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Four prism dioptre reflex test. Purpose. assess alignment of both eyes. 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. [1]
measuring strabismus. 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]
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.
Esotropia is a form of strabismus in which one or both eyes turn inward. The condition can be constantly present, or occur intermittently, and can give the affected individual a "cross-eyed" appearance. [1]
If test prisms with increasing amount are placed in front of the observer’s eyes, the fixation disparity changes in the eso direction with base-in prisms and in the exo direction with base-out prisms (Fig. 3).
Esotropia. In an Esotropic (ET) deviation, the patient will experience uncrossed diplopia. When questioned about the position of the lights, they will report that: They see 5 lights, 2 red and 3 green; The lights are horizontally displaced, seen side by side; The 2 red lights from the right eye are seen on the right side
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.
Hypertropia is a condition of misalignment of the eyes ( strabismus ), whereby the visual axis of one eye is higher than the fellow fixating eye. Hypotropia is the similar condition, focus being on the eye with the visual axis lower than the fellow fixating eye.
Anisometropic persons who have strabismus are mostly far-sighted, and almost all of these have (or have had) esotropia. However, there are indications that anisometropia influences the long-term outcome of a surgical correction of an inward squint, and vice versa.
Dissociated vertical deviation ( DVD) is an eye condition which occurs in association with a squint, typically infantile esotropia. The exact cause is unknown, although it is logical to assume it is from faulty innervation of eye muscles.