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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).
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. It is used by ophthalmologists and orthoptists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. [1]
The most common application for this is the treatment of strabismus. By moving the image in front of the deviated eye, double vision can be avoided and comfortable binocular vision can be achieved. Other applications include yoked prism where the image is shifted an equal amount in each eye.
Subsequently, spectacles for size correction ("iseikonic correction") allowed binocular fusion with depth perception to be achieved. Bielschowsky took note that the condition reappeared whenever the spectacles were not worn.
Observers with a fixation disparity are more likely to report eye strain in demanding visual tasks; therefore, tests of fixation disparity belong to the diagnostic tools used by eye care professionals: remediation includes vision therapy, prism eye glasses, or visual ergonomics at the workplace.
The Worth Four Light Test is indicated for use when assessing the binocular functions, the ability of eyes to work in coordination, of an individual. It can be used to develop a diagnosis or to support or confirm an initial diagnosis.
Treatment. Convergence insufficiency may be treated with convergence exercises prescribed by an eyecare specialist trained in orthoptics or binocular vision anomalies (see: vision therapy ). Some cases of convergence insufficiency are successfully managed by prescription of eyeglasses, sometimes with therapeutic prisms .
Hans-Joachim Haase (1915 – December 20, 2001) was a German clockmaker, optician and inventor, who became known for an apparatus for testing binocular vision and for the MKH method, an alternative method intended to improve binocular vision using corrective lenses.
A Schmidt–Pechan prism is a type of optical prism used to rotate an image by 180°. These prisms are commonly used in binoculars as an image erecting system. The Schmidt–Pechan prism makes use of a roof prism section (from the German: "Dachkante", lit. roof edge ).
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.