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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). Steps: 1. The patient should be measured in primary position first and then in any other positions of gaze of concern.
When measuring horizontal fusion ranges, base in prisms assess fusional divergence while base out prisms assess fusional convergence. The vertical fusional vergence amplitude can also be measured with base up and base down prisms although the horizontal PFR is typically the main focus when testing.
If test prisms with increasing amount are placed in front of the observer’s eyes, the fixation disparity changes in the eso direction with base-in prisms and in the exo direction with base-out prisms (Fig. 3). These prisms force the eyes to change the vergence angle while the viewing distance remains unchanged.
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.
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Exophoria. Exophoria is a form of heterophoria in which there is a tendency of the eyes to deviate outward. [1] During examination, when the eyes are dissociated, the visual axes will appear to diverge away from one another. [2] The axis deviation in exophoria is usually mild compared with that of exotropia .