Question about monovision fitting

Discussion in 'Eye-Care' started by MS, Jul 25, 2006.

  1. MS

    MS Guest

    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, Jul 25, 2006
    #1
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  2. MS

    Jan Guest

    MS schreef:
    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.

    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.

    No, there is no relation what so ever. (besides the fact that in both
    issues brains are involved )
    No, not in general.

    Jan (normally Dutch spoken)
     
    Jan, Jul 25, 2006
    #2
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  3. MS

    Dr. Leukoma Guest

    I typically pick the dominant eye for distance, and the non-dominant
    eye for near.
    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.
    Usually, yes.
    Also correct in many cases.
    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, Jul 25, 2006
    #3
  4. MS

    Jan Guest

    Dr. Leukoma schreef:
    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)
     
    Jan, Jul 25, 2006
    #4
  5. MS

    Dr. Leukoma Guest

    That has always been my assumption.

    DrG schreibt.
     
    Dr. Leukoma, Jul 25, 2006
    #5
  6. MS

    Jan Guest

    Dr. Leukoma schreef:

    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)
     
    Jan, Jul 25, 2006
    #6
  7. MS

    Dr. Leukoma Guest

    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
     
    Dr. Leukoma, Jul 25, 2006
    #7
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