Impact of Mimicked Anisometropia on Visual Functions and Aniseikonia in Adults

Main Article Content

Norsham Ahmad
Fatin Amalina Che Arif
Nura Syahiera Ibrahim
Firdaus Yusof

Abstract

Introduction: Anisometropia is a condition in which refractive error between two eyes is differs in ≥ 1Diopter (D) and potentially disrupt the visual function. This study aimed to investigate the effects of mimicked anisometropia on stereoacuity, visual acuity (VA), contrast sensitivity (CS) and aniseikonia among different magnitude of anisometropia groups. Materials and methods: This cross-sectional study was conducted on 20 healthy emmetropic adults. Soft contact lenses from 1Diopter Sphere (DS) to 4DS were fitted to induce unilateral myopia, hyperopia and astigmatism. VA, stereoacuity, CS and aniseikonia were measured at baseline and at each level of defocus. Results: VA degraded in all groups at all magnitudes of anisometropia induced as compared to baseline (p<0.05). No significant changes was observed on stereoacuity and CS in hyperopic (stereoacuity:0.08±0.21; CS: 1.71±0.25) and astigmatic (stereoacuity:0.03±0.35; CS: 1.78±0.17) groups at 1D anisometropia induced compared to baseline (stereoacuity: -0.11±0.20; CS: 1.91±0.11). In comparison with baseline, significant percentage of horizontal aniseikonia was observed at magnitude of 3D (myopic: p<0.01; hyperopic: p=0.04; astigmatic: p=0.03) and 4D (myopic: p<0.01; hyperopic and astigmatic: p=0.02) for all groups. Meanwhile, for vertical anisometropia, significant percentage was presented at 3D (p=0.04) and 4D (p<0.01) in myopic group, 4D (p=0.02) in hyperopic group and non-significant increment was observed in vertical aniseikonia of astigmatic anisometropia group. Conclusion: Maximum effects on visual functions were observed among mimicked myopic anisometropia, followed by hyperopic and astigmatic anisometropia. Out of all visual functions assessed, the most pronounce change was observed in stereoacuity.

Downloads

Download data is not yet available.

Article Details

How to Cite
Ahmad, N., Che Arif, F. A., Ibrahim, N. S., & Yusof, F. (2025). Impact of Mimicked Anisometropia on Visual Functions and Aniseikonia in Adults. Malaysian Journal of Medicine and Health Sciences, 21(5), 141–149. https://doi.org/10.47836/mjmhs.21.5.18
Section
Original Articles

References

Magdalene D, Nethralaya SS, Assam G. Correlation of Anisometropia with Axial Length and Corneal Curvature : An Institution-Based Cross-Sectional Study. *Optom Vis Perform*. 2022;10(4):216–20. Available from: [https://www.researchgate.net/publication/366530151](https://www.researchgate.net/publication/366530151).

Tannous M, Dantas D, Tayah D, Carricondo P, Avakian A, Alves MR. Stereopsis, Aniseikonia, and Associated Symptoms in Patients with Bilateral Pseudophakia with and without Anisometropia: A Comparative Study. *Open J Ophthalmol*. 2022;12(01):107–20. doi: 10.4236/ojoph.2022.121011.

Flitcroft I, McCullough S, Saunders K. What Can Anisometropia Tell Us about Eye Growth? *Br J Ophthalmol*. 2020;1211–5. doi: 10.1136/bjophthalmol-2020-316406.

Min FCL, Thavaratnam LK, Shukor INCB, Ramasamy S, Rahmat J, Reidpath DD, et al. Visual Impairment and Amblyopia in Malaysian Preschool Children - The SEGPAEDS Study. *Med J Malaysia*. 2018;73(1):25–30. Available from: [https://pubmed.ncbi.nlm.nih.gov/29531199/](https://pubmed.ncbi.nlm.nih.gov/29531199/).

Madhavan I, Batumalai UM, Barodawala FS, Ariffin AE. Prevalence of Myopia Among Indian School Children in Kuala Lumpur. *Online J Heal Allied Sci*. 2018;17(1):1–5. Available from: [https://www.ojhas.org/issue65/2018-1-7.html](https://www.ojhas.org/issue65/2018-1-7.html).

Yahya AN, Sharanjeet-Kaur S, Akhir SM. Distribution of Refractive Errors Among Healthy Infants and Young Children Between The Age of 6 to 36 Months in Kuala Lumpur, Malaysia-a Pilot Study. *Int J Env Res Public Heal*. 2019;16(23). doi: 10.3390/ijerph16234730.

Aljohani S, Aldakhil S, Alrasheed SH, Tan QQ, Alshammeri S. The Clinical Characteristics of Amblyopia in Children Under 17 Years of Age in Qassim Region, Saudi Arabia. *Clin Ophthalmol*. 2022;16(August):2677–84. doi: 10.2147/OPTH.S379550.

Adhikari S, Suwal R, Singh B, Shrestha R, Karki S, Khatri B. Amblyopia among Patients Attending the Outpatient Department of Ophthalmology of a Tertiary Care Centre: A Descriptive Cross-sectional Study. *J Nepal Med Assoc*. 2022;60(254):844–7. doi: 10.31729/jnma.7868.

Pons C, Jin J, Mazade R, Dul M, Zaidi Q, Alonso JM. Amblyopia Affects the ON Visual Pathway More than the OFF. *J Neurosci*. 2019;39(32):6276–90. doi: 10.1523/JNEUROSCI.3215-18.2019.

Lee C-W, Chiang C-C, Tsai D-C, Tsai C-Y, Liou YM. Risk Factors for Anisometropia in School Children: A Population-based, Longitudinal Cohort Study. *Ophthalmic Physiol Opt*. 2023;43(6):1500–9. doi: 10.1111/opo.13215.

Levi DM, Mckee SP, Movshon JA. Visual deficits in anisometropia. *Vis Res*. 2011;51(1):48–57. doi: 10.1016/j.visres.2010.09.029.

Chen Y, Zuo J, Xiong Y, Yu X, Wei L, Luo Y, et al. Refraction development in anisometropic amblyopia with patching therapy. *Front Med*. 2022;9. doi: 10.3389/fmed.2022.959085.

Jethani J, Shah K, Kellaiya A, Patel N. The Effect of Experimentally Induced Anisometropia on Binocularity and Bifoveal Fixation. *Gujarat Med J*. 2015;70(1):52–8. Available from: [https://www.scribd.com/document/296764111/gaat15i1p52](https://www.scribd.com/document/296764111/gaat15i1p52).

Murray SJ, Codina CJ. The Role of Binocularity in Anisometropic Amblyopia. *J Binocul Vis Ocul Motil*. 2019;69(4):141–52. doi: 10.1080/2576117X.2019.1656034.

Murray J, Garg K, Ghasia F. Monocular and Binocular Visual Function Deficits in Amblyopic Patients with and without Fusion Maldevelopment Nystagmus. *Eye Brain*. 2021;13:99–109. doi: 10.2147/EB.S300454.

South J, Gao T, Collins A, Turuwhenua J, Robertson K, Black J. Aniseikonia and Anisometropia: Implications for Suppression and Amblyopia. *Clin Exp Optom*. 2019;102(6):556–65. doi: 10.1111/cxo.12881.

Young G, Hall L, Sulley A, Osborn-Lorenz K, Wolffsohn JS. Inter-relationship of Soft Contact Lens Diameter, Base Curve Radius, and Fit. *Optom Vis Sci*. 2017;94(4):458–65. doi: 10.1097/OPX.0000000000001048.

Ibrahim NS, Alias FY, Ahmad N. The Consistency of Retinal Image Size Measurement using Smartphone Application. *Malaysian J Med Heal Sci*. 2020;16(3):15–20. Available from: [https://www.researchgate.net/publication/351536721](https://www.researchgate.net/publication/351536721).

Gawe M. Threshold Values of Myopic Anisometropia Causing Loss of Stereopsis. *J Ophthalmol*. 2019;1–8. doi: 10.1155/2019/2654170.

Rao DP, Negiloni K, Gurunathan S, Velkumar S, Sivaraman A, Baig AU, et al. Validation of a Simple-to-Use, Affordable, Portable Wavefront Aberrometry-Based Auto Refractometer in a Paediatric Population. *Clin Ophthalmol*. 2022;4281–91. doi: 10.2147/OPTH.S387831.

Lim J, Chia A, Saffari SE, Handa S. Factors Affecting Pupil Reactivity After Cycloplegia in Asian Children. *Asia Pac J Ophthalmol*. 2019;304–7. doi: 10.1097/APO.0000000000000254.

Wang Z, Xie R, Luo R, Yao J, Jin L, Zhou Z, et al. Comparisons of Using Cycloplegic Biometry Versus Non-cycloplegic Biometry in the Calculation of the Cycloplegic Refractive Lens Powers. *Ophthalmol Ther*. 2022;11(6):2101–15. doi: 10.1007/s40123-022-00569-w.

Kulkarni V, Puthran N, Gagal B. Correlation between Stereoacuity and Experimentally Induced Graded Monocular and Binocular Astigmatism. *J Clin Diagn Res*. 2016;10(5):14–17. doi: 10.7860/JCDR/2016/17341.7873.

Kim H-Y. Statistical Notes for Clinical Researchers: Assessing Normal Distribution (2) using Skewness and Kurtosis. *Restor Dent Endod*. 2013;38(1):52. doi: 10.5395/rde.2013.38.1.52.

Singh D, Aggarwal S, Sachdeva MM, Saxena R. Effect of Induced Monocular Blur on Monocular and Binocular Visual Functions. *Indian J Clin Exp Ophthalmol*. 2015;1(4):197. doi: 10.5958/2395-1451.2015.00015.3.

Kiran A, Rashid F, Siddique M, Jabbar M, Shahid MH, Khokhar SQ, et al. Comparison of the Efficacy of TNO and Titmus Fly in Myopic Anisometropes. *Pakistan J Med Heal Sci*. 2022;16(6):321–3. doi: 10.53350/pjmhs22166321.

Atchison DA, Lee J, Lu J, Webber AL, Hess RF, Baldwin AS, et al. Effects of Simulated Anisometropia and Aniseikonia on Stereopsis. *Ophthalmic Physiol Opt*. 2020;40(3):323–32. doi: 10.1111/opo.12680.

Hoosen T, Mitha F, Narothan C, Ramcharan K, Zinyembe F, Gcabashe N, et al. Effect of Induced Blur on Distance Visual Function. *African Vis Eye Heal*. 2020;79(1):1–8. doi: 10.4102/aveh.v79i1.575.

Spang K, Fahle M. Impaired Temporal, Not Just Spatial, Resolution in Amblyopia. *Investig Ophthalmol Vis Sci*. 2009;50(11):5207–12. doi: 10.1167/iovs.07-1604.

Atchison DA, Nguyen T, Schmid KL, Rakshit A, Baldwin AS, Hess RF. The Effects of Optically and Digitally Simulated Aniseikonia on Stereopsis. *Ophthalmic Physiol Opt*. 2022;42(4):921–30. doi: 10.1111/opo.12973.

Oguz H, Oguz V. The Effects of Experimentally Induced Anisometropia on Stereopsis. *J Pediatr Ophthalmol Strabismus*. 2000;37(4):214–8. doi: 10.3928/0191-3913-20000701-08.

Yang XB, Huang WD, Liao YC. Assessment of The Effects of Induced Anisometropia on Binocularity with Glasses-free 3D Technique. *Int J Ophthalmol*. 2023;16(4):601–7. doi: 10.18240/ijo.2023.04.14.

Nabie R, Andalib Di, Khojasteh H, Aslanzadeh S. Comparison of The Effect of Different Types of Experimental Anisometropia on Stereopsis Measured with Titmus, Randot and TNO Stereotests. *J Ophthalmic Vis Res*. 2019;14(1):48–51. doi: 10.4103/jovr.jovr_189_17.

Hopkins S, Narayanasamy S, Vincent SJ, Sampson GP, Wood JM. Do Reduced Visual Acuity and Refractive Error Affect Classroom Performance? *Clin Exp Optom*. 2019;103(3):278–89. doi: 10.1111/cxo.12953.

Hairol MI, Arusulem L, Ying WJ. Effects of Monocular Blur on Clinical Measurements of Stereopsis and Binocular Contrast Sensitivity. *J Sains Kesihat Malaysia*. 2017;15(1):19–25. doi: 10.17576/JSKM-2017-1501-03.

Jiménez JR, Ponce A, González Anera R. Induced Aniseikonia Diminishes Binocular Contrast Sensitivity and Binocular Summation. *Optom Vis Sci*. 2004;81(7):559–62. doi: 10.1097/00006324-200407000-00019.

Pang Y, Allen M, Robinson J, Frantz KA. Contrast Sensitivity of Amblyopic Eyes in Children with Myopic Anisometropia. *Clin Exp Ophthalmol*. 2018;102(1):57–62. doi: 10.1111/cxo.12817.

Bradley A, Freeman RD. Contrast Sensitivity in Anisometropic Amblyopia. *Investig Ophthalmol Vis Sci*. 1981;21(3):467–76. Available from: [https://pubmed.ncbi.nlm.nih.gov/7275532/](https://pubmed.ncbi.nlm.nih.gov/7275532/).

Radhakrishnan H, Pardhan S, Calver RI, O’Leary DJ. Effect of Positive and Negative Defocus on Contrast Sensitivity in Myopes and Non-myopes. *Vis Res*. 2004;44(16):1869–78. doi: 10.1016/j.visres.2004.03.007.

Radhakrishnan H, Pardhan S. Contrast Detection in Noise with Positive and Negative Defocus in Myopes. *Vis Res*. 2006;46(18):2949–55. doi: 10.1016/j.visres.2006.03.001.

Krarup T, Nisted I, Kjærbo H, Christensen U, Kiilgaard JF, la Cour M. Measuring Aniseikonia Tolerance Range for Stereoacuity –A Tool for The Refractive Surgeon. *Acta Ophthalmol*. 2021;99(1):43–53. doi: 10.1111/aos.14507.

El-Abedin Rajab G, Elaziz M, Soliman S, Basiony A. Measurement of Spectacle-induced Aniseikonia in Axial Anisometropia using the New Aniseikonia Test. *J Egypt Ophthalmol Soc*. 2022;115(4):180. doi: 10.4103/ejos.ejos_56_22.

Seddon A, Chaki HM, Phan HMJ, Spink JG, Ha MLP, Wijesuriya S, et al. Effects of Induced Aniseikonia on Binocular Visual Acuity. *Clin Exp Optom*. 2024;107(1):51–7. doi: 10.1080/08164622.2023.2203315.

Ojiabo SN, Munsamy AJ. Stereoacuity and Refractive, Accommodative and Vergence Anomalies of South African School Children, Aged 13–18 years. *Afr Vis Eye Heal*. 2018;77(1):1–8. doi: 10.4102/aveh.v77i1.400.

South J, Gao T, Collins A, Lee A, Turuwhenua J, Black J. Clinical Aniseikonia in Anisometropia and Amblyopia. *Br Ir Orthopt J*. 2020;16(1):44–54. doi: 10.22599/bioj.154.