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Such prisms alleviated eye strain and remained stable over time. The usefulness of prism eye glasses has been criticized since the initial fixation disparity may reappear again after some time due to the adaptability of the vergence system.
Heterophoria is the misalignment of the visual axis such that one or both eyes are not properly fixated to an object of interest. When the visual axis is misaligned in such a way, it is corrected by the fusional vergence system. Diagnosis. The cross-cover test, or alternating cover test is usually employed to detect heterophoria.
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. It is used by ophthalmologists and orthoptists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. [1]
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.
Prism spectacles incorporate higher power prisms, with variable shapes and designs. The Gottlieb button prism, and the Peli superior and inferior horizontal bands are some proprietary examples of prism glasses.
Prism lenses reduce vertical fusional demands by allowing the eyes to rest in their vertically misaligned state. When they are removed the patient may experience vertical diplopia they find hard to resolve due to the rested state of their eyes.