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Correction of refractive errors by glasses; Prism therapy (if tolerated, to manage diplopia) Vision Therapy; Patching (mainly to manage amblyopia in children and diplopia in adults) Botulinum toxin injection; Surgical correction; Surgical correction of the hypertropia is desired to achieve binocularity, manage diplopia and/or correct the ...
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. [1] It is used by ophthalmologists and orthoptists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. [1]
Prism dioptres. Prism correction is commonly specified in prism dioptres, a unit of angular measurement that is loosely related to the dioptre. Prism dioptres are represented by the Greek symbol delta (Δ) in superscript. A prism of power 1 Δ would produce 1 unit of displacement for an object held 100 units from the prism. [2]
Esotropia (eyes crossed); exotropia (eyes diverge); hypertropia (eyes vertically misaligned) Causes: Muscle dysfunction, farsightedness, problems in the brain, trauma, infections: Risk factors: Premature birth, cerebral palsy, family history: Diagnostic method: Observing light reflected from the pupil: Differential diagnosis
Esotropias measuring more than 15 prism diopters (PD) and exotropias more than 20 PD that have not responded to refractive correction can be considered candidates for surgery. Techniques Disinserting the medial rectus muscle. The goal of strabismus surgery is to correct misalignment of the eyes.
When this muscle's function is diminished due to a fourth cranial nerve ( CN IV) palsy, the affected eye will extort, deviate upward ( hypertropia ), and, to a smaller extent, drift inward.
Hypertropia/Hypotropia. In a patient with an unsuppressed vertical deviation, one line will appear higher than the other. If the image of the right eye is higher than that of the left, this means the right eye is lower than the left. This could be either a right hypotropia or a left hypertropia. Harmonious Abnormal retinal correspondence
For an abnormal result, based on where the light lands on the cornea, the examiner can detect if there is an exotropia (abnormal eye is turned out), esotropia (abnormal eye is turned in), hypertropia (abnormal eye higher than the normal one) or hypotropia (abnormal eye is lower than the normal one).
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
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.