Aniseikonia: A 21st Century Look

ABSTRACT

Purpose: Aniseikonia, an appreciation of image size differences between the eyes, can produce symptoms in patients, ranging from headaches to loss of fusion. The purpose of this research was to take a 21st century look at aniseikonia.

Methods: Kellogg Eye Center patient records were evaluated for measurable aniseikonia in patients tested with the Aniseikonia Helper, a tablet-based application. Anaglyph slides for the synoptophore were developed to test the limits of induced aniseikonia on stereopsis and fusion. A survey was developed to determine how frequently members of the American Association of Certified Orthoptists (AACO) examine and treat patients with aniseikonia.Results: The prevalence of measurable aniseikonia in this cohort was 7.8%. Moderate amounts of induced aniseikonia, 4% induced image size disparity, disrupt fusion and can cause a loss of stereopsis. Eighty percent of responding AACO members see patients with aniseikonia and among those, 25% see them on a monthly basis. Treatment options, other than wearing contact lenses, are limited to occlusion or fogging techniques.

Conclusions: Aniseikonia remains a frequent complaint among patients. The ophthalmologic community needs to use the best methods for measuring aniseikonia and to develop better methods for treating aniseikonia.

KEYWORDS:

• Aniseikonia
• asthenopia
• and fusion loss

Acknowledgments

Thank you again to the Richard G. Scobee Memorial Lecture selection committee. What an honor it has been to be selected and to present this lecture. Thanks to my lovely wife, Susan, of 41 wonderful years. Thanks to Dr. Steven Archer. He has been my mentor at Michigan for the past 12 years. Thank you to the Pediatric Ophthalmology and Adults Strabismus Department at the Kellogg Eye Center in Michigan. Thank you to the Orthoptists and Ophthalmologists at the University of Iowa, where I did my Orthoptic training: Sue Stewart-Havertape, Pamela Kutschke, and Wanda Ottar-Pfeifer. Thank to Drs. Robert King and Diana DeSantis who gave me my first job in Denver. Thanks to the doctors, fellow Orthoptists, and Orthoptic students who I have had the pleasure to work with, over the last 27 years.

Disclosure statement

The author has no financial conflicts to report and has not received any benefits from conducting this research, giving the lecture, or publishing this manuscript.

Additional information

Funding

This research was not funded.