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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.
Either BASE IN for an exodeviation (eye turned out), BASE OUT for an esodeviation (eye turned in), BASE UP for a hypodeviation (eye turned down) or BASE DOWN for a hyperdeviation (eye turned up). Steps: 1. The patient should be measured in primary position first and then in any other positions of gaze of concern.
If the patient saw a red line to the right and white light to the left, they are said to have esotropia or esophoria (uncrossed diplopia) in which base out (BO) prisms of increasing strength are used until the lines are superimposed.
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".
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.
Dissociated vertical deviation (DVD) is an eye condition which occurs in association with a squint, typically infantile esotropia. The exact cause is unknown, although it is logical to assume it is from faulty innervation of eye muscles.
Suppression of an eye is a subconscious adaptation by a person's brain to eliminate the symptoms of disorders of binocular vision such as strabismus, convergence insufficiency and aniseikonia. The brain can eliminate double vision by ignoring all or part of the image of one of the eyes.
If test prisms with increasing amount are placed in front of the observer’s eyes, the fixation disparity changes in the eso direction with base-in prisms and in the exo direction with base-out prisms (Fig. 3). These prisms force the eyes to change the vergence angle while the viewing distance remains unchanged.
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.
Spherical lenses and miotic eye drops can provide relief in some types of horizontal strabismus by biasing the neural link between convergence (orienting the lines of sight for near objects) and accommodation (focusing), and prism lenses can relieve diplopia (double vision) by refracting the visual axis, [unreliable medical source] [unreliable ...