Effect of aniseikonia on binocular function.

The pattern reversal visual evoked response (VER) was recorded under conditions of artificially unbalanced visual input between two eyes, an aniseikonia induced by size lenses that alter the perceived retinal image size without changing refraction. At 3.0% aniseikonia binocular summation started to decrease, and at 5.0% aniseikonia there was no significant binocular summation. In higher aniseikonia (8.0-10.0%), binocular inhibition replaced binocular summation. The phase difference between binocular and monocular VER was largest at zero aniseikonia. When aniseikonia exceeded 5.0%, there was no significant phase difference between the two recording conditions. These results suggested that the binocular system can compensate for up to a 3.0% difference in perceived retinal image size (aniseikonia), but in higher aniseikonia the binocular system can no longer compensate for the difference and binocular inhibition takes place. These findings agree with previously reported subjective and psychophysical results. The authors suggest that this objective method of evaluation using the pattern reversal VER may be helpful in pediatric ophthalmology when subjective methods are of limited use.