Assessment Of Dominant Eye And Comparison Accommodation Between Dominant And Non-dominant Eye

Purpose 1.To analyze the consistency of the dominant eye measured by different methods.2.To guess the reason and the theoretical basis of the difference in the measurement results,and evaluate the advantages of different methods of the dominant eye.3.The monocular accommodative function of three types of dominant and non-dominant eyes was measured respectively,the difference between them was analyzed and the reason was inferred.To discuss the significance of dominant eye for monocular accommodative function.Methods Eighty students from Tianjin Medical University were randomly selected and invited to participate in this prospective study.The range of age from 18 to 37 years old,(mean 23.03 ± 4.92 years old),including 33 males and 47 females.Include criteria:monocular best corrected visual acuity was 0.8 or better,the difference of both eyes were less than two lines.No obvious strabismus and amblyopia;no accommodative function abnormalities and convergent function abnormalities;no eye organic disease and systemic disease;no use of drugs that affect accommodative function and eye muscle movement within a year.The subjects were examined by refractive examination,three types of dominant eye and monocular accommodative function.The detailed methods can be interpreted as follows: 1.Refractive examination: After auto-refractometer,the baseline refractive state of each participant was measured by the manifest refraction obtained from a phoropter with the same optometrist.2.Dominant eye examination: The subjects' dominant eye was measured using Pointing-a-finger test,Hole-in-the-card test,convergence near-point test,Worth-four-dot test,PEDIG fixation preference test,add lens test,Dunlop test,respectively.3.Monocular accommodative function examination:Near point of accommodation was determined using the push-up method.Accommodative facility was tested using flipper lens.The selected power for the flipper was ±2.00 D.Snellen chart of approximately 20/30 size was used to test the accommodative facility.The Grand Seiko WAM-5500 was used to measure the monocular accommodative response.After data collection,data were analyzed in the software program Statistical Package for the Social Sciences(SPSS version 19.0).Paired t-tests were used for statistical significance of accommodative amplitude,accommodative facility,accommodative lag of dominant eye and non-dominant eye.Kappa test was performed on the data of sighting dominant eye,motor dominant eye and sensory dominant eye,respectively.P<0.05 is considered statistically significant,P<0.01 is considered to be of obviously statistical significance.The Kappa tests were interpreted as follows: Perfect agreement,k = 1.0;Almost perfect agreement,k = 0.81–1.0;Substantial agreement,k = 0.61 – 0.80;Moderate agreement,k = 0.41–0.60;Fair agreement,k = 0.21 – 0.40;Slight agreement,k = 0.00 – 0.20.Results 1.The success rate of Pointing-a-finger test,Hole-in-the-card test,convergence near-point test,Worth-four-dot test,PEDIG fixation preference test,add lens test,Dunlop test are 97.5%,100%,100%,21.25%,91.25%,100%,88.75%,respectively 2.The right eye for the sighting dominant eye has 46 people,accounting for 57.5%;left eye has 34 eyes,accounting for 34.5%.The mean refractive errors in the sighting dominant eye and non-dominant eye of subjects are(-3.19±2.81)D and(-3.63±2.48)D,the difference is(0.43±2.29)D.The right eye for the motordominant eye has 32 people,accounting for 40.00%;left eye has 48 eyes,accounting for 60.00%.The mean refractive errors in the motor dominant eye and non-dominant eye of subjects are(-3.32±2.69)D and(-3.50±2.46)D,the difference is(0.18±2.32)D.The right eye for the sensory dominant eye has 40 people,accounting for 50.00%;left eye has 40 eyes,accounting for 50.00%.The mean refractive errors in the sensory dominant eye and non-dominant eye of subjects are(-3.27±2.82)D and(-3.56±2.49)D,the difference is(0.29±2.31)D.3.The difference of three types of dominant eye the mean refractive errors were not statistically significant.4.The sighting dominant eye had moderate agreement with motor dominant eye(k=0.48);the sighting dominant eye had fair agreement with sensory dominant eye(k=0.32);the motor dominant eye had fair agreement with sensory dominant eye(k=0.37).The higher the anisometropia,the poorer agreement between sighting dominant eye and motor dominant eye(r=0.732,P<0.05).5.Sighting dominant eye:The differences of accommodative amplitude of dominant eye and non-dominant eye were not statistically significant(t =-1.627,P>0.05);the difference of accommodative lag of dominant eye and non-dominant eye were not statistically significant(t=-1.676,P>0.05),The difference of accommodative facility of dominant eye and non-dominant eye were not statistically significant(t =-0.274,P>0.05).Motor dominant eye:The difference of accommodative amplitude of dominant eye and non-dominant eye were not statistically significant(t =0.55,p=0.956>0.05);the difference of accommodative lag of dominant eye and non-dominant eye were statistically significant(t =-4.034,P <0.05),The difference of accommodative facility of dominant eye and non-dominant eye were statistically significant(t =-3.253,P <0.05).Sensory dominant eye:The difference of accommodative amplitude of dominant eye and non-dominant eye were not statistically significant(t =-0.757,P>0.05);the difference of accommodative lag of dominant eye and non-dominant eye were not statistically significant(t =1.256,P>0.05),The difference of accommodative facility of dominant eye and non-dominant eye were not statistically significant(t =-0.091,P>0.05).6.Accommodative lag of motor dominant eye was significantly correlated with the non-dominant eye(r=0.442,P <0.01),the dominant eye has less accommodative lag.Accommodative facility of motor dominant eye was significantly correlated with the non-dominant eye(r=0.864,P <0.05).Conclusion 1.The dominant eye is not constant,in different binocular vision conditions,the dominant eye may be not the same.2.The dominant eye should be evaluated synthetically,including sighting dominant eye,motor dominant eye and sensory dominant eye.3.Motor dominant eye was significantly correlated with the monocular accommodative function.Motor dominant eye has less accommodative lag and lower accommodative facility.4.The difference of mean refractive errors of dominant eye and non-dominant eye were not statistically significant,but the greater anisometropia,the greater the difference between binocular vision function.The poorer the consistency of the sighting and motor dominant eye,the less conducive to the conversion among the different kinds of dominant eye,and the more fatigued.