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Thread: Iseikonic Lenses

  1. #1
    One eye sees, the other feels. OptiBoard Gold Supporter
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    Iseikonic Lenses

    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.
    Attached Thumbnails Attached Thumbnails Isekonic IMG_0195.jpg   Isekonic IMG_0197.jpg  
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    Science is a way of trying not to fool yourself. - Richard P. Feynman

  2. #2
    What's up? drk's Avatar
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    Amazing work.

    Very few people IN THE ENTIRE UNITED STATES can do what you just did.

    Tell me more about shape minifiers. I only remember shape magnifiers.

  3. #3
    Master OptiBoarder optical24/7's Avatar
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    That Rx certainly wouldn't indicate iseikonic lens needs. I've never heard of retina detachment surgery alone caused aniseikonia either. Great catch and great job taking him from 11% to sub 5%!

  4. #4
    What's up? drk's Avatar
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    Scleral buckling (if that's what was done) bulges the eye backwards, causing the receptors to expand. Just like if you drew a little troll face on the back of a balloon when it was halfway inflated, then blew it up the rest of the way, you'd have one big troll face.

    Now, the troll face doesn't know it's now "big troll face", and when it sees someone's avatar on the computer, it sure looks tinier than he remembers it looking. So he needs to look through a magnifying glass.

    ...wait...that's backwards.

  5. #5
    One eye sees, the other feels. OptiBoard Gold Supporter
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    Quote Originally Posted by drk View Post
    Amazing work.

    Very few people IN THE ENTIRE UNITED STATES can do what you just did.

    Tell me more about shape minifiers. I only remember shape magnifiers.
    Minus base curves can minify, and will minify more as we increase the thickness, the opposite of what happens with plus base curves. If you don't want thickness to have any effect on size, use a plano base.

    Quote Originally Posted by optical24/7 View Post
    That Rx certainly wouldn't indicate iseikonic lens needs. I've never heard of retina detachment surgery alone caused aniseikonia either. Great catch and great job taking him from 11% to sub 5%!
    Sub 5 just barely, I think. A +12 base would have helped but availability was a concern. The incidence of aniseikonia is probably underreported, getting under most folks radar.

    Best regards,

    Robert Martellaro
    Roberts Optical Ltd.
    Wauwatosa Wi.
    www.roberts-optical.com
    ~~~~~~~~~~~~~~~~~~
    Science is a way of trying not to fool yourself. - Richard P. Feynman

  6. #6
    What's up? drk's Avatar
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    https://iovs.arvojournals.org/articl...icleid=2128801

    I did not know this.

    Conclusions.: These results suggested that approximately half of patients with successful repair of RD had aniseikonia. Eyes with macula-off RD tended to show micropsia, while those with macula-on RD mostly presented macropsia. Micropsia and macropsia were primarily caused by respective specific abnormal structures at the foveal region.

  7. #7
    Manuf. Lens Surface Treatments OptiBoard Gold Supporter
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    Quote Originally Posted by drk View Post

    Just learned something new ...............................
    Chris Ryser
    ________________________________________
    DLO. NA.IC.I.T.PO

    http://optochemicals.com............................. http://arcoatings.com

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    Fantastic. I need to study more.

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