1112: surgical pearls for ocular asymmetry

While most patients have eyes that are very similar, there are a few patients where the eyes are remarkably different, particular with regards to potential visua acuity. These are patients who may be relatively monocular or even frankly monocular. There are patients with amblyopia from strabismus or anisometropia. Some may have corneal irregularities, macular disease, or optic nerve pathology which renders one eye significantly better than the other. The approach to cataract surgery in these asymmetric eyes must be approached cautiously and there are different considerations in play.

Click to learn about my approach to cataract surgery in patients with ocular asymmetry:


  1. IOL on the amblyopiceye: I woud put in a monfocal IOL with the aim of +1.0 or +1.5 (in order to leave some anisometropie / but no EDOF because the patient could not make any use of it, because it’s an ambyopie c eye
    Dr. R. Graemiger, Switzerland

  2. Thanks so much for your dedication to excellence in ophthalmology. I have benefitted greatly from your messages, videos, etc. and I’m 8 years into practice.

  3. Monofocal in amblyopic eye. Single focal point to maximize acuity… no need to have patient incur cost of specialty implant in amblyopic eye.

    1. I would put monofocal acrylic lens in the amblyopic eye. No point incurring a higher cost to the pt puttind EDOF Lens in amblyopic eye

  4. Do the Worth 4 dot test. If patient sees four dots, implant an EDOF IOL in the left eye. If patient sees two red dots, implant a monofocal IOL in the left eye aiming for plano,

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