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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). [5] Steps: 1. The patient should be measured in primary position first and then in any other positions of gaze of concern.
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. In an eyeglass prescription, the base is typically specified as up, down, in, or out, but left and right are also used sometimes.
Convergence insufficiency is characterized by one or more of the following diagnostic findings: patient symptoms, high exophoria at near, reduced accommodative convergence/accommodation ratio, receded near point of convergence, and low fusional vergence ranges and/or facility. Some patients with convergence insufficiency have concurrent ...
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 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.
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).
If the eye was exotropic, covering the fixating eye will cause an inwards movement; and if esotropic, covering the fixating eye will cause an outwards movement. The alternating cover test, or cross cover test is used to detect total deviation (tropia + phoria).
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.
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.
The Maddox Wing is an instrument utilized by ophthalmologists, orthoptists and optometrists in the measurement of strabismus (misalignment of the eyes; commonly referred to as a squint or lazy eye by the lay person).