Snowbird age 60's client had two tears, a wrinkle (that flattened out), then a retina detachment OD about two years ago. At that time, he mentioned that he could easily see that images in the right eye were larger than the left eye. I showed him how it would look with the disparate image sizes somewhat equalized. I told him his clinic should have access to an aniseikonic tester because I filled iseikonic RXs previously. Long story short, they had to purchase a tester (I wouldn't supply lenses without an Rx), probably the Aniseikonia Inspector, and I filled this Rx:
OD -0.50 Sphere add +3.00
OS -1.25 +0.50 x 052 add +3.00
11 degrees minus aniseikonia
Degrees should have been percentage, but I knew what they wanted, that the image of the right eye needed to be 11% smaller to correct the aniseikonia, or the image in the left eye 11% larger, or a combination of both. My estimate of his corrected VA was OD 20/20 minus OS 20/60. I knew I couldn't get -11% without a CL, which he didn't want. He doesn't wear general purpose eyeglasses, SVNO. On paper, I was able to get the aniseikonia to less than 5%, hoping for improved binocular vision under the most difficult circumstances, night driving.
At dispense today, he said the images looked equal, with improved VA. The temples closed without rolling the edge. Moral to the story- look for symptoms of aniseikonia after retinal detachment surgery.
