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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]
Either BASE IN for an exodeviation (eye turned out), BASE OUT for an esodeviation (eye turned in), BASE UP for a hypodeviation (eye turned down) or BASE DOWN for a hyperdeviation (eye turned up). [5] Steps: 1. The patient should be measured in primary position first and then in any other positions of gaze of concern.
Strabismus surgery (also: extraocular muscle surgery, eye muscle surgery, or eye alignment surgery) is surgery on the extraocular muscles to correct strabismus, the misalignment of the eyes. [1] Strabismus surgery is a one-day procedure that is usually performed under general anesthesia most commonly by either a neuro- or pediatric ...
Treatment options for esotropia include glasses to correct refractive errors (see accommodative esotropia below), the use of prisms, orthoptic exercises, or eye muscle surgery.
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.
Strabismus surgery attempts to align the eyes by shortening, lengthening, or changing the position of one or more of the extraocular eye muscles. The procedure can typically be performed in about an hour, and requires about six to eight weeks for recovery.
In an eyeglass prescription, the base is typically specified as up, down, in, or out, but left and right are also used sometimes. Whether a patient needs this type of correction can be determined by a variety of methods.
Management of strabismus. The management of strabismus may include the use of drugs or surgery to correct the strabismus. Agents used include paralytic agents such as botox used on extraocular muscles, [1] topical autonomic nervous system agents to alter the refractive index in the eyes, and agents that act in the central nervous system to ...
Today, the injection of botulinum toxin into the muscles that surround the eyes is one of the available options in the management of strabismus. Other options for strabismus management are vision therapy and occlusion therapy, corrective glasses (or contact lenses) and prism glasses, and strabismus surgery .
Congenital fourth cranial nerve palsy can be treated with strabismus surgery, where muscle attachment sites on the globe are modified to realign the eyes. Some eye doctors prefer conservative or no management of congenital fourth nerve palsy.