The role of sensory ocular dominance on through-focus visual performance in monovision presbyopia corrections.

Monovision presbyopia interventions exploit the binocular nature of the visual system by independently manipulating the optical properties of the two eyes. It is unclear, however, how individual variations in ocular dominance affect visual function in monovision corrections. Here, we examined the impact of sensory ocular dominance on visual performance in both traditional and modified monovision presbyopic corrections. We recently developed a binocular adaptive optics vision simulator to correct subjects' native aberrations and induce either modified monovision (1.5 D anisometropia, spherical aberration of +0.1 and -0.4 μm in distance and near eyes, respectively, over 4 mm pupils) or traditional monovision (1.5 D anisometropia). To quantify both the sign and the degree of ocular dominance, we utilized binocular rivalry to estimate stimulus contrast ratios that yield balanced dominance durations for the two eyes. Through-focus visual acuity and contrast sensitivity were measured under two conditions: (a) assigning dominant and nondominant eye to distance and near, respectively, and (b) vice versa. The results revealed that through-focus visual acuity was unaffected by ocular dominance. Contrast sensitivity, however, was significantly improved when the dominant eye coincided with superior optical quality. We hypothesize that a potential mechanism behind this observation is an interaction between ocular dominance and binocular contrast summation, and thus, assignment of the dominant eye to distance or near may be an important factor to optimize contrast threshold performance at different object distances in both modified and traditional monovision.