PURPOSE. To determine the association between ocular dominance and spherical or astigmatic anisometropia, age, and sex. METHODS. Medical records of 10,264 myopic refractive surgery candidates were filtered. Ocular dominance was assessed with the hole-in-the-card test. Manifest refractive error was measured in each subject and correlated to ocular dominance. Only subjects with corrected distance visual acuity (CDVA) of Ͼ20/22 in each eye were enrolled, to exclude amblyopia. Associations between

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... sociations between ocular dominance and refractive state were analyzed by means of the t-test, 2 test, Spearman correlation, and multivariate logistic regression analysis. RESULTS. Right and left eye ocular dominance was noted in 61.7% and 35.6% of the individuals. Ocular dominance had no significant impact on SE refraction in subjects with SE or cylindrical anisometropia Ͻ0.5 D. For anisometropia Ͼ2.5 D (n ϭ 278) the nondominant eye was more myopic in 63.7% (SE Ϫ5.8 Ϯ 2.64 D) compared to 36.3% (Ϫ4.69 Ϯ 2.39 D; P Ͻ 0.001; adjusted P (Padj) Ͻ 0.001) for the dominant eye being more myopic. Nondominant eyes showed higher astigmatic power than dominant eyes (Ϫ0.95 Ϯ 0.91 D versus Ϫ0.89 Ϯ 0.84 D; P Ͻ 0.001). For astigmatic anisometropia Ͼ2.5 D, nondominant eyes exhibited a higher amount of astigmatism in 75% of subjects. Nondominant eyes of subjects Ͻ29 years and 30 to 39 years of age had a significantly higher astigmatic power than did dominant eyes of the same age group. CONCLUSIONS. In contrast to previous reports, this study, including myopic refractive surgery candidates, revealed that the nondominant eye was more myopic for SE anisometropia Ͼ2.5 and more astigmatic for cylindrical anisometropia Ͼ0.5 D. (Invest Ophthalmol Vis Sci. 2011;52:9166-9173)