Comparison of Binocular Vision Parameters in Patients With Irregular Corneas Corrected With Spectacles Versus Rigid Contact Lenses (RGP, Rose K, & Scleral Lenses)
DOI:
https://doi.org/10.15353/cjo.v87i1.5932Keywords:
stereopsis, visual acuity, spectacles, rigid contact lenses, irregular cornea, Binocular vision parametersAbstract
To compare Binocular vision (BV) parameters between spectacle and rigid lenses among patients with irregular cornea
Design: Comparative prospective study
Method: All the binocular vision parameters were evaluated on two different occasions in 30 irregular corneas (22 Keratoconus, 3 pellucid marginal degeneration, 2 post-LASIK ectasia and 3 Post graft) patients who wore contact lenses and single vision spectacle had average age of 26±8.0 years. The binocular vision parameters measured in the study were; near the point of accommodation (NPA), accommodative facility, near negative and positive fusional vergence, distance negative fusional vergence (NFV) and positive fusional vergence (PFV), vergence facility, near the point of convergence (NPC), negative relative accommodation (NRA), and positive relative accommodation (PRA), AC: A ratio, and stereo acuity.
Result: A total 60 subjects were participated in the study in which 30 was aged match control group & 30 patients with irregular cornea. When a patient with an irregular cornea switched from single vision glasses to rigid contact lenses, their monocular and binocular logMAR distant and near visual acuity (VA), as well as stereoacuity, improved dramatically (P <.05).The stereoacuity with spectacle was 400±60 sec of arc and with rigid contact lens 140±30 sec of arc which were statistically significant (p<0.05). Near horizontal phoria was less with rigid contact lens: -7.50±2.71 as compared to spectacle: -9.67±3.17, but this difference was not statistically significant (p=0.06). . The clinical findings of patient with rigid contact lens were Distance phoria: -4.83±3.35; near phoria: -7.50±2.71 (Negative values in the Phoria indicate exodeviations) and; PRA: 7.22±0.50; stereoacuity: 140.0±30 which were statistically significant compared to aged match control group. (p<0.05).
Conclusion: Binocular & monocular logMAR visual acuity, near phoria and stereopsis improve from single vision spectacles to rigid contact lenses in patient with irregular cornea and also all binocular vision parameters with rigid contact lenses among irregular cornea remained poorer than aged matched control subjects.
References
1. Kamiya K, Hirohara Y, Mihashi T, Hiraoka T, Kaji Y, Oshika T. Progression of Pellucid Marginal Degeneration and Higher-Order Wavefront Aberration of the Cornea. Jpn J Ophthalmol 2003;47(5):523–5. doi:10.1016/s0021-5155(03)00126-6
2. Shneor E, Piñero DP, Doron R. Contrast Sensitivity and Higher-Order Aberrations in Keratoconus Subjects. Sci Rep 2021 Jun 21;11(1):12971. doi:10.1038/s41598-021-92396-5
3. Romero-Jiménez M, Flores-Rodríguez P. Utility of a Semi-Scleral Contact Lens Design in the Management of the Irregular Cornea. Cont Lens Anterior Eye 2013;36(3):146–50. doi:10.1016/j.clae.2012.12.006
4. Alió JL, Shabayek MH. Corneal Higher Order Aberrations: A Method to Grade Keratoconus. J Refract Surg 2006;22(6):539–45. doi:10.3928/1081-597X-20060601-05
5. Choi J, Wee WR, Lee JH, Kim MK. Changes of Ocular Higher Order Aberration in On- and Off-Eye of Rigid Gas Permeable Contact Lenses. Optom Vis Sci 2007; 84(1):42–51. doi:10.1097/01.opx.0000254036.45989.65
6. Westheimer G. The Relationship Between Accommodation and Accommodative Convergence. Am J Optom Arch Am Acad Optom 1955;32(4):206–12. doi:10.1097/00006324-195504000-00005
7. Fannin TE GT. Clinical Optics. 2nd ed. New York: Butterworth–Heinemann; 1997.
8. Hermann JS, Johnson R. The Accommodation Requirement in Myopia. A Comparison of Contact Lenses and Spectacles. Arch Ophthalmol 1966;76(1):47–51. doi:10.1001/archopht.1966.03850010049011
9. Antunes-Foschini RMS, Coutinho JVAL, Rocha EM, Bicas HEA. Oculomotor Status, Binocular Vision, and Stereoacuity in a Series of Keratoconus Subjects. Invest Ophthalmol Vis Sci 2018;59(5):1869–77. doi:10.1167/iovs.17-23484
10. Sherafat H, White JE, Pullum KW, Adams GG, Sloper JJ. Anomalies of Binocular Function in Patients With Longstanding Asymmetric Keratoconus. Br J Ophthalmol 2001;85(9)1057–60. doi:10.1136/bjo.85.9.1057
11. Barba-Gallardo LF, Jaramillo-Trejos LM, Agudelo-Guevara AM, Galicia-Durán AP, Casillas-Casillas E. Binocular Vision Parameters and Visual Performance in Bilateral Keratoconus Corrected With Spectacles Versus Rigid Gas-Permeable Contact Lenses. J Optom 2024;17(3):100514. doi:10.1016/j.optom.2024.100514
12. Dandapani SA, Padmanabhan P, Hussaindeen JR. Spectrum of Binocular Vision Anomalies in Keratoconus Subjects. Optom Vis Sci 2020;97(6):424–8. doi:10.1097/OPX.0000000000001517
13. Lovasik JV, Szymkiw M. Effects of Aniseikonia, Anisometropia, Accommodation, Retinal Illuminance, and Pupil Size on Stereopsis. Invest Ophthalmol Vis Sci 1985;26(5):741–50.
14. Nilagiri VK, Metlapally S, Kalaiselvan P, Schor CM, Bharadwaj SR. LogMAR and Stereoacuity in Keratoconus Corrected With Spectacles and Rigid Gas-Permeable Contact Lenses. Optom Vis Sci 2018;95(4):391–8. doi:10.1097/OPX.0000000000001205
15. Barba-Gallardo LF, Jaramillo-Trejos LM, Agudelo-Guevara AM, Galicia-Durán AP, Casillas-Casillas E. Binocular Vision Parameters and Visual Performance in Bilateral Keratoconus Corrected With Spectacles Versus Rigid Gas-Permeable Contact Lenses. J Optom. 2024;17(3):100514. doi:10.1016/j.optom.2024.100514
16. Bennett ES, Weissman BA. Clinical Contact Lens Practice. Philadelphia: Lippincott Williams & Wilkins; 2005.
17. Robertson DM, Ogle KN, Dyer JA. Influence of Contact Lenses on Accommodation: Theoretic Considerations and Clinical Study. Am J Ophthalmol 1967;64(5):860–71. doi:10.1016/0002-9394(67)92228-3
18. Gemoules G, Morris KM. Rigid Gas-Permeable Contact Lenses and Severe Higher-Order Aberrations in Postsurgical Corneas. Eye Contact Lens 2007;33(6 Pt 1):304–7. doi:10.1097/ICL.0b013e318033edde
19. Negishi K, Kumanomido T, Utsumi Y, Tsubota K. Effect of Higher-Order Aberrations on Visual Function in Keratoconic Eyes With a Rigid Gas Permeable Contact Lens. Am J Ophthalmol 2007;144(6):924–9. e1. doi: 10.1016/j.ajo.2007.08.004
20. Jinabhai A, Radhakrishnan H, O’Donnell C. Visual Acuity and Ocular Aberrations With Different Rigid Gas Permeable Lens Fittings in Keratoconus. Eye Contact Lens 2010;36(4):233–7. doi:10.1097/ICL.0b013e3181e52dd1
21. Bharadwaj SR, Sarkar S, Reddy J, Vadavalli PK. Optical Quality and Visual Performance After Relex SMILE, LASIK or PRK Refractive Surgery Procedures for Myopia. Invest Ophthalmol Vis Sci 2016;57(12)
22. Alpern M. Accommodation and Convergence With Contact Lenses. Am J Optom Arch Am Acad Optom 1949;26(9):379–87. doi:10.1097/00006324-194909000-00002
23. Carney LG, Woo GC. Comparison of Accommodation With Rigid and Flexible Contact Lenses. Am J Optom Physiol Opt 1977;54(9):595–7. doi:10.1097/00006324-197709000-00003
24. Jiménez R, Martínez-Almeida L, Salas C, Ortíz C. Contact Lenses vs Spectacles in Myopes: Is There Any Difference in Accommodative and Binocular Function? Graefes Arch Clin Exp Ophthalmol 2011;249(6):925–35. doi:10.1007/s00417-010-1570-z
25. Hunt OA, Wolffsohn JS, García-Resúa C. Ocular Motor Triad With Single Vision Contact Lenses Compared to Spectacle Lenses. Cont Lens Anterior Eye 2006;29(5):239–45. doi:10.1016/j.clae.2006.08.004
26. Fulk GW, Cyert LA, Parker DE, West RW. The Effect of Changing From Glasses to Soft Contact Lenses on Myopia Progression in Adolescents. Ophthalmic Physiol Opt 2003;23(1):71-77. doi:10.1046/j.1475-1313.2003.00094.x
27. Stone J. Near Vision Difficulties in Non-Presbyopic Corneal Lens Wearers. Contact Lens 1967;1(2):14-25.
28. Scheiman M, Wick B. Diagnostic Testing: Clinical Management of Binocular Vision, Heterophoric, Accommodative and Eye Movement Disorders. Philadelphia: Lippincott Williams & Wilkins; 2008:3-35.
29. Yekta A, Hashemi H, Khabazkhoob M, et al. The Distribution of Negative and Positive Relative Accommodation and Their Relationship With Binocular and Refractive Indices in a Young Population. J Curr Ophthalmol 2017 Jan 21;29(3):204–9. doi:10.1016/j.joco.2017.01.001
30. Kragha IK. Accommodative Vergence and Related Findings for a Nigerian Population. Ophthalmic Physiol Opt. 1985;5(4):435–9.
31. Buzzelli AR. Vergence Facility: Developmental Trends in a School Age Population. Am J Optom Physiol Opt 1986;63(5):351–5.
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