Effectiveness of Base in Prism for Presbyopes with Convergence Insufficiency

Teitelbaum, Bruce; Pang, Yi; Krall, Joseph

doi:10.1097/opx.0b013e318194e985

Cited by 35 publications

(56 citation statements)

References 14 publications

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“…One study randomized presbyopic patients with convergence insufficiency to glasses with base-in prism correction or presbyopic correction alone. This study revealed a greater improvement in convergence insufficiency survey scores in patients with prism [21].…”

Section: Convergence Insufficiencymentioning

confidence: 72%

Prism use in adult diplopia

Gunton

Brown

2012

Current Opinion in Ophthalmology

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Section: Convergence Insufficiencymentioning

confidence: 72%

Prism use in adult diplopia

Gunton

Brown

2012

Current Opinion in Ophthalmology

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“…bases in opposing directions, e.g. base-in prisms) can assist the patient with a binocular vision anomaly, such as a convergence insufficiency which is a common problem in those with traumatic brain injury (TBI) [5,6], functioning in a compensatory manner. In contrast, 'yoked prisms' (i.e.…”

Section: Introductionmentioning

confidence: 99%

Use of yoked prisms in patients with acquired brain injury: A retrospective analysis

2014

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“…2 Convergence insufficiency in adults has a peak incidence in the eighth decade of life, 3 and commonly exists without any association of ocular or neurological disorders, but can be associated with head trauma, neurodegenerative diseases, cerebral ischemia, thyroid ophthalmopathy, myasthenia gravis, toxic agents or medications, infection, inflammation or decompression sickness. 4 Management options for convergence insufficiency include base-in prisms, 5,6 convergence exercises, 7 psychotherapy, or even surgery. 8,9,10 If surgery is performed, procedures include either recessions of the lateral rectus muscles, or resections of the medial recti muscles with or without slanting, but the surgical success rates varied from 18–92%.…”

Section: Introductionmentioning

confidence: 99%

Sustained improvement of reading symptoms following botulinum toxin A injection for convergence insufficiency

Saunte

Holmes

2014

Strabismus

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Introduction We evaluated the use of botulinum toxin A in adults with convergence insufficiency in whom prior treatment had failed. Methods We studied 8 patients (median age 36 years, range 17 to 77 years) with reading symptoms due to convergence insufficiency defined as an exodeviation greater at near, not exceeding 10 PD in the distance measured by prism and alternate cover test, and either convergence near point >6 cm or reduced fusional amplitudes. All patients were still symptomatic after prior treatment by convergence exercises (n = 8), base-in prism glasses (n = 5) or strabismus surgery (n = 2). Five patients received injection of 5 IU botulinum toxin in 0.1 ml saline to one lateral rectus muscle, two received 2.5 IU, and one received 2.5 IU to both lateral rectus muscles. Results At 1 month post injection, all patients had an initial reduction of exodeviation from baseline (median 9 PD, p = 0.008) at near, although 2 patients had a temporary intermittent esotropia in the distance with diplopia associated with difficulty driving. At 6 months, when the pharmacological effect of botulinum toxin had completely worn off, patients still maintained a small reduction of exodeviation (median 4 PD, p = 0.3) at near. Reading symptoms improved in 7 of 8 patients at 1-month post injection, and in all patients at 6 months. Two patients had health-related quality of life assessed with the Adult Strabismus 20 Questionnaire, showing improved Reading Function scores at 6 months. Interestingly, 3 patients reported improved reading despite returning to the baseline angle at 6 months, and 2 of 4 with 12-month follow-up still reported improvement. Conclusions In adult convergence insufficiency, botulinum toxin injection to a lateral rectus muscle improves reading symptoms beyond the duration of the pure pharmacological effect. Botulinum toxin injection may be useful in management of adult convergence insufficiency, although repeat injections may be needed.

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Effectiveness of Base in Prism for Presbyopes with Convergence Insufficiency

Abstract: The progressive addition glasses with BI-prism were found to be effective in alleviating symptoms of presbyopes with symptomatic CI.

Cited by 35 publications

References 14 publications

Prism use in adult diplopia

Prism use in adult diplopia

Use of yoked prisms in patients with acquired brain injury: A retrospective analysis

Sustained improvement of reading symptoms following botulinum toxin A injection for convergence insufficiency

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