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The prism cover test ( PCT) is an objective measurement and the gold standard in measuring strabismus, i.e. ocular misalignment, or a deviation of the eye. [1] It is used by ophthalmologists and orthoptists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. [1]
The two primary types of cover tests are: the alternating cover test. the unilateral cover test (or the cover-uncover test). The test involves having the patient focusing on both a distance as well as near object at different times during the examination.
It can be used to establish whether a patient has the ability for the eyes to fuse the light that is received from each eye into 4 lights. 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.
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.
Prism correction is measured in prism dioptres. A prescription that specifies prism correction will also specify the "base". The base is the thickest part of the lens and is opposite from the apex. Light will be bent towards the base and the image will be shifted towards the apex.
Description ( notes ) AC. Anterior chamber. fluid-filled space between the iris and the endothelium. AC 4/4. Grade 4 anterior chamber angle. open angle between cornea and iris. AC 3/4. Grade 3 anterior chamber angle.
Surgery or special glasses (prisms) may be advised if there is no recovery in 6 to 12 months.
Prism lenses set to make minor optical changes in the vertical alignment may be prescribed instead of or after surgery to fine-tune the correction. Prism lenses do not address torsional misalignment and this may limit their use in certain cases.
Ophthalmology. Esophoria is an eye condition involving inward deviation of the eye, usually due to extra-ocular muscle imbalance. It is a type of heterophoria .
In his case description, the condition was present years after surgical correction of strabismus acquired during childhood and co-existed with aniseikonia. Subsequently, spectacles for size correction ("iseikonic correction") allowed binocular fusion with depth perception to be achieved.
