Stereoacuity and foveal fusion in adults with long-standing surgical monovision

Abstract

Purpose: Although binocular vision deficits occur in children who have a constant esotropia onset following significant maturation of stereopsis, it is uncertain whether adults are susceptible to changes to binocular vision. We examined binocular vision in adults with longstanding surgical monovision (≥6 month's duration) to determine whether the binocular visual system remains susceptible to change. Methods: Participants included 32 adults with longstanding monovision through laser-assisted in situ keratectomy or photorefractive keratectomy and 20 age-matched control subjects. After full binocular correction, binocular function was measured by using the Randot Stereoacuity Test, the Randot Preschool Stereoacuity Test, and the Worth 4-dot test at near and distance. Monovision patients were grouped as having low anisometropia (<1.5 spherical D) or moderate anisometropia (≥1.5 spherical D). Results: Non-parametric analysis of variance revealed a significant difference between group median stereoacuity (H = 16.062; P <.001). Pairwise multiple comparisons indicated both groups with monovision had significantly worse stereoacuity compared with control subjects (P <.05). Median stereoacuity values were 100 seconds of arc for patients with low anisometropia, 150 seconds of arc for patients with moderate anisometropia, and 40 seconds of arc for control subjects. A larger proportion of patients with moderate anisometropia failed the Worth-4 dot test at distance than control subjects (z = 2.619; P =.009). Conclusions: Reduced stereoacuity and an absence of foveal fusion in adults with longstanding surgical monovision suggest continued susceptibility of the binocular visual system to anomalous binocular experience. (J AAPOS 2001;5:342-7)