An Investigation into the

Relationship Between
Vision and Personality
Ragna Godtland, OD
Sartell, Minnesota

Abstract
Background: It is often said that the patients personality is predictable based on the refraction or eso/exo posture,
but there is little support in the literature as to the validity of this statement. This study investigated the correlation
between personality and refractive error, near heterophoria, and distance heterophoria.
Methods: Students and faculty (n=54) from Southern College of Optometry answered a 72-question Myers-Briggs
personality survey. Participants disclosed their current refractive condition. Heterophoria was measured at distance
and near using the Howell card.
Results: Pearson correlations did not show significant correlation between personality and refractive error or
distance/near phoria. The distance and near phoria showed a medium correlation (r=0.580) to one another.
Conclusion: No significant relationship between personality and refractive error or phoria was found. There were a
number of difficulties encountered that might skew this data. This study does not discount the important of behavioral
observations made by each doctor throughout the examination, as personality type may be beneficial in providing the
practitioner insights into how their patients relate to their visual world.
Key Words
heterophoia, Myers-Briggs personality survey, personality, refractive error

Introduction
Are myopic esophores more bookish? Are hyperopic exo-
phores more outgoing?1 Personality and refractive status have
been linked in the optometric and psychological literature for
over 70 years. Lanyon and Gidding2 in their 1974 review of
the literature, cited numerous papers describing myopic in-
dividuals as introverted, shy, and socially embarrassed, with
relatively few friends, having a dogmatic or self-centered
personality, and preferring reading, writing, and other intel-
lectual activities to outdoor activities. A study by Beedle and
Young3 found hyperopes more likely to describe themselves as
anxious, changeable, defensive, excitable, impatient, nervous,
stubborn, and worrying. Myopes were more likely to describe
themselves as ambitious, conscientious, fair-minded, infor-
mal, kind, mannerly, pleasant, and generous.
The relationship between personality and refractive error,
especially as it relates to myopia progression, has been inves-
tigated with varying results. The relationship between per-
sonality and heterophoria is not as prevalent in the literature.
Much of the evidence stating a relationship between phoria
and personality or refractive error and personality is based on
clinical observation and anecdotal evidence. The purpose of
this study was to investigate any correlations between refrac-
tive condition, distance phoria, near phoria, and introverted or
extroverted personalities.
Materials and Methods
Fifty-two participants were selected from students and
faculty at Southern College of Optometry (sample of conve-
nience). Those with -1.00 diopter or more of cylinder were ex-
Journal of Behavioral Optometry
cluded from this study. This value was chosen as less than 1.00
diopter of cylinder is typically not compensated for in contact
lenses. For those with low amounts of astigmatic compensa-
tion in their prescriptions, the spherical equivalent was used.
The eye with the higher prescription or spherical equivalent
was recorded. Presbyopic patients or those with 1.50 diopters
or more of anisometropia were also excluded from this study.
Participants disclosed their refractive condition that had been
determined within the past six months at SCO.
The phoria was measured through the habitual correction at
distance (3 meters) and near (33 cm) using the Howell card.
The Howell card uses a modified Thorington technique, which
has been shown to have high inter-observer repeatability.4
Six prism diopters base down was placed in front of the par-
ticipants right eye. To avoid proximal feedback, individuals
were not allowed to hold the near card. Participants reported to
which number the top arrow was pointing.
Participants then completed a Myers-Briggs Jung Typology
survey online. The 72-question survey was from HumanMet-
rics.com.5 The Myers-Briggs Jung Typology is one of the most
widely used and accepted measures of personality. This partic-
ular website was chosen because it gave results free of charge.
The amount of introversion or extroversion was expressed
and reported on a 100 point scale. The higher the value the
more introverted or extroverted the person is reported to be. A
Pearson correlation was performed comparing personality to
refractive error, personality to near phoria, and personality to
distance phoria.
Volume 23/2012/Number 3/Page 59
Results
Of the 52 participants, six were hyperopic with prescrip-
tions ranging from +0.25DS to +1.75DS. One participant was
emmetropic. Forty-five participants were myopic, ranging
between a spherical equivalent of 0.13DS to 13.00DS. Ten
participants were esophoric, 2 orthophoric, and 40 exophoric
at near. The range of near phoria was from 3 esophoria to 16
exophoria. Distance phoria measurement showed that 13 sub-
jects were esophoric, 15 were orthophoric, and 24 were exo-
phoric, ranging from 2.5 esophoria to 12 exophoria.
A Pearson correlation was performed between the variables
(Table 1). Graphs for each set of data were also made to dem-
onstrate the relationship between each of the variables (Fig-
ures 1-6). Myopia, esophoria, and introversion were assigned
negative values; hyperopia, exophoria, and extroversion were
given positive values. The only medium/high correlation was
between near and far heterophoria (r=0.580). The remaining
variables showed a low correlation ranging from -0.036 to
0.152.
Discussion
The results of this study show that there is no correlation
between personality and refractive error. Similar results were
found by van de Berg et al.6 in the Genes and Myopia (GEM)
study. The study looked at data from over 600 twins and family
members using the International Personality Item Pool (IPIP)
Five Factor Inventory. No significant correlation was found
between refractive error and any of the five personality factors
including extroversion nor was it found between personality
and distance phoria or personality and near phoria. Chen et al.7
investigated the relationship between free-space phoria, using
a card similar to the Howell card, and personality. Again, no
significant difference was found between myopes and emme-
tropes in the amount or type of phoric posture. Also, no cor-
relation was demonstrated between refractive status and near
phoria or between refractive status and distance phoria. Simi-
lar to the current study, there was a moderately significant cor-
relation between distance phoria and near phoria.
Our study looked at introvertedness and extrovertedness as
they easily relate to the classic stereotypes of refractive status
and phoria. However, introversion and extroversion are just a
small part of the information given by the Myers-Briggs per-
sonality indicator. There are four distinct personality types and
Figure 1: Refractive error and introversion/
extroversion.
Volume 23/2012/Number 3/Page 60
Table 1: Correlation coefficients
Pearson Correlation Coefficient
Refractive
Personality Error Near Phoria
Refractive
Error 0.144031
Near Phoria 0.061569 0.151719
Distance
Phoria 0.03822 -0.03604 0.580601
within each personality type a person may be introverted or ex-
troverted. The four Myers-Briggs personality types date back
as early as Hippocrates and have been described by Galan,
Paracelsus, Plato, Aristotle, Chaucer, Shakespeare, L. Frank
Baum and Tolstoy.8 Modern work on personality has been
studied by Myers and Keirsey.8
The first of the personality types is what Plato called the
Artisans (Myers Sensing Perceiving type). They are described
as adaptable, artistic, athletic, open-minded, able to see the
needs of the moment, storing up useful facts, no use for theo-
ries, easy-going, tolerant, persuasive, gifted with machines and
tools, and sensitive to color, line and texture.8
Plato referred to the second group as the Guardians (Myers
Sensing Judging type). They are described as conservative,
stable, consistent, rountinized, sensible, factual, unimpulsive,
patient, dependable, hard-working, detailed, painstaking, pre-
serving, and thorough.7 The third group, the Idealists (Myers
Intuitive Feeling type), is described as humane, sympathetic,
enthusiastic, religious, creative, intuitive, insightful, and
subjective.7 The final group, the Rationals (Myers Intuitive
Thinking type), are described as analytical, systematic, ab-
stract, theoretical, intellectual, complex, competent, technical,
curious, scientific, and research oriented.8
Full personality information was collected on 45 of our 52
study participants. As the participants were recruited from a
scientific program, it should not come as a surprise that there
were no Artisan personalities. There were 19 Guardians, 12
Idealists, and 14 Rationals. While there was not enough data
to run reliable statistical analysis, there were some definite
trends. The Rationals were more likely to be hyperopic and
Figure 2: Near phoria and introversion/
extroversion.
Journal of Behavioral Optometry
Figure 3: Distance phoria and introversion/ Figure 4: Refractive error and near phoria
extroversion.

Figure 5: Refractive error and distance phoria Figure 6: Near phoria and distance phoria

Table 2: Summary of information by personality type.

Guardians Idealists Rationals
Average Refractive Error -2.90 -3.67 -2.31
Range of Refractive Error +1.75 to -7.50 +1.75 to -8.00 +0.75 to -5.75
% Myopia 95 92 71
% Hyperopia 5 8 21
% Emmetropia 0 0 7
Average Near Phoria 4.53 3.25 3.89
Range of Near Phoria 3 EP to 16 XP 2 EP to 9 XP 2 EP to 14 XP
% Near Esophoria 16 17 29
% Near Exophoria 79 83 64
% Near Exo OMN 33 20 40
% Near OMN 42 33 57
Average Distance Phoria 1.21 1.13 0.86
Range of Distance Phoria 2 EP to 10 XP 1 EP to 8 XP 2.5 EP to 8 XP
% Distance Esophoria 26 17 29
% Distance Exophoria 53 42 29
% Distance Exo OMN 40 20 50
% Distance Ortho 21 42 4
% Distance OMN 47 25 43

OMN=outside Morgans norms

Journal of Behavioral Optometry Volume 23/2012/Number 3/Page 61

esophoric. They were most likely to be outside of Morgans 4. Scheiman S, Wick B. Clinical Management of Binocular Vision. Philadel-
norms for exophoria at distance and near. The Idealist group phia, PA: Lippincott Williams Wilkins, 2002.
had the highest average refractive error and the highest per- 5. Human Metrics. www.humanmetrics.com/cgi-win/jtypes1.htm Last ac-
cessed April 3, 2012.
centage of near exophoria. The Idealist group was most likely
6. van de Berg R, Dirani M, Chen CY, Haslam N, et al. Myopia and personal-
to be inside Morgans norms. The Guardian group had the ity: The genes in myopia (GEM) personality study. Invest Ophthalmol Vis
highest percentage of subjects with myopia and distance exo- Sci 2008;49:882-6.
phoria. They also had the highest average phoria at distance 7. Chen AH. Dom AA. Heterophoria in young adults with emmetropia and
and near (Table 2). myopia. Malaysian J Med Sci 2003;10:90-4.
8. Keirsey D. Please Understand Me II: Temperament, Character, Intelli-
Conclusions gence. Del Mar, CA: Prometheus Nemesis, 1998.
As tempting as it may be to stereotype patients sitting in
the exam chair based on refractive measures and examination
findings, this investigation showed no significant relationship Corresponding author:
between either refractive error or phoria and personality. This Ragna Godtland, OD
study does not, however, discount the importance of behavior- PineCone Vision Center
al observations made by a doctor throughout the examination. 2380 Troop Drive Suite 201
Sartell, MN 56377
Knowing the personality type of a patient may be beneficial RGodtland@PineConeVisionCenter.com
as it gives the practitioner insight into how their patient relates Date submitted for publication: 20 June 2011
to visual information and may assist them in relating better to Date accepted for publication: 23 December 2011
their patient. This study looked at levels of introversion and
extroversion as they easily relate to the classic stereotypes of
refractive condition and phoria. However, introversion and ex-
troversion are just a minor aspect of the information provided
by the Myers-Briggs personality indicator. While there was
not enough data to run reliable statistical analysis, there were ADDITIONAL CONTENT AVAILABLE!
some definite trends observed. Further investigation is needed
to determine a correlation between the personality type and The JBO Online version of this article
refractive error as well as phoric posture.
features videos. Access JBO Online at:
References
1. Lauriola M. Psychological correlates of eye refractive errors. Personality www.oepf.org/journals or by
Ind Diff 1997;23:917-20. scanning this QR code with
2. Lanyon RI, Giddings JW. Psychological approaches to myopia: A review.
Am J Optom Physiol Opt 1974;51:271-81. your smartphone!
3. Beedle SL, Young FA. Values, personality, physical characteristics, and
refractive error. Am J Optom Physiol Opt 1976;53:735-9.

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