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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.
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]
The base is the thickest part of the lens and is opposite from the apex. Light will be bent towards the base and the image will be shifted towards the apex. In an eyeglass prescription, the base is typically specified as up, down, in, or out, but left and right are also used sometimes.
Base-out prism reading, stereogram cards, computerized training programs are used to improve fusional vergence. The wearing of convex lenses. The wearing of concave lenses. "Cawthorne Cooksey Exercises" also employ various eye exercises, however, these are designed to alleviate vestibular disorders, such as dizziness, rather than eye problems.
When measuring horizontal fusion ranges, base in prisms assess fusional divergence while base out prisms assess fusional convergence. The vertical fusional vergence amplitude can also be measured with base up and base down prisms although the horizontal PFR is typically the main focus when testing.
Equipment used in Maddox rod testing. Top left (Maddox rod), top right (vertical base up and base down prisms), bottom left (pen torch) and bottom right (horizontal base out or in prisms) Maddox rod; Light source at near (33 cm) and at distance (6m) Base in, base out, base up, base down prisms; Trial frames; Indication of use