RESUMO
PURPOSE: To report a case of reduced aniseikonia in a myopic axial anisometrope during orthokeratology (OK) lens wear. CASE REPORT: A 19-year-old female university student with myopic anisometropia presented for an OK lens fitting consultation. At baseline, perceptual interocular image size difference or aniseikonia of 1.45% was found, with a smaller image seen by the right eye compared to the left eye. The patient was fitted with a pair of OK lenses and interocular image size differences, subjective refraction and corneal topography were measured after 7, 14 and 47 days of overnight lens wear. Hyperopic shifts in central refraction and corresponding flattening of the central cornea was measured during OK treatment. Aniseikonia reduced after OK wear with the most significant change measured from baseline to day 7. Aniseikonia recorded after 7, 14 and 47 nights of lens wear was 0.05%, 0.35% and 0.85%, respectively. Although minimum differences in refractive error between eyes was reached after 47 days of OK, aniseikonia was greater than that measured after 7 and 14 days of OK. CONCLUSION: This case report demonstrates reduction in aniseikonia with OK lens wear in a myopic patient with axial anisometropia, although this effect was not sustained beyond 1 week of lens wear. As the impact of corneal curvature changes on aniseikonia is not well understood, future studies on the impact of OK on aniseikonia and associated asthenopia is required.
