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Topical Review

Retinally Induced Aniseikonia

Rutstein, Robert P. OD, MS, FAAO1; Currie, Debra C. OD, MS, FAAO2*

doi: 10.1097/OPX.0000000000001431

SIGNIFICANCE We review retinally induced aniseikonia, an underrecognized condition resulting from common retinal conditions that has a significant effect on quality of life. Optometrists can influence the timing of surgical intervention to mitigate the damage from delaying surgical intervention in patients whose other findings do not meet a surgeon's treatment threshold.

Aniseikonia due to optical differences between the eyes occurs in 1 to 3.5% of the population and can hinder the quality of binocular vision. The less noted retinally induced aniseikonia is due to mechanical distortion and displacement of the retinal photoreceptors and occurs with disorders such as epiretinal membrane, reattached retinal detachment, macular hole, and macular edema. Despite that it was first reported in 1950 and its incidence continues to rise in the aging population, many eye care practitioners are unaware of this condition, which can persist or even be exacerbated after treatment as a contributing cause of binocular vision symptoms. The purpose of this report is to allow more eye care practitioners to become familiar with retinally induced aniseikonia. The review of the literature includes demographics and epidemiology, etiology, pathogenesis, diagnosis, results of treatment, prognosis, and case examples.

1School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama

2University of Houston College of Optometry, Houston, Texas


Supplemental Digital Content: Appendix Table A1, available at parameters for afocal magnifiers (size lenses) using CR-39 (n = 1.498)43

Appendix Table A2, available at summary of studies assessing retinally induced aniseikonia for patients with various retinal disorders, showing patient demographics, magnitude of aniseikonia (positive aniseikonia values indicate macropsia and negative values indicate micropsia) and method of measurement, other visual symptoms, retinal imaging, intervention and outcomes.

Submitted: September 22, 2018

Accepted: July 10, 2019

Funding/Support: None of the authors have reported funding/support.

Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest.

Author Contributions and Acknowledgment: Writing - Original Draft: RPR, DCC.

The authors thank Dr. Usha Pinninti, MD, for sharing her clinical expertise in the surgical treatment of epiretinal membrane.

Supplemental Digital Content: Direct URL links are provided within the text.

© 2019 American Academy of Optometry