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Symptoms. When the eye position is fully corrected (for example after surgical alignment of the eyes) or when the patient is provided with the best achievable prism correction, the patient does not experience binocular fusion and, instead, sees a double image that is very close to the fixation image and is perceived as "dancing around" it.
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.
Where appropriate, prismatic correction can be used, either temporarily or permanently, to relieve symptoms of double vision. In specific cases, and primarily in adult patients, botulinum toxin can be used either as a permanent therapeutic approach, or as a temporary measure to prevent contracture of muscles prior to surgery
Treatment options include eye exercises, wearing an eye patch on alternative eyes, prism correction, and in more extreme situations, surgery or botulinum toxin. If your provider diagnoses swelling or inflammation of, or around the nerve, medicines called corticosteroids may be used.
Symptoms may include ptosis (droopy eyelids) or diplopia (double vision, i.e. seeing two of the same images, either side by side or one above the other).
Fixation disparity is a tendency of the eyes to drift in the direction of the heterophoria. While the heterophoria refers to a fusion-free vergence state, the fixation disparity refers to a small misalignment of the visual axes when both eyes are open in an observer with normal fusion and binocular vision. [1]
Ophthalmoplegia (the inability or difficulty to move the eye) is usually symmetrical, therefore, patients are not affected by diplopia (double vision). The progressive ophthalmoplegia is often unnoticed till decreased ocular motility limits peripheral vision. Often someone else will point out the ocular disturbance to the patient.
Management of residual symptoms. Depending on the severity of symptoms, various treatment options are available to people with persistent ophthalmoplegia. For mild conditions, prism glasses can be prescribed to correct specific types of double vision.
Different kinds of aberrations may have equal RMS across the pupil but have different effects on vision, therefore, RMS error is unrelated to visual performance. The majority of eyes have total RMS values less than 0.3 μm.
Incorrect vergence response can cause double vision. Accommodation is the eye’s focusing mechanism and it is engaged to produce a sharp image on a retina. Both of these mechanisms are neurally linked forming the accommodation-convergence reflex [1] of eyes.
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