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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. [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]
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.
Bagolini striated glasses test, or BSGT, is a subjective clinical test to detect the presence or extent of binocular functions and is generally performed by an optometrist or orthoptist or ophthalmologist (medical/surgical eye doctor). It is mainly used in strabismus clinics.
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.
Diplopia with normal binocular function is treated with prism glasses, botulinum injections into the muscles, or repeated surgery. If binocular function is not normal, a more individualized approach is necessary to best suit the patient's needs.