Abstract
Purpose :
To examine the role of ocular dominance on monovision corrections, using different eye dominance tests. The ultimate goal is to determine the most appropriate test to determine the dominant eye to optimize monovision.
Methods :
14 presbyopic subjects (53±5 yo; SE 0.55±1.33 D) participated, performing measurements at far (F, 4m) and near (N, 40cm) distances. A wearable binocular simulator (SimVis Gekko, 2Eyes Vision) was used to induce different monovision corrections. The following tests were performed: (1) Monovision Preference test (MP, best-perceived quality of grayscale natural images for 2.00 D monovision in OS/OD) at F and N; (2) Clinical Aiming Dominance (AD) at F; (3) Clinical Sensory Dominance (SD) with two levels of monocular blur, 0.50 and 1.50 D at F; (4) Binocular Rivalry (BR, fraction of predominance) using orthogonal Gabor patches at F & N (both eyes best corrected); (5) Multifocal Acceptance Score (MAS-2EV) with 4 perceptual scores (PS, 0-10 range) of perceived image quality at F/N of day/night real-world scenes for monovision (2.00 D near add in OS/OD); (6) Visual Strehl (VS) in OD/OS, from Laser Ray Tracing aberrometry.
Results :
AD and SD matched in 71% of the subjects for SD1.50D (50% for SD0.50D). 78% of the subjects showed the same SD with 1.50D and 0.50D blur. VS ranged from 0.88-0.01 OS & 0.96-0.02 OD, and BR from 0.31-0.74 OS & 0.26-0.69 OD, with interocular differences >0.24, and >0.20 in 43% and 35% of the subjects, respectively. MP at F & N were negatively correlated (r=-0.89, p<10-4). Highest MP was obtained using dominant eye (far vision) selected from AD only in 36% of the subjects, SD1.50D in 65%, SD0.50D in 86% and BR in 79%. BR at F matched with subjects’ preferences in AD (57%), SD0.50 (64%) and VS (50%). MAS-2EV scores were highly correlated with MP, both at F & N (r=0.71 & 0.82, p<0.004 both). Selecting the eye for far in a monovision correction based on SD1.50, SD0.50, BR and VS (more aberrated eye) improved MP and MAS-2EV F scores by 54.9% over a flipped correction, except for AD which produced lower scores.
Conclusions :
Eyes with high VS and BR interocular differences exhibited the largest differences in MP or MAS-2EV when reversing monovision. SD0.50 was the best ocular dominance predictor of optimal vision at far with monovision. Given the high discrepancies across ocular dominance tests, direct task/perception tests with simulated monovision appear most suited to select a correction.
This is a 2021 ARVO Annual Meeting abstract.