anisometropia

[hagi]

After conducting an eye examination the following prescription is deduced

right eye: +5.00Ds, visual acuity 6/5
left eye:+8.00DS, visual acuity 6/6

Would it be correct to issue the patient with the total prescription or would the qualified optometrist deem it appropriate to give a reduced prescription for the left eye e.g. +6.00Ds but giving the right eye the full prescription.

[chip anderson]

It's not something I am an expert in, but most patient's can handle a less than four diopter imballance. If not, I wouldn't cut the 8 to a 6, maybe a 7.00. Also try to ascertain whether the patient has had this much imballlance in the past, with/without appeareant difficulty.

Chip

[Stopper]

As Chip suggested, find out how much imbalance he is use to having. Most people can handle a 3D anisometropia. Also does the patient have binocular vision? If no, give the full amount. It won't bother him/her. You might want to try puting it in a trial frame and let the patient walk around the office and adjust it to what the patient can tolerate.

[Tim Hunter]

Patients can cope with anisometropia up to 4.00 DS in some cases and have problems with 0.50DS in other cases(particularly where it has been surgically induced). If they are not presbyopic it would be worth having a go but warning the patient of adaptation problems and if they are struggling after a couple of weeks of trying, reducing the left prescription. If they are presbyopic it would be sensible to avoid bifocals or varifocals unless you want to use unequal segment sizes or slab off.

Other option of course is contact lenses which would get rid of the aniseikonia which is usually the problem with anisometropia. :D

[Mary Deas]

Mild amblyopia? Stereo acuity? Cover test = any phorias? These questions need answers. I agree contact lenses usually are a good solution and aniso will sometimes bring a "medically necessary" Dx and a benefit for the patient.

[Pete Hanlin]

Another thing I'd be just as, if not more concerned about would be image size. Might want to consider working with the base curves, thicknesses, and vertex distance to minimize the magnification differences.