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Cross-sectionalOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026

Ocular Dominance is Associated With Interocular Asymmetry in Refractive Error and Axial Length Across Childhood and Early Adulthood.

Síofra C Harrington, Gareth Lingham, James Loughman … Michael Moore

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OphthalmologyCross-sectional

Ocular dominance, not left-right side, explains most interocular eye-size differences.

Ocular Dominance is Associated With Interocular Asymmetry in Refractive Error and Axial Length Across Childhood and Early Adulthood.

Síofra C Harrington … Michael Moore

Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026

Purpose

To determine whether ocular dominance is associated with systematic interocular asymmetry in spherical equivalent refraction (spherical equivalent refraction) and axial length (axial length) across childhood and early adulthood, and assess whether such asymmetry exceeds laterality effects.

Methods

Data were analysed from three population-based cohorts: 728 children (6-7-year-olds) and 898 adolescents (12-13-year-olds) from Ireland and 303 young adults (25-30-year-olds) from Western Australia.

n = 728 children

85%

Results

85%

ocular dominance - not left vs. right - drove nearly all the size difference

n = 728 children

More results

Across all age groups, right-left differences in spherical equivalent refraction and axial length were minimal (mean differences <0.05 D and <0.05 mm in children and adolescents), with small, significant laterality effects observed only in young adults (-0.13 D in spherical equivalent refraction; 0.06 mm in axial length).

More results

In contrast, dominant-non-dominant comparisons demonstrated consistent directional asymmetry: the dominant eye was less hyperopic/more myopic (-0.09 D at 6-7 years; -0.10 D at 12-13 years; -0.08 D at 25-30 years) and longer (0.03-0.06 mm; all p < 0.05).

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Conclusion · 1 of 2

In this cross-sectional analysis, ocular dominance was associated with small but systematic interocular asymmetry in spherical equivalent refraction and axial length across childhood and early adulthood, which exceeds laterality effects.

Conclusion · 2 of 2

Dominance-related asymmetry was attenuated in myopia and amplified in anisometropia. Ocular dominance should be considered when analysing interocular refractive and biometric data in research and clinical contexts.

Post

Ocular Dominance is Associated With Interocular Asymmetry in Refractive Error and Axial Length Across Childhood and Early Adulthood.

Ocular dominance, not left-right side, explains most interocular eye-size differences.

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