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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.
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.
Loupes are used in many professions where magnification enables precision work to be done with greater efficiency and ease. Examples include surgery, dentistry, ophthalmology, the jewelry trade, gemology, questioned document examination and watchmaking. [3] Loupes are also sometimes used in photography and printing.
Exotropia is a form of strabismus where the eyes are deviated outward. It is the opposite of esotropia and usually involves more severe axis deviation than exophoria. People with exotropia often experience crossed diplopia. Intermittent exotropia is a fairly common condition.
Bifocals. A bifocal lens with areas of differing magnification. Bifocals with separate lenses. In this case, the Swedish ethnologist Jan-Öjvind Swahn [ sv]. Bifocals are eyeglasses with two distinct optical powers. Bifocals are commonly prescribed to people with presbyopia who also require a correction for myopia, hyperopia, and/or astigmatism .
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.
Also, plastic prisms (Fresnel prisms) can be attached to eyeglasses of a diplopic patient, allowing for alignment of vision from both eyes in the affected direction, but are often problematic if the degree of muscle weakness, and therefore ocular misalignment, fluctuates frequently.
For mild conditions, prism glasses can be prescribed to correct specific types of double vision. In more extreme cases, additional intervention such as botulinum toxin injection and strabismus surgery, might be required to rebalance the actions of the extraocular muscles.
Low order aberrations (hyperopia, Myopia and regular astigmatism), are correctable by eyeglasses, soft contact lenses and refractive surgery. Neither spectacles nor soft contact lenses nor routine keratorefractive surgery adequately corrects high order aberrations.
Surgery or special glasses (prisms) may be advised if there is no recovery in 6 to 12 months. If diplopia turns out to be intractable, it can be managed as last resort by obscuring part of the patient's field of view.