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At least 19 recordsLinked to original sources
PubMed2005

Aniseikonia testing in an adult population using a new computerized test, "the Aniseikonia Inspector".

PURPOSE: To determine the measurement characteristics of a new computerized test, the Aniseikonia Inspector Version 1, on a sample of clinic patients. METHODS: Aniseikonia was measured in the vertical, horizontal, and oblique meridians on 320 patients (mean 55 years old, range 17-89 years) prior to their optometric exam using the psychometric methods programmed into the Aniseikonia Inspector Version 1. Statistical analyses were performed to determine the distribution of aniseikonia in the sample of patients and the relationships between the amount of aniseikonia and patients' habitual refractive correction, visual acuity, stereopsis and binocular alignment status. The characteristics of the individual measurements were also examined. RESULTS: The means and standard deviations of the measured aniseikonia in the vertical, horizontal, and oblique meridians were -0.5% (2.5%), -0.1% (3.3%) and 0.3% (2.8%) respectively. The means in the vertical and oblique meridians were significantly different from 0.0 (p=0.0001, p=0.0314) while that in the horizontal was not (p=0.61). The distributions of aniseikonia showed that 65.6%, 57.5% and 64.3% had within +/-1.0% aniseikonia in the vertical, horizontal and oblique meridians, respectively. Correspondingly, 16.9%, 25.6% and 25.8% had aniseikonia of +/-3.0% or greater. The discrepancy between these percentages and those expected in a normal distribution indicate that the distributions were significantly more peaked than a normal distribution. This departure from normal is due to a few extreme values in the tails. The magnitude of aniseikonia had no statistically significant relationship with the patients' habitual refractive correction, visual acuity or stereopsis. The effect of phoria on the amount of aniseikonia was significant, more so for measurements in the horizontal meridian. The individual measurements, which are the average of two trials using the method of adjustment, showed no significant bias, no relationship between the means and differences in the two readings, but large differences between the two readings. Measurements in the vertical direction seem to be more stable than those in the other two meridians. CONCLUSION: As measured with the Aniseikonia Inspector 1.0, the majority of the patients sampled in this study exhibited 1.0% or less aniseikonia and were therefore not likely to have symptoms related to aniseikonia. At least 17% of patients had 3.0% or greater aniseikonia measured in the vertical meridian. The Aniseikonia Inspector warrants further evaluation in a clinical setting because of the large limits of agreement between the two settings that are average to determine the magnitude of the aniseikonia. These limits differ considerably from those established by the designers and, therefore, raise questions regarding the actual resolution of the instrument as compared to the nominal resolution.

Adolescent↗
PubMed2006

Comparison of aniseikonia as measured by the aniseikonia inspector and the space eikonometer.

PURPOSE: The purpose of this study was to compare the new, computerized Aniseikonia Inspector with the Space Eikonometer for the measurement of aniseikonia. METHODS: Eighteen subjects, ages 21 to 61 years, with normal binocular vision and normal visual acuity had aniseikonia measured with both the Aniseikonia Inspector Version I and the Space Eikonometer. Aniseikonia was measured first with the subjects' habitual refractive correction and then with afocal size lenses of 1%, 2%, and 3.5% added in random order before the right and left eyes. Measurements were taken initially with the Aniseikonia Inspector and on a subsequent day with the Space Eikonometer. RESULTS: For the Space Eikonometer, the slopes of the lines for the relationship between the measured aniseikonia and the induced magnification differences in the vertical and horizontal meridians are not significantly different from 1.0. For the Aniseikonia Inspector, the slopes of the lines in the vertical and the horizontal meridians are less than and significantly different from 1.0. On average, the Aniseikonia Inspector underestimates the magnitude of induced aniseikonia, predicting only 68% and 61% of the overall size lens magnification in the vertical and horizontal meridians, respectively. The corresponding values of the Space Eikonometer in the vertical and horizontal meridians are 99% and 93%. Variability is greater with the Space Eikonometer than the Aniseikonia Inspector. CONCLUSION: The Space Eikonometer appears to be measuring the induced aniseikonia appropriately, whereas the Aniseikonia Inspector underestimates the amount of aniseikonia. However, the Space Eikonometer shows greater measurement variability. Modification of the Aniseikonia Inspector or the testing conditions should be pursued in future studies.

Adult↗
PubMed1987

[Fusion amplitude and aniseikonia. Experimental studies of aniseikonia tolerance in unilateral aphakia].

The fusion amplitude of image pairs with aniseikonia was measured using the synoptophore. Aniseikonia was produced in five subjects by alteration of slide drawings. The subject's right eye was in cycloplegia after paralysis with cycloplegic eye drops. To compare these measurements with aniseikonic pictures to those using the same image pairs without aniseikonia the fusion amplitude achieved was expressed as a percentage of the aniseikonia-free fusion amplitude. The relation between aniseikonia, eccentricity of the image borders and percent fusion amplitude was described using a mathematical approach. The experimental results reveal that a minimal increase in overall aniseikonia with greater eccentricities (greater than 5 degrees) leads to a rapid decrease in the fusion amplitude and the occurrence of diplopia. The aniseikonia tolerance level of images with greater eccentricities achieved experimentally and theoretically are in good agreement with results found in unilaterally aphakic patients.

Accommodation, Ocular↗
PubMed1989

Anisophoria and aniseikonia. Part I. The relation between optical anisophoria and aniseikonia.

Part I of this publication demonstrates and explains the close relation between aniseikonia and anisophoria induced by spectacles. It discusses the clinical implications of this relation by discussing certain aspects of aniseikonia theory, prismatic effects during oblique gaze through spectacles as for reading, and a simple formula that presents a comprehensive description of all prismatic effects and prismatic differences produced by a pair of spectacles. It also describes an easy method of specifying iseikonic lenses, as well as some conventional methods of measuring aniseikonia and anisophoria. Part II will deal with the correction and management of anisophoria when induced together with aniseikonia. Parts I and II, together, will convey a new approach toward the management of anisophoric spectacle corrections.

Adaptation, Ocular↗
PubMed2005

Field-dependent aniseikonia associated with an epiretinal membrane a case study.

PURPOSE: Aniseikonia is a binocular anomaly in which the two eyes perceive images of different sizes and/or shapes. It is usually assumed to be constant as a function of visual field angle (VFA) (i.e., angular distance from the line of sight). This is correct for optically induced aniseikonia, such as the aniseikonia that is associated with anisometropia and probably also pseudophakia. The purpose of this article is to show that if the aniseikonia is of retinal origin, then the aniseikonia may no longer be constant as a function of VFA (i.e., field-dependent aniseikonia). DESIGN: Case report, with the patient having a unilateral epiretinal membrane. METHODS: The aniseikonia was measured in vertical and horizontal directions with a customized version of the Aniseikonia Inspector software. The VFA was made variable by changing the dimensions of the comparison targets in the direct comparison procedure. MAIN OUTCOME MEASURE: Aniseikonia as a function of VFA. RESULTS: The patient exhibited good repeatable aniseikonia, ranging from 23% to 2.5% for VFAs ranging from 0.36 degrees to 5.7 degrees . Higher angles had lower aniseikonia. A control subject did not show this field-dependent aniseikonia. CONCLUSIONS: Aniseikonia may vary with VFA due to a retinal cause such as an epiretinal membrane. The problem with field-dependent aniseikonia is that it cannot be corrected fully with conventional optics, which exhibit an approximately constant magnification as a function of VFA. Nevertheless, by correcting 5% to 10% aniseikonia, which showed up in the VFA measurement range at 2 degrees to 3 degrees , our patient had improved visual comfort, especially for reading.

Aniseikonia↗
PubMed2003

Evaluation of a new direct-comparison aniseikonia test.

BACKGROUND AND PURPOSE: Aniseikonia is a condition in which the two eyes perceive images of different size or shape, causing a variety of visual symptoms including asthenopia. Besides anisometropes (with a prevalence of 5-10% in the population above age 20 years), also pseudophakes and refractive surgery patients are at risk. For example, 40% of the pseudophakes seem to suffer from aniseikonia. Reliable measurement and management of aniseikonia is therefore important. The "Aniseikonia Inspector" is a new, commercially available, software product to measure and manage aniseikonia. The purpose of this study is to evaluate this aniseikonia test of the Aniseikonia Inspector. METHODS: Aniseikonia was induced in four subjects, with normal vision, by means of afocal size lenses. Using the Aniseikonia Inspector, the resulting aniseikonia was measured in vertical, horizontal and diagonal directions. RESULTS: The average ratio between the measured aniseikonia and the induced aniseikonia was 0.98, 0.89 and 0.93 respectively for the vertical, horizontal and diagonal directions. For two consecutive measurements of the same aniseikonic state, the difference in measurement value was 97%, 75% and 94% of the time within one resolution step size (0.5% horizontally and vertically, and 0.7% diagonally). CONCLUSION: Aniseikonia was measured accurately. Measurements in the vertical direction were more accurate than in the diagonal or horizontal directions, which is probably due to fixation disparities. The Aniseikonia Inspector is a very useful new tool in treating the growing number of aniseikonia patients.

Adult↗
PubMed2004

Dynamic aniseikonia measurement: prismatic effect appears on the hess chart.

PURPOSE: To determine if aniseikonia appears on the Hess [Screen] Chart and if it can be measured thereby; and to compare such measurement to the standard Awaya New Aniseikonia Test in both artificial and pathologic aniseikonia. SUBJECTS AND METHODS: Twenty normal subjects with 20% artificial induced aniseikonia (Group 1) and 21 patients with pathologic aniseikonia (Group 2) were examined with the New Aniseikonia Test (NAT) and the Hess Chart. Group 2 was divided into three subgroups: Group 2-1, 13 patients with aphakia, whose operated eyes were more hypermetropic that their better eyes; Group 2-2, 3 patients with myopic anisometropia more than 5 diopters; and Group 2-3, 5 patients who had received macular translocation surgery (MTS). RESULTS: In normals, measurement of the 20% artificial aniseikonia ranged from 10% to 21% (mean 15%) using the NAT, and from 16% to 39% (mean 27.1% vertically and 24.6% horizontally) using the Hess Chart. In the 21 patients with pathologic aniseikonia, the NAT measurements ranged from 0% to 24% (upper limit of the NAT) and the Hess Chart measurements ranged from 0% to 65%. A large amount of the aniseikonia that appeared on the Hess Chart disappeared or was significantly reduced by changing the spectacle correction to a contact lens or intraocular lens. CONCLUSION: The aniseikonia that appeared on the Hess Chart was dynamic aniseikonia, due to rotational magnification inherent and unavoidable in the execution of the aniseikonia measurement on the Hess Chart. Aniseikonia, not due to refractive errors brought on by retinal surgery such as MTS, is difficult to correct with iseikonic lenses or other optical means.

Adolescent↗
PubMed1996

[Binocular problems caused by aniseikonia and anisophoria after cataract operation].

BACKGROUND: Cataract and refractive surgery aiming at emmetropia, runs the risk to induce binocular problems, e.g. asthenopia or diplopia. If the compatibility concerning binocularity is solely estimated by the calculation of the difference of the retinal image sizes, using intraocular lens formulas or so-called "aniseikonia-programs", important physiological facts are not considered. The actual amount of the aniseikonia, this is the difference of the image size which the patient perceives subjectively, depends on 3 parameters: 1. the optically induced difference of the retinal image size, 2. the spatial density of the retinal photoreceptors and the size of the receptive fields, 3. a possibly existing anomalous retinal correspondence for different retinal image sizes. Besides aniseikonia, the induction of postoperative anisophoria by the required spectacle correction is a considerable aspect. Aniseikonia and anisophoria can cause fusional problems or diplopia because of the mentioned parameters and/or disparity of the retinal images. CASE REPORT: Cataract surgery should reduce a monolateral high myopia, aiming emmetropia, in axial anisometropia. This resulted in one exemplary case in high aniseikonia with complaints, while in other, comparable patients only a small amount of aniseikonia could be measured by haploscopy. This preoperative refractive situation is comparable to refractive surgery. In a second case with symmetrical myopia of -4 D, binocular problems with diplopia and asthenopia were induced after monolateral cataract surgery by the combination of a moderate aniseikonia and anisophoria. CONCLUSIONS: To predict the actual postoperative aniseikonia it is necessary for the patient to wear a contact lens preoperatively for a short time to measure the aniseikonia by haploscopy, particularly prior to refractive surgery in axial length ametropia. Due to the different sizes of the receptive fields of the retina, different postoperative aniseikonias may result in spite of similar axial length anisometropia. The individual tolerance of an adult for a postoperatively created anisophoria is hardly predictable. It is obvious that the fusional stress ensued from aniseikonia and anisophoria adds or multiplies. In contrast to horizontal eye movements, vertical eye movements can hardly be compensated by head movements, as the use of bi- or multifocals requires a down gaze of about 30 degrees. Here a height-balance-prism could help.

Adult↗
PubMed1999

Aniseikonia in relation to strabismus, anisometropia and amblyopia.

PURPOSE: To study the interrelationships among these four entities which are critical to binocular vision and its precision. SUBJECTS AND METHODS: 102 selected patients (for their ability to have stereoscopic depth perception, a requisite for space eikonometry) were evaluated. Patient testing included stereoscopic testing, Essilor Projection Space Eikonometry, ultrasonic echographic axial length measurements and orthoptic evaluation. Aniseikonia was measured on the Essilor Projection Space Eikonometer. RESULTS: 1. Anisometropia alone was correlated with a marked increase in amblyopia, a moderate increase in aniseikonia and no noteworthy increase in strabismus. Statistical analysis (chi square ratio) showed that persons with elevated anisometropic values had a 4.4 fold increased risk of aniseikonia (p=.003). 2. Aniseikonia alone was not responsible for marked variations in strabismus. 3. Amblyopia was correlated with increases in anisometropia and aniseikonia. 4. Adding aniseikonia to anisometropia produced a possible increase in strabismus and a great increase in amblyopia (using Fisher's Exact Test, 2-tailed). 5. Spearman correlations of the "absolute values" (the mean of the mathematical difference between the two eyes of anisometropia and amblyopia) were as follows: anisometropia (abs) vs. aniseikonia r=.294, p=.006; anisometropia (abs) vs. amblyopia (abs) 4=.555, p=<.001; amblyopia (abs) vs. aniseikonia r=.234, p=.02. CONCLUSIONS: Aniseikonia per se does not appear to have a major causal role in amblyopia or strabismus, but anisometropia does for amblyopia. This role is greatly augmented by aniseikonia and this combination may then produce strabismus.

Amblyopia↗
PubMed1992

Differences in tests of aniseikonia.

The New Aniseikonia Test (NAT), a hand-held direct-comparison test using red/green anaglyphs, has several potential advantages as a screener. We compared the validity of the NAT to that of the Space Eikonometer in three experiments: (1) aniseikonia was induced by calibrated size lenses in a double-blind study of 15 normal subjects; (2) habitual aniseikonia was measured with both instruments in four patients; and (3) eight of the normal subjects were retested with a computer-video simulation of the NAT. The NAT underestimated induced aniseikonia by a factor of 3 in the normal subjects and underestimated habitual aniseikonia in four patients. The Space Eikonometer correctly measured the magnitude of induced aniseikonia in the normal subjects. The simulation test did not show underestimation in the eight normal subjects. We could not attribute the NAT's underestimation of aniseikonia to the red/green anaglyph method, printing error, psychophysical method, or the direct-comparison test format. We speculate that the NAT induces a different sensory fusion response to aniseikonia than do the other tests, and that this altered sensory fusion response diminishes measured aniseikonia. We conclude that the NAT is not a valid measure of aniseikonia.

Adult↗
PubMed2005

Aniseikonia associated with epiretinal membranes.

AIMS: To determine whether the computerised version of the new aniseikonia test (NAT) is a valid, reliable method to measure aniseikonia and establish whether aniseikonia occurs in patients with epiretinal membranes (ERM) with preserved good visual acuity. METHODS: With a computerised version of the NAT, horizontal and vertical aniseikonia was measured in 16 individuals (mean 47 (SD 16.46) years) with no ocular history and 14 patients (mean 67.7 (14.36) years) with ERM. Test validity was evaluated by inducing aniseikonia with size lenses. Test reliability was assessed by the test-retest method. RESULTS: In normal individuals, the mean percentage (SD) aniseikonia was -0.24% (0.71) horizontal and 0% (0.59) vertical. Validity studies revealed mean (SD) 0.990 (0.005) horizontal and 0.991 (0.004) vertical correlation coefficients, 0.985 (0.111) horizontal and 0.989 (0.102) vertical slope. Repeatability coefficients were 1.04 horizontal and 0.88 vertical. Aniseikonia in patients with ERM ranged from 4% to 14%. Eight patients showed 2% or more size difference between horizontal and vertical meridians. CONCLUSIONS: The aniseikonia test used in this study can be considered a simple, fast, valid and reliable method to measure the difference in image size perceived by each eye. Aniseikonia does occur in symptomatic patients with ERM. The effect of ERM on image size is heterogeneous across the retinal area affected.

Adult↗
PubMed1999

Symptomatic aniseikonia in unilateral and bilateral pseudophakia. A projection space eikonometer study.

PURPOSE: To determine the incidence of aniseikonia and aniseikonic symptoms in pseudophakia (intraocular lens implantation after cataract extraction). METHOD: Aniseikonia, stereoacuity, and clinical symptoms were evaluated in patients with unilateral and bilateral pseudophakia. Aniseikonia was determined with the Essilor projection space eikonometer. Eight-seven cases were studied, fifty-four of unilateral pseudophakia and thirty-three of bilateral pseudophakia. Nine of the 87 patients had insufficient stereopsis to be examined or measured for aniseikonia with the Essilor instrument, and were studied with the "Double-D", a two dimensional "direct comparison eikonometer" device programmed and viewed on a computer. Stereoacuity was determined with the Titmus Stereo Test. RESULTS: Thirty-five (40.2%) of all pseudophakes had ophthalmic complaints referable to aniseikonia. The mean aniseikonia in the unilateral pseudophakia group was 4.1%, SD=3.41, while the mean aniseikonia in the bilateral group was 3.2%, SD=2.6. CONCLUSION: Symptomatic aniseikonia is common in pseudophakia. Unilateral pseudophakia has the higher degrees of aniseikonia, and is at a greater risk of loss of binocularity and of asthenopia.

Adult↗
PubMed1997

[Evaluation of the clinical usefulness of the New Aniseikonia Tests].

PURPOSE: We performed the following experiments to evaluate the clinical usefulness of the New Aniseikonia Tests (NAT). METHODS: 1. Aniseikonia was induced artificially by wearing a spectacle lens on the right eye and a contact lens on the left eye in myopic but otherwise normal subjects. The amount of aniseikonia detected was compared between the NAT and the Phase Difference Haploscope (PDH). Three different conditions were used with the PDH in order to study whether the fusional background affects the amount of the aniseikonia. 2. The size of aniseikonia was measured by the NAT in normal subjects. We presented the NAT in two ways in order to study if the method of presentation affects the result. One was the regular NAT which consists of 6 pairs of half-moons on each page, and the other one was one pair of half-moons on each page. RESULTS: The degree of aniseikonia measured was 1.4% smaller in the NAT than with the PDH. Backgrounds did not affect the amount of aniseikonia. Normal subjects showed essentially no aniseikonia regardless of the presentation technique of half-moons. CONCLUSIONS: NAT may underestimate the degree of aniseikonia, but the difference is too small to contraindicate clinical usage.

Adult↗