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Surgical correction. Surgical correction of the hypertropia is desired to achieve binocularity, manage diplopia and/or correct the cosmetic defect. Steps to achieve the same depend on mechanism of the hypertropia and identification of the offending muscles causing the misalignment.
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 most common application for this is the treatment of strabismus. By moving the image in front of the deviated eye, double vision can be avoided and comfortable binocular vision can be achieved. Other applications include yoked prism where the image is shifted an equal amount in each eye.
When this muscle's function is diminished due to a fourth cranial nerve palsy, the affected eye will extort, deviate upward (hypertropia), and, to a smaller extent, drift inward. Treatment [ edit ] Congenital fourth cranial nerve palsy can be treated with strabismus surgery, where muscle attachment sites on the globe are modified to realign the ...
Treating a case of unsatisfactory alignment often involves prisms, botulinum toxin injections, or more surgery. The likelihood that the eyes will stay misaligned over the longer term is higher if the patient is able to achieve some degree of binocular fusion after surgery than if not.
Prisms change the way light, and therefore images, strike the eye, simulating a change in the eye position. Surgery. Strabismus surgery does not remove the need for a child to wear glasses. Currently it is unknown whether there are any differences for completing strabismus surgery before or after amblyopia therapy in children.
It is mainly used in strabismus clinics. Through this test, suppression, microtropia, diplopia and manifest deviations can be noted. However this test should always be used in conjunction with other clinical tests, such as Worth 4 dot test, Cover test, Prism cover test and Maddox rod to come to a diagnosis.
For an abnormal result, based on where the light lands on the cornea, the examiner can detect if there is an exotropia (abnormal eye is turned out), esotropia (abnormal eye is turned in), hypertropia (abnormal eye higher than the normal one) or hypotropia (abnormal eye is lower than the normal one).
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.
Other options for strabismus management are vision therapy and occlusion therapy, corrective glasses (or contact lenses) and prism glasses, and strabismus surgery. The effects that are due only to the toxin itself (including the side effects) generally wear off within 3 to 4 months.