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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]
In general, strabismus can be approached and treated with a variety of procedures. Depending on the individual case, treatment options include: Correction of refractive errors by glasses; Prism therapy (if tolerated, to manage diplopia) Vision Therapy; Patching (mainly to manage amblyopia in children and diplopia in adults) Botulinum toxin ...
The Maddox rod test can be used to subjectively detect and measure a latent, manifest, horizontal or vertical strabismus for near and distance. The test is based on the principle of diplopic projection.
To perform the test you will need Bagolini Striated Glasses; Pen torch or a distant light source. Alternatively, trial frames and lenses or a lorgnette can be used. In some cases, the use of prisms is necessary to measure a deviation and test for the presence of binocular functions. Principles
Prism correction is measured in prism dioptres. A prescription that specifies prism correction will also specify the "base". The base is the thickest part of the lens and is opposite from the apex. Light will be bent towards the base and the image will be shifted towards the apex.
Esotropias measuring more than 15 prism diopters (PD) and exotropias more than 20 PD that have not responded to refractive correction can be considered candidates for surgery. Techniques Disinserting the medial rectus muscle. The goal of strabismus surgery is to correct misalignment of the eyes.
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.
Based on prism-FD curves (Fig. 3b), one can find the aligning prism sP 0 that nullifies the naturally prevailing fixation disparity sFD 0. This test procedure is typically made in near vision of 40 cm, e.g. with the Mallett-unit, the Disparometer, or the Wesson card (see above).
Keratophakia and epi-keratophakia are another two non laser surgical procedures used to correct hypermetropia. Keratophakia is a surgical technique developed by Barraquer for treating high hypermetropia and aphakia.
Treatment options for esotropia include glasses to correct refractive errors (see accommodative esotropia below), the use of prisms, orthoptic exercises, or eye muscle surgery. The term is from Greek eso meaning "inward" and trope meaning "a turning".