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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.
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]
If the patient saw a red line to the left and white light to the right, they are said to have exotropia or exophoria (crossed diplopia) in which base in (BI) prisms of increasing strength are used until the lines are superimposed. [5] Maddox rod test tutorial. Method for measuring vertical deviations:
When this muscle's function is diminished due to a fourth cranial nerve ( CN IV) palsy, the affected eye will extort, deviate upward ( hypertropia ), and, to a smaller extent, drift inward.
Prism correction. Prism lenses (here unusually thick) are used for pre-operative prism adaptation. Eye care professionals use prism correction as a component of some eyeglass prescriptions. A lens which includes some amount of prism correction will displace the viewed image horizontally, vertically, or a combination of both directions.
Bagolini Striated Glasses. Pen torch or a distant light source. Alternatively, trial frames and lenses or a lorgnette can be used. In some cases, the use of prisms is necessary to measure a deviation and test for the presence of binocular functions.
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.
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.
Heterophoria is an eye condition in which the directions that the eyes are pointing at rest position, when not performing binocular fusion, are not the same as each other, or, "not straight".
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.