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Incomitant strabismus cannot be fully corrected by prism glasses, because the eyes would require different degrees of prismatic correction dependent on the direction of the gaze.
Today, the injection of botulinum toxin into the muscles that surround the eyes is one of the available options in the management of strabismus. Other options for strabismus management are vision therapy and occlusion therapy, corrective glasses (or contact lenses) and prism glasses, and strabismus surgery.
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. It is used by ophthalmologists and orthoptists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. [1]
Treatment of the double vision depends on both the type of double vision and the ability of two eyes to work together, also called binocular function. Diplopia with normal binocular function is treated with prism glasses, botulinum injections into the muscles, or repeated surgery.
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.
In young children with any form of strabismus, the brain may learn to ignore the misaligned eye's image and see only the image from the best-seeing eye. This is called amblyopia , or lazy eye, and results in a loss of binocular vision, impairing depth perception.
Only about 20% of children with hyperopia greater than +3.5 diopters develop strabismus. Where the esotropia is solely a consequence of uncorrected hyperopic refractive error, providing the child with the correct glasses and ensuring that these are worn all the time, is often enough to control the deviation.
In general, strabismus can be approached and treated with a variety of procedures. Depending on the individual case, treatment options include: 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 ...
The test is indicated with the use of a presence of a prism in individuals with a strabismus and fusion is considered present if 4 lights are maintained, with or without the use of a prism. The W4LT can also be indicated when aiding a person to develop and strengthen their fusional capacities.
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 ...
