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The Four Prism Dioptre Reflex Test (also known as the 4 PRT, or 4 Prism Dioptre Base-out Test) is an objective, non-dissociative test used to prove the alignment of both eyes (i.e. the presence of binocular single vision) by assessing motor fusion.
If the patient saw a red line to the right and white light to the left, they are said to have esotropia or esophoria (uncrossed diplopia) in which base out (BO) prisms of increasing strength are used until the lines are superimposed.
If the residual esotropia is small, or if the patient is unfit or unwilling to have surgery, prisms can be incorporated into their glasses to provide more permanent symptom relief. When the deviation is too large for prismatic correction to be effective, permanent occlusion may be the only option for those unfit or unwilling to have surgery.
Treatment options for esotropia include glasses to correct refractive errors (see accommodative esotropia below), the use of prisms, orthoptic exercises, or eye muscle surgery. The term is from Greek eso meaning "inward" and trope meaning "a turning".
In a person with normal ocular alignment the light reflex lies slightly nasal from the center of the cornea (approximately 11 prism diopters—or 0.5mm from the pupillary axis), as a result of the cornea acting as a temporally-turned convex mirror to the observer.
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The test is indicated with the use of a presence of a prism in individuals with a strabismus and fusion is considered present if 4 lights are maintained, with or without the use of a prism. The W4LT can also be indicated when aiding a person to develop and strengthen their fusional capacities.
Suppression of an eye is a subconscious adaptation by a person's brain to eliminate the symptoms of disorders of binocular vision such as strabismus, convergence insufficiency and aniseikonia. The brain can eliminate double vision by ignoring all or part of the image of one of the eyes.
Patients may have up to 3D of anisometropia before the condition becomes clinically significant due to headache, eye strain, double vision or photophobia. [4] In certain types of anisometropia, the visual cortex of the brain cannot process images from both eyes simultaneously ( binocular summation ), but will instead suppress the central vision ...
Glasses, surgery [3] Frequency. ~2% (children) [3] Strabismus is a vision disorder in which the eyes do not properly align with each other when looking at an object. [2] The eye that is pointed at an object can alternate. [3] The condition may be present occasionally or constantly. [3]
Stereopsis recovery. Eye patches may strengthen the weaker eye but fail to stimulate binocular vision and stereopsis, which may sometimes be recovered by different means. Stereopsis recovery, also recovery from stereoblindness, is the phenomenon of a stereoblind person gaining partial or full ability of stereo vision ( stereopsis ).