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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.
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.
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".
The prisms are available in different strengths and the most appropriate one can be selected for each patient. However, in patients with large deviations, the thickness of the prism required may reduce vision so much that binocularity is not achievable.
Suppression of an eye is a subconscious adaptation by a person's brain to eliminate the symptoms of disorders of binocular vision such as strabismus, convergence insufficiency and aniseikonia. The brain can eliminate double vision by ignoring all or part of the image of one of the eyes.
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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]
Infantile esotropia is an ocular condition of early onset in which one or either eye turns inward. It is a specific sub-type of esotropia and has been a subject of much debate amongst ophthalmologists with regard to its naming, diagnostic features, and treatment.
Dissociated vertical deviation ( DVD) is an eye condition which occurs in association with a squint, typically infantile esotropia. The exact cause is unknown, although it is logical to assume it is from faulty innervation of eye muscles.
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).