Management of aniseikonia after intraocular lens implantation or refractive surgery

Aniseikonia is a difference in perceived image size in the two eyes resulting in asthenopic symptoms and distortions of binocular space perception. This is a complication of refractive and implant surgery in patients with binocular vision. While many individuals adapt readily to modest aniseikonic errors, quite a number do not.

Few instruments exist to adequately test for aniseikonia. A means is described to determine if aniseikonia exists and a series of simple steps is suggested to minimize aniseikonia induced by refractive surgery or by surgery for removal of cataract and intraocular lens insertion. Also, using the proposed protocol, it is possible to determine if existing image size differences resulting from prior and/or induced aniseikonia are predominantly refractive or axial. A case report is presented.

The techniques described are not costly, provide no risk, take little time, and resolve or meaningfully reduce aniseikonia in many patients having non-extreme errors of this type.