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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.
The inability of an eye to turn outward, results in a convergent strabismus or esotropia of which the primary symptom is diplopia (commonly known as double vision) in which the two images appear side-by-side. Thus, the diplopia is horizontal and worse in the distance.
Side effects. The most common side effects are droopy eyelids and over- or undercorrections; a further common side effects are diplopia and inadvertent vertical deviation (hypo- or hypertropia). The side effects typically resolve in 3–4 months.
Prism exposure promotes the resetting of the ocular-motor system in the brain and results in improved higher order visual spatial representations that allow for the sustained improvement of unilateral neglect symptoms (Serino et al., 2006).
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.
The prism FD-curve (measured subjectively in near vision) tends to have a steeper slope (see Fig. 3b), meaning that the binocular system is not able to reach a small fixation disparity when vergence is forced by prisms in the base-in and base-out direction.
The test is indicated with the use of a presence of a prism in individuals with a strabismus and fusion is considered present if 4 lights are maintained, with or without the use of a prism. The W4LT can also be indicated when aiding a person to develop and strengthen their fusional capacities.
A cover test or cover-uncover test is an objective determination of the presence and amount of ocular deviation. It is typically performed by orthoptists, ophthalmologists and optometrists during eye examinations . The two primary types of cover tests are: the alternating cover test. the unilateral cover test (or the cover-uncover test).
Hirschberg corneal reflex test. Purpose. whether a person has strabismus. In the fields of optometry and ophthalmology, the Hirschberg test, also Hirschberg corneal reflex test, is a screening test that can be used to assess whether a person has strabismus (ocular misalignment).