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Four prism dioptre reflex test. Purpose. assess alignment of both eyes. 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. [1]
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.
measuring strabismus. 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]
The inability of an eye to turn outward, results in a convergent strabismus or esotropia of which the primary symptom is diplopia (commonly known as double vision) in which the two images appear side-by-side. Thus, the diplopia is horizontal and worse in the distance.
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).
Esotropia is a form of strabismus in which one or both eyes turn inward. The condition can be constantly present, or occur intermittently, and can give the affected individual a "cross-eyed" appearance. [1]
In a person with normal ocular alignment the light reflex lies slightly nasal from the center of the cornea (approximately 11 prism diopters—or 0.5mm from the pupillary axis), as a result of the cornea acting as a temporally-turned convex mirror to the observer.
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.
Esotropia. In an Esotropic (ET) deviation, the patient will experience uncrossed diplopia. When questioned about the position of the lights, they will report that: They see 5 lights, 2 red and 3 green; The lights are horizontally displaced, seen side by side; The 2 red lights from the right eye are seen on the right side
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.