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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. 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 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:
Prism correction. Prism lenses (here unusually thick) are used for pre-operative prism adaptation. Eye care professionals use prism correction as a component of some eyeglass prescriptions. A lens which includes some amount of prism correction will displace the viewed image horizontally, vertically, or a combination of both directions.
Step 1: Determine which eye is hypertropic in primary position. If there is right hypertropia in primary position, then the depressors of the R eye (IR/SO) or the elevators of the L eye are weak (SR/IO). Step 2: Determine whether the hypertropia increases on right or left gaze.
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).
Hypertropia/Hypotropia. In a patient with an unsuppressed vertical deviation, one line will appear higher than the other. If the image of the right eye is higher than that of the left, this means the right eye is lower than the left. This could be either a right hypotropia or a left hypertropia. Harmonious Abnormal retinal correspondence
Diplopia with normal binocular function is treated with prism glasses, botulinum injections into the muscles, or repeated surgery. If binocular function is not normal, a more individualized approach is necessary to best suit the patient's needs.
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.
Hypotropia or hypertropia. In cases of vertical deviations, patients will report that: They see 5 lights: 2 red and 3 green; The lights are vertically displaced in relation to one another; The green lights (left eye) are on top of the red lights (right eye), which is interpreted as : R HT or LHypoT