Purpose: Previous studies of the relationship between visual acuity (VA) and ocular dominance have produced conflicting results. We hypothesized that (1) the discrepancies were related mostly to sample size and interocular visual acuity difference (IOVAD); (2) in large samples of individuals with marked IOVADs, the eye with the better uncorrected distance visual acuity (UDVA) would be dominant. These hypotheses were tested in a large group of myopic patients.
Methods: This prospective study of cycloplegic refraction involved 2045 myopic refractive surgery candidates. Patients with amblyopia or strabismus were excluded. Ocular dominance was assessed using the hole-in-the-card test.
Results: In 2045 patients, the dominant eye had significantly better UDVA (p = 0.028) and was less astigmatic (p = 0.000) than the nondominant eye. In 426 patients with marked interocular difference in the UDVA (≥0.2 logMAR), the dominant eye not only had significant UDVA (p = 0.022) but also significantly less myopic (p = 0.028) and had a shorter axial length (AL; p = 0.001). In patients with smaller differences in UDVA (0.1 logMAR, n = 411) or no difference (n = 1208), the dominant and nondominant eyes did not differ significantly with respect to UDVA, myopic power, and AL (p > 0.05).
Conclusions: The present study showed that the dominant eyes had significantly better UDVA than the nondominant eyes, especially in individuals with marked differences in UDVA. These results supported our hypothesis regarding the relationship between better VA and ocular dominance.
Keywords: Hole-in-the-card test; interocular visual acuity difference; myopia; ocular dominance; visual acuity.