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Concerns with Lasik, Bladeless Lasik, PRK, LASEK, Epi-Lasik, P-IOL, RLE, etc.

Image of woman with effect similar to vision with Aniseikonia.  
Differing image sizes can cause headaches, blurry vision, and poor depth perception.  

Aniseikonia is a binocular condition in which left and right images differ significantly in size or shape. Aniseikonia can be resolve with with conventional or custom wavefront Lasik, Bladeless Lasik, PRK, LASEK, Epi-Lasik excimer laser assisted or lens based refractive surgery procedures like RLE and P-IOL refractive surgery if the imbalance is caused by simple myopia (nearsighted, shortsighted), hyperopia (farsighted, longsighted), or astigmatism that can be corrected.

Static and Dynamic

There are two types of aniseikonia – static and dynamic aniseikonia. The first type is the classical aniseikonia, denoting a perceived image size difference with a fixed gaze direction. Classic aniseikonia can occur naturally or be induced by refractive surgery. Aniseikonia is most pronounced when one eye is hyperopic and one eye is myopic.

Symptoms of Aniseikonia

Typical symptoms of aniseikonia are headaches, blurry vision, sore burning tearing eyes, photophobia, reading difficulty, distorted depth perception, nausea, binocular diplopia, and even nervousness, vertigo and dizziness.

Lasik Induced

Aniseikonia can be induced by refractive surgery, typically when refractive error is different in one eye than the other after surgery. Aniseikonia may occur if a myopic patient is overcorrected in one eye into hyperopia, a hyperopic patient is overcorrected in one eye into myopia, or any combination where the refractive error is significantly different after refractive surgery. Aniseikonia may occur if one eye is significantly more astigmatic than the other, or irregular astigmatism causes an imbalance in the two images.

Temporary aniseikonia almost always occurs during the gap between refractive surgeries when a patient has surgery performed on one eye at a time.

If aniseikonia occurs or when refractive surgery is planned one eye at a time, the least invasive response is for the patient to wear a contact lens or lenses to fully correct both eyes to plano. If aniseikonia occurs as an unplanned complication of refractive surgery, refractive surgery induced aniseikonia may be able to be be resolved with enhancement surgery to balance the refractive error in both eyes.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

Recent Aniseikonia Medical Journal Articles...

Related Articles

Relationship Between Vertical and Horizontal Aniseikonia Scores and Vertical and Horizontal OCT Images in Idiopathic Epiretinal Membrane.

Invest Ophthalmol Vis Sci. 2015 Oct 1;56(11):6542-8

Authors: Chung H, Son G, Hwang DJ, Lee K, Park Y, Sohn J

PURPOSE: The purpose of this study was to identify the relationship between aniseikonia scores in the vertical and horizontal meridians and the foveal microstructure on vertical and horizontal spectral-domain optical coherence tomography (SD-OCT) in patients with idiopathic epiretinal membrane (ERM).
METHODS: All patients (n = 65) with unilateral ERM were examined, and the aniseikonia scores in the vertical (VAS) and horizontal (HAS) meridians were determined using the New Aniseikonia Test. Vertical and horizontal images passing through the fovea were obtained by axial SD-OCT in both eyes. The thicknesses of the ganglion cell layer + inner plexiform layer, inner nuclear layer (INL), and outer retinal layer were measured on the SD-OCT images, and color histograms were analyzed using Photoshop software.
RESULTS: Of the 65 ERM patients, 81.5% (53 patients) had macropsia. The VAS and HAS were equal in 52.8% (28 patients). Multiple regression analysis revealed significant correlations between the VAS and vertical INL thickness (R = 0.388, P = 0.001) and between the HAS and horizontal INL thickness (R = 0.349, P = 0.001). The difference between VAS and HAS was proportional to the ratio of the vertical INL thickness to horizontal INL thicknesses (R = 0.370, P < 0.001).
CONCLUSIONS: Eyes with ERM mostly presented macropsia. The aniseikonia scores in the vertical and horizontal meridians correlate well with INL thickness on the vertical and horizontal directions of SD-OCT images, respectively. Aniseikonia induced by ERM may be related to the INL thickening detected with SD-OCT.

PMID: 26451682 [PubMed - in process]


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