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Four prism dioptre reflex test. Purpose. assess alignment of both eyes. 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. [1]
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".
relevant position of the prism in front of the eye denoted by: base in “BI” or “-” for fusional divergence; base out “BO” or “+” for fusional convergence; base up “BU” or base down “BD” for vertical fusional vergence.
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). These prisms force the eyes to change the vergence angle while the viewing distance remains unchanged.
Krimsky Test. The Krimsky test is essentially the Hirschberg test, but with prisms employed to quantitate deviation of ocular misalignment by determining how much prism is required to centre the reflex [2] The Krimsky test is advisably used for patients with tropias, but not with phorias.
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.
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.
Prism lenses (here unusually thick) are used for pre-operative prism adaptation. Health insurances always review therapies in terms of clinical effectiveness in view of existing scientific literature, benefit, risk and cost.
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.