I have been treating many patients with Aniseikonia over the past 10 years.  Some even come from out-of-state for the Aniseikonia Evaluation since there are very few optometrists who provide such evaluation and treatment these days. The following are the FAQ list:


• What causes aniseikonia?
Aniseikonia can be caused by any asymmetric changes in the optical components of the eyes that results in a difference in retinal image size. Possible causes may include unequal prescription between the two eyes, cataract surgery, intraocular lens implant, refractive surgery, retinal detachment, and macular degeneration.
• How come I haven’t heard of it before?
Aniseikonia is very difficult to diagnose. Many of the classical instruments that measure aniseikonia are not manufactured any more. Only a few eye clinics today are equipped with the expertise and instrumentation to diagnose and treat aniseikonia.
• How common is aniseikonia?
As many of 10-15% of the population may have some aniseikonia; not everyone becomes symptomatic from it. It becomes clinically significant (about 4% of the population based on the Dartsmouth Study) usually if (1) it is of late-onset, i.e. the brain has a hard time readjusting to the size difference, (2) the patient is very sensitive to small visual changes, and/or (3) the patient’s work of life-style places great demand on the visual system.
• Can aniseikonia be measured?
Yes. At our clinic, we utilized a state-of-the-art aniseikonia test that measures aniseikonia to the nearest 1%.
• What are iseikonic lenses (size lenses)?
Iseikonic lenses are custom-designed lenses that alter the magnification in one or both eyes by changing several lens parameters: front curvature, center thickness, vertex distance, and/or lens material. The perceptual disturbances caused by the image size difference between the two eyes are relieved by either magnification of the eye seeing through the smaller image and/or minification of the eye seeing through the larger image.
• Can anything be done about it?
Yes. Iseikonic lenses, contact lenses, vision therapy, occlusion therapy, or a combination are possible treatment options . Only a comprehensive evaluation can confirm the diagnosis of aniseikonia and rule out other similar visual disorders before the best recommendations can be made.

About tongvision

Dr. Tong founded the Center for Vision Development Optometry in 2002 and the center is known for its friendly and caring staff. The center’s main focus are helping children and adults with learning-related vision problem, strabismus (eye turn), amblyopia (lazy eye), autism, head injury, and stroke. In his spare time, he enjoys travelling with his family and teaching children’s bible lessons at his local Bible Study Fellowship. Dr. Tong has been an Optometrist for over 20 years. He is a Fellow of the College of Optometrists in Vision Development (COVD), the American Academy of Optometry (AAO), and the Neuro-Optometric Rehabilitation Association (NORA). His professional affiliations include memberships in the California and American Optometric Associations, the International Sports Vision Association, Optometric Extension Program Foundation, COVD, AAO, and NORA. He has served as trustee and past-president of the San Gabriel Valley Optometric Society. He is also a Clinical Adjunct Assistant Professor of both the Southern California College of Optometry at Marshall B. Ketchum University and the Western University of Health Sciences College of Optometry.
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