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If the eye was exotropic, covering the fixating eye will cause an inwards movement; and if esotropic, covering the fixating eye will cause an outwards movement. The alternating cover test, or cross cover test is used to detect total deviation (tropia + phoria).
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.
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. Prism lenses (here unusually thick) are used for pre-operative prism adaptation. Eye care professionals use prism correction as a component of some eyeglass prescriptions. A lens which includes some amount of prism correction will displace the viewed image horizontally, vertically, or a combination of both directions.
Incomitant strabismus cannot be fully corrected by prism glasses, because the eyes would require different degrees of prismatic correction dependent on the direction of the gaze.
Relaxation of accommodation can result in an increase in exophoria and a decrease in esophoria, leading to an inaccurate result. The examiner should check the function of the Maddox Wing Instrument before use; the septa can be easily bent, leading to the septa not covering the intended view.
Prism spectacles with a single prism perform a relative displacement of the two eyes, thereby correcting eso-, exo, hyper- or hypotropia. In contrast, spectacles with prisms of equal power for both eyes, called yoked prisms (also: conjugate prisms, ambient lenses or performance glasses) shift the visual field of both eyes to the same extent.
Esophoria is an eye condition involving inward deviation of the eye, usually due to extra-ocular muscle imbalance. It is a type of heterophoria. Cause. Causes include: Refractive errors; Divergence insufficiency; Convergence excess; this can be due to nerve, muscle, congenital or mechanical anomalies.
Esotropias measuring more than 15 prism diopters (PD) and exotropias more than 20 PD that have not responded to refractive correction can be considered candidates for surgery. Techniques Disinserting the medial rectus muscle. The goal of strabismus surgery is to correct misalignment of the eyes.
Where appropriate, prismatic correction can be used, either temporarily or permanently, to relieve symptoms of double vision. In specific cases, and primarily in adult patients, botulinum toxin can be used either as a permanent therapeutic approach, or as a temporary measure to prevent contracture of muscles prior to surgery