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While there was not enough high-quality evidence to recommend the best surgical treatment, all four types of surgery did result in a reduction of hypertropia. [7]
Surgical correction. Surgical correction of the hypertropia is desired to achieve binocularity, manage diplopia and/or correct the cosmetic defect. Steps to achieve the same depend on mechanism of the hypertropia and identification of the offending muscles causing the misalignment.
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]
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.
If the patient saw a red line to the left and white light to the right, they are said to have exotropia or exophoria (crossed diplopia) in which base in (BI) prisms of increasing strength are used until the lines are superimposed. [5] Maddox rod test tutorial. Method for measuring vertical deviations:
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.
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It is mainly used in strabismus clinics. Through this test, suppression, microtropia, diplopia and manifest deviations can be noted. However this test should always be used in conjunction with other clinical tests, such as Worth 4 dot test, Cover test, Prism cover test and Maddox rod to come to a diagnosis.
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.
Cyclotropia cannot be corrected with prism spectacles in the way other eye position disorders are corrected. [12] (Nonetheless two Dove prisms can be employed to rotate the visual field in experimental settings.)