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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]
The Maddox rod test can be used to subjectively detect and measure a latent, manifest, horizontal or vertical strabismus for near and distance. The test is based on the principle of diplopic projection.
For an abnormal result, based on where the light lands on the cornea, the examiner can detect if there is an exotropia (abnormal eye is turned out), esotropia (abnormal eye is turned in), hypertropia (abnormal eye higher than the normal one) or hypotropia (abnormal eye is lower than the normal one).
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.
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. [5] Techniques [ edit ]
Step 1: Determine which eye is hypertropic in primary position. If there is right hypertropia in primary position, then the depressors of the R eye (IR/SO) or the elevators of the L eye are weak (SR/IO). Step 2: Determine whether the hypertropia increases on right or left gaze.
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.
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.
Prism correction is measured in prism dioptres. A prescription that specifies prism correction will also specify the "base". 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.
Based on prism-FD curves (Fig. 3b), one can find the aligning prism sP 0 that nullifies the naturally prevailing fixation disparity sFD 0. This test procedure is typically made in near vision of 40 cm, e.g. with the Mallett-unit, the Disparometer, or the Wesson card (see above).