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aniseikonia

ICD-10 Codes

Related ICD-10:

Description

Aniseikonia refers to a binocular vision disorder where there is a significant difference in the perceived size of images between the two eyes [1][2]. This condition can occur as an overall difference between the two eyes, or as a difference in a particular meridian [3].

In essence, aniseikonia means "unequal images" [4], indicating that the image in one eye is perceived as different in size compared to the image in the other eye. This disparity can be caused by various factors, including defects in the lens of the eye or retinal pathology [5][8].

Aniseikonia can manifest in different ways, such as a difference in the shape and size of ocular images between the two eyes [12]. The condition is often associated with anisometropia (unequal refractive powers) or macular pathology [14], which can lead to symptoms like blurred vision or eye strain.

In some cases, it may be challenging to determine whether the symptoms are caused by aniseikonia or another underlying issue, such as retinal pathology [11]. However, precise methods have been developed for measuring and correcting aniseikonia, using sophisticated optical devices [3].

Overall, aniseikonia is a condition that affects binocular vision, leading to differences in perceived image size between the two eyes.

Additional Characteristics

  • binocular vision disorder
  • unequal refractive powers
  • macular pathology
  • retinal pathology
  • anisometropia

Signs and Symptoms

Understanding Aniseikonia: Signs and Symptoms

Aniseikonia is a condition where there is a significant difference in the perceived size of images between the two eyes. This can lead to various symptoms, which are essential to recognize for proper diagnosis and treatment.

Common Symptoms:

  • Defective Binocular Vision: Patients with aniseikonia may experience diplopia (double vision), which is a common complaint.
  • Headaches or Dizziness: These symptoms may occur due to the visual discomfort and distortion caused by aniseikonia.
  • Disturbance in Spatial Perception: The floor may appear to slope, or other horizontal objects may seem tilted when walking along them.
  • Visual Discomfort and Distortion: Aniseikonia can cause a range of visual disturbances, including dimness of vision, ghost images, and pain or discomfort in the eyes.

Age-Related Symptoms:

  • Amblyopia (at a young age): Aniseikonia at a young age can result in amblyopia, which is a condition where one eye does not develop properly.
  • Asthenopia (at a later age): Aniseikonia at a later age can cause asthenopia, headache, diplopia, dizziness, and other symptoms.

Other Relevant Information:

  • Up to 7% difference in image size is well tolerated [4].
  • If magnification difference becomes excessive, the effect can cause diplopia [4].
  • Aniseikonia is incompatible with binocular vision when more than 5% of aniseikonia is present [3].

References:

[1] Symptoms of Aniseikonia (Context #1) [2] While various factors can cause aniseikonia, such as a difference in refractive error, astigmatism, or photoreceptor density (Context #2) [3] It is thought that over 0.75% of aniseikonia can start to cause symptoms, that at 1 to 3% definite symptoms are present, and that more than 5% of aniseikonia is incompatible with binocular vision (Context #3) [4] Up to 7% difference in image size is well tolerated [Context #4] [14] Other symptoms of Aniseikonia are similar to Asthenopia or Eye Strain, a condition characterized by dimness of vision, ghost images, and pain or discomfort in the eyes (Context #14)

Additional Symptoms

  • Defective Binocular Vision
  • Disturbance in Spatial Perception
  • Visual Discomfort and Distortion
  • dizziness

Diagnostic Tests

Diagnostic Tests for Aniseikonia

Aniseikonia, a condition where there is a significant difference in image size between the two eyes, can be diagnosed using various tests. Here are some of the diagnostic tests used to detect and measure aniseikonia:

  • Brecher Test: This test uses a Maddox rod and two penlights to diagnose and quantify aniseikonia (1). The Brecher Test is a simple and effective method for detecting aniseikonia, and it can also be used to determine the degree of image size difference between the eyes.
  • Space Eikonometric Method: This method involves using a space eikonometer to measure the amount of aniseikonia (2). The space eikonometer is a device that uses a combination of lenses and prisms to create a virtual image of the object being viewed, allowing for accurate measurement of the image size difference between the eyes.
  • Direct Comparison Method: This method involves directly comparing the images seen by each eye using a hand-held direct-comparison test (4). The New Aniseikonia Test (NAT) is an example of this type of test, which uses red/green anaglyphs to create a virtual image that can be compared between the two eyes.
  • Aniseikonia Inspector: This computer-based clinical test requires the direct comparison of two rectangles viewed through red-green anaglyphs (3). The Aniseikonia Inspector is a reliable and accurate method for diagnosing and measuring aniseikonia.
  • Specialized Testing: Special testing is performed to measure image size differences between the eyes, which is important for the diagnosis of aniseikonia (5).

These diagnostic tests are used to accurately diagnose and measure aniseikonia, allowing for effective treatment options such as spectacle lenses, contact lenses, or surgical intervention.

References:

[1] - The Brecher Test consists of a Maddox rod and two penlights used to diagnose and to quantify aniseikonia (Figure 2).

[2] - There are basically two methods to test for aniseikonia: the space eikonometric method and the direct comparison method.

[3] - The Aniseikonia Inspector Version 3 (AI3) is a computer-based clinical test requiring the direct comparison of two rectangles viewed through red-green anaglyphs.

[4] - The New Aniseikonia Test (NAT), a hand-held direct-comparison test using red/green anaglyphs, has several potential advantages as a screener.

[5] - Special testing is performed to measure image size differences between your eyes, which is important for the diagnosis of aniseikonia.

Additional Diagnostic Tests

  • Brecher Test
  • Space Eikonometric Method
  • Direct Comparison Method
  • Aniseikonia Inspector
  • Specialized Testing

Treatment

Treatment Options for Aniseikonia

Aniseikonia, a condition where there is a significant difference in image size perceived between the two eyes, can be treated using various methods. While some treatments focus on correcting the underlying cause, others aim to alleviate symptoms.

  • Glasses: Special glasses with characteristics that reduce the size difference between the eyes can correct aniseikonia (4). The prescription of these glasses depends on factors such as base curve, center thickness, dioptric power, and vertex distance (6).
  • Contact Lenses: Contact lenses are often considered the most effective treatment option for managing aniseikonia (7, 10). However, they may not be suitable for retinal aniseikonia, where the retina is swollen or stretched, causing photoreceptors to spread out over a larger area.
  • Corneal Refractive Surgery: In cases of anisometropia caused by corneal transplant, cataract surgery, or epiretinal membrane peel, treatment may involve refractive surgery (2).
  • Lens-Based Treatments: For aniseikonia due to anisometropia, lens-based treatments such as glasses, contact lenses, or refractive surgery can be effective (1).

It's essential to note that the most suitable treatment option depends on the underlying cause of aniseikonia. A comprehensive diagnosis and consultation with an eye care professional are necessary to determine the best course of action.

References: [1] [Context 1] [2] [Context 2] [4] [Context 4] [6] [Context 6] [7] [Context 7] [10] [Context 10]

Recommended Medications

  • Glasses
  • Contact Lenses
  • Corneal Refractive Surgery
  • Lens-Based Treatments

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Aniseikonia, a condition where one eye sees objects larger than the other, can be caused by various factors. To determine the underlying cause, a differential diagnosis is essential.

Common Causes

  • Refractive Error: A significant difference in refractive error between the eyes is a common cause of aniseikonia [6]. This can result from a variation in nearsightedness or farsightedness between the two eyes.
  • Retinal Pathology: Conditions such as epiretinal membrane, macular edema, and central serous chorioretinopathy can lead to aniseikonia [8].
  • Anisometropia: A significant difference in refractive error between the two eyes, often resulting from a variation in nearsightedness or farsightedness.
  • Dynamic Aniseikonia: This type of aniseikonia is caused by the unequal demand on eye movement as they move left and right and up and down due to glasses [3].

Other Causes

  • Microphthalmia: A rare congenital condition where one eye is significantly smaller than the other, leading to aniseikonia [9].
  • Tumors of the Eye and Brain: Certain tumors can cause secondary aniseikonia by affecting the visual pathway.
  • Corneal Diseases or Surgery: Conditions such as keratoconus or post-penetrating keratoplasty can lead to aniseikonia [4].

Symptoms

  • Diplopia: Double vision is a common symptom of aniseikonia, resulting from the brain's inability to fuse the images from both eyes.
  • Headache: Headaches and dizziness are also symptoms associated with aniseikonia.

To accurately diagnose aniseikonia, a comprehensive evaluation of the patient's history, simple screening tests (such as the "trapezoidal card test" [5]), and further diagnostic testing may be necessary.

Additional Differential Diagnoses

Additional Information

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