Association between ocular dominance and spherical/astigmatic anisometropia, age, and sex: analysis of 10,264 myopic individuals

Invest Ophthalmol Vis Sci. 2011 Nov 25;52(12):9166-73. doi: 10.1167/iovs.11-8131.


Purpose: To determine the association between ocular dominance and spherical or astigmatic anisometropia, age, and sex.

Methods: Medical records of 10,264 myopic refractive surgery candidates were filtered. Ocular dominance was assessed with the hole-in-the-card test. Manifest refractive error was measured in each subject and correlated to ocular dominance. Only subjects with corrected distance visual acuity (CDVA) of >20/22 in each eye were enrolled, to exclude amblyopia. Associations between ocular dominance and refractive state were analyzed by means of the t-test, χ(2) test, Spearman correlation, and multivariate logistic regression analysis.

Results: Right and left eye ocular dominance was noted in 61.7% and 35.6% of the individuals. Ocular dominance had no significant impact on SE refraction in subjects with SE or cylindrical anisometropia <0.5 D. For anisometropia >2.5 D (n = 278) the nondominant eye was more myopic in 63.7% (SE -5.8 ± 2.64 D) compared to 36.3% (-4.69 ± 2.39 D; P < 0.001; adjusted P (Padj) < 0.001) for the dominant eye being more myopic. Nondominant eyes showed higher astigmatic power than dominant eyes (-0.95 ± 0.91 D versus -0.89 ± 0.84 D; P < 0.001). For astigmatic anisometropia >2.5 D, nondominant eyes exhibited a higher amount of astigmatism in 75% of subjects. Nondominant eyes of subjects <29 years and 30 to 39 years of age had a significantly higher astigmatic power than did dominant eyes of the same age group.

Conclusions: In contrast to previous reports, this study, including myopic refractive surgery candidates, revealed that the nondominant eye was more myopic for SE anisometropia >2.5 and more astigmatic for cylindrical anisometropia >0.5 D.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Anisometropia / physiopathology*
  • Astigmatism / physiopathology*
  • Dominance, Ocular / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myopia / physiopathology*
  • Refraction, Ocular / physiology
  • Sex Factors
  • Visual Acuity / physiology
  • Young Adult