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Fig. 3: Fixation disparity as a function of the forced vergence angle which is induced by base-in prisms and base-out prisms in front of the eyes. These prism FD-curves have widely been used for subjective fixation disparity and the clinical implications are described below.
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]
When measuring horizontal fusion ranges, base in prisms assess fusional divergence while base out prisms assess fusional convergence. The vertical fusional vergence amplitude can also be measured with base up and base down prisms although the horizontal PFR is typically the main focus when testing.
Exophoria is a form of heterophoria in which there is a tendency of the eyes to deviate outward. During examination, when the eyes are dissociated, the visual axes will appear to diverge away from one another. The axis deviation in exophoria is usually mild compared with that of exotropia.
Heterophoria is an eye condition in which the directions that the eyes are pointing at rest position, when not performing binocular fusion, are not the same as each other, or, "not straight".
If the patient saw a red line to the left and white light to the right, they are said to have exotropia or exophoria (crossed diplopia) in which base in (BI) prisms of increasing strength are used until the lines are superimposed. [5] Maddox rod test tutorial. Method for measuring vertical deviations:
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.
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.
The cover-uncover test can also be used for more problematic disorders of binocular vision, the tropias. In the cover part of the test, the examiner looks at the first eye as he or she covers the second. If the eye moves from in to out, the person has exotropia. If it moved from out to in, the person has esotropia.
In geometry, a prism is a polyhedron comprising an n-sided polygon base, a second base which is a translated copy (rigidly moved without rotation) of the first, and n other faces, necessarily all parallelograms, joining corresponding sides of the two bases.