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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.
Sixth nerve palsy, or abducens nerve palsy, is a disorder associated with dysfunction of cranial nerve VI (the abducens nerve ), which is responsible for causing contraction of the lateral rectus muscle to abduct (i.e., turn out) the eye. [1] The inability of an eye to turn outward, results in a convergent strabismus or esotropia of which the ...
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".
The treatment may need to be repeated three to four months later once the paralysis wears off. Common side effects are double vision, droopy eyelid, overcorrection, and no effect. The side effects typically resolve also within three to four months.
Side effects. The most common side effects are droopy eyelids and over- or undercorrections; a further common side effects are diplopia and inadvertent vertical deviation (hypo- or hypertropia). The side effects typically resolve in 3–4 months.
The management of strabismus may include the use of drugs or surgery to correct the strabismus. Agents used include paralytic agents such as botox used on extraocular muscles, [1] topical autonomic nervous system agents to alter the refractive index in the eyes, and agents that act in the central nervous system to correct amblyopia. [2]
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]
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]
- BD: base down prisms - BU: base up prisms - BO: base out prisms - BI: base in prisms - eso: esotropia - exo: exotropias - L/R: left hypertropia or right hypotropia - R/L: right hypertropia or left hypotropia Double Maddox rod test. The double Maddox rod test can also be used to assess torsion and measure cyclotropias.
Efforts must first be made to identify and treat the underlying cause of the problem. Treatment options include eye exercises, wearing an eye patch on alternative eyes, prism correction, and in more extreme situations, surgery or botulinum toxin.