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Medical Forum / General / Vision / July 2006Question about monovision fitting
When a patient is to be fitted with monovision contact lenses to control both myopia and presbyopia, how is it decided which eye to fit for distance, and which for near work? I have read before about "dominant eye" and "non-dominant eye", but I don't know what that means. How is it determined which eye is "dominant"? If the patient is right-handed, can one assume that the right eye is "dominant", to be fitted for distance? Or, does "dominant eye" mean, in this case, the eye that is less myopic? The eye that is more myopic undercorrected for near work, and the less myopic eye used with full distance correction? I would appreciate learning more about how this is done. Thank you in advance for your information. MS schreef: > When a patient is to be fitted with monovision contact lenses to control > both myopia and presbyopia, how is it decided which eye to fit for distance, > and which for near work? Personally ,I prefer to check this out by trial. First perform a refraction for the distance and for the needed addition for nearby. Then ask the client, while he/she is looking through the distance glasses in a trialframe, where the additional reading glass disturb him less while viewing far away, when placed in front of the right or placed in front of the left eye. Having checked, also ask to read nearby with the addition placed in front of the eye which disturbed him less. Everything okay than go for it. If however, the client is someone who works the whole day looking just to objects in front of him you could decide to put the nearby correction just on the other eye. In other words , talk with the client and show him the possibilities to decide what is best. > I have read before about "dominant eye" and "non-dominant eye", but I don't > know what that means. How is it determined which eye is "dominant"? Try to ''cover'' a spot far away with both eyes open with your thumb. Some how you see a kind of ''through'' your thumb, however if you close one eye and the other open while ''holding'' your thumb on the spot you should notice that either the thumb is placed just on the spot (this means the open eye is the dominant eye) or is placed just beside the spot which means it is the non dominant eye. > If the patient is right-handed, can one assume that the right eye is > "dominant", to be fitted for distance? No, there is no relation what so ever. (besides the fact that in both issues brains are involved ) > Or, does "dominant eye" mean, in this case, the eye that is less myopic? The > eye that is more myopic undercorrected for near work, and the less myopic > eye used with full distance correction? No, not in general. Jan (normally Dutch spoken) > When a patient is to be fitted with monovision contact lenses to control > both myopia and presbyopia, how is it decided which eye to fit for distance, > and which for near work? I typically pick the dominant eye for distance, and the non-dominant eye for near. > I have read before about "dominant eye" and "non-dominant eye", but I don't > know what that means. How is it determined which eye is "dominant"? One common method is to find the patient's "aiming" eye, by having them sight a target through a small hole in a piece of cardboard. Sometimes it can be deduced from the visual acuity, or sometimes the patient's prescription. > If the patient is right-handed, can one assume that the right eye is > "dominant", to be fitted for distance? Usually, yes. > Or, does "dominant eye" mean, in this case, the eye that is less myopic? The > eye that is more myopic undercorrected for near work, and the less myopic > eye used with full distance correction? Also correct in many cases. > I would appreciate learning more about how this is done. Thank you in > advance for your information. You forgot to mention trial and error using trial contact lenses. While I use my professional judgement to pick the initial arrangement, if there is any sign of an adaptation problem, I will switch the eyes. Another rule is to go with the least amount of reading add that the patient can function with, in order to keep the anisometropia as low as possible. DrG Dr. Leukoma schreef: >> If the patient is right-handed, can one assume that the right eye is >> "dominant", to be fitted for distance? > > Usually, yes. Are you saying there are more people having a dominant right-eye than having a dominant left eye? (knowing there are more right handed people) Jan (normally Dutch spoken) > Dr. Leukoma schreef: > [quoted text clipped - 7 lines] > > Jan (normally Dutch spoken) That has always been my assumption. DrG schreibt. Dr. Leukoma schreef: >> Dr. Leukoma schreef: >> [quoted text clipped - 9 lines] > > DrG schreibt. TMHO there is no relation between right-eye dominance and being right-handed or right-footed (also not for left) Being a former rifleman and having tested many other marksman for eye-dominance and vision I have not been aware of such a relation. Jan (normally Dutch spoken) > TMHO there is no relation between right-eye dominance and being > right-handed or right-footed (also not for left) > > Being a former rifleman and having tested many other marksman for > eye-dominance and vision I have not been aware of such a relation. Well great. That's good to know. Since you're apparently an expert, I'm not going to argue with you on that minor point. I just assume most people are right eye dominant and work from there. DrG |
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