of binocular simultaneous perception in amblyopia may also prevent the measurement of aniseikonia, as most common techniques require direct comparisons of images seen by each eye. Current guidelines for the treatment of amblyopia advocate full correction of anisometropia to equalise image clarity, but do not address aniseikonia. Significant image size differences between eyes may lead to suppression and abnormal binocular adaptations. It is possible that correcting anisometropia and aniseikonia simultaneously, particularly at the initial diagnosis of anisometropia, would reduce the need to develop suppression and improve treatment outcomes for anisometropic amblyopia.

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Aniseikonia Induced by Cataract Surgery and Its Effect on Binocular Vision

Abstract: Aniseikonia induced by cataract surgery may not be a substantial problem for ametropic adults with normal binocular vision, at least in the short term.

Cited by 37 publications

References 20 publications

The tolerance of anisometropia

The tolerance of anisometropia

Stereopsis assessment at multiple distances with an iPad application

Aniseikonia and anisometropia: implications for suppression and amblyopia

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