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During an eye examination, the presence of suppression and the size and location of the suppression scotoma may be the Worth 4 dot test (a subjective test that is considered to be the most precise suppression test), or with other subjective tests such as the Bagolini striated lens test, or with objective tests such as the 4 prism base out test.
Convergence excess; this can be due to nerve, muscle, congenital or mechanical anomalies. [ 1 ] Unlike esotropia , fusion is possible and therefore diplopia is uncommon.
The cause of congenital fourth nerve palsy is unclear in most cases. It may be neurogenic in origin, due to a dysgenesis of the CN IV nucleus or nerve, but a clinically similar palsy may result from absence or mechanical dysfunction (e.g., abnormal laxity) of the superior oblique tendon.
Clinically, accommodative convergence is measured as a ratio of convergence, measured in prism diopters, to accommodation, measured in diopters of near demand. The patient is instructed to make a near target perfectly clear and their phoria is measured as the focusing demand on the eye is changed with lenses.
The prism fusion range (PFR) or fusional vergence amplitude is a clinical eye test performed by orthoptists, optometrists, and ophthalmologists to assess motor fusion, specifically the extent to which a patient can maintain binocular single vision in the presence of increasing vergence demands.
Prismatic, self-masking glasses are now being used by some cross-eyed-view advocates. These reduce the degree of convergence required and allow large images to be displayed. However, any viewing aid that uses prisms, mirrors or lenses to assist fusion or focus is simply a type of stereoscope, excluded by the customary definition of freeviewing.
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