Prism use in adult diplopia

Gunton, Kammi B.; Brown, A.

doi:10.1097/icu.0b013e3283567276

Cited by 28 publications

(6 citation statements)

References 16 publications

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“…The current standard treatment for amblyopia is to provide a period of refractive correction (Cotter et al, 2012), then to use occlusion (eye patching) or penalization (blurring eye drops) therapies that temporarily impair vision in the fellow eye and force the use of the amblyopic eye (for review, see Clarke, 2010). Strabismus may be treated surgically (Mets et al, 2004), with prism correction (Gunton and Brown, 2012), or with vision therapy (Scheiman et al, 2011; for review, see Rutstein et al, 2012). However, these treatments for amblyopia (Woodruff et al, 1994a; Pediatric Eye Disease Investigator Group, 2003; Fresina and Campos, 2014) and strabismus (Fresina and Campos, 2014) rarely restore normal binocular vision.…”

Section: Introductionmentioning

confidence: 99%

Binocular Summation and Suppression of Contrast Sensitivity in Strabismus, Fusion and Amblyopia

Dörr

Kwon

Lesmes

et al. 2019

Front. Hum. Neurosci.

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Purpose : Amblyopia and strabismus affect 2%–5% of the population and cause a broad range of visual deficits. The response to treatment is generally assessed using visual acuity, which is an insensitive measure of visual function and may, therefore, underestimate binocular vision gains in these patients. On the other hand, the contrast sensitivity function (CSF) generally takes longer to assess than visual acuity, but it is better correlated with improvement in a range of visual tasks and, notably, with improvements in binocular vision. The present study aims to assess monocular and binocular CSFs in amblyopia and strabismus patients. Methods : Both monocular CSFs and the binocular CSF were assessed for subjects with amblyopia ( n = 11), strabismus without amblyopia ( n = 20), and normally sighted controls ( n = 24) using a tablet-based implementation of the quick CSF, which can assess a full CSF in <3 min. Binocular summation was evaluated against a baseline model of simple probability summation. Results : The CSF of amblyopic eyes was impaired at mid-to-high spatial frequencies compared to fellow eyes, strabismic eyes without amblyopia, and control eyes. Binocular contrast summation exceeded probability summation in controls, but not in subjects with amblyopia (with or without strabismus) or strabismus without amblyopia who were able to fuse at the test distance. Binocular summation was less than probability summation in strabismic subjects who were unable to fuse. Conclusions : We conclude that monocular and binocular contrast sensitivity deficits define important characteristics of amblyopia and strabismus that are not captured by visual acuity alone and can be measured efficiently using the quick CSF.

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Section: Introductionmentioning

confidence: 99%

Binocular Summation and Suppression of Contrast Sensitivity in Strabismus, Fusion and Amblyopia

Dörr

Kwon

Lesmes

et al. 2019

Front. Hum. Neurosci.

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“…To the best of our knowledge, no previous study of prismatic correction aimed at eliminating esotropia in a step-by-step manner to reduce the prismatic strength in patients with AACE has been conducted. Given increased optical aberrations, loss of contrast, and light scatter in larger Fresnel prisms (> 12PD) [ 30 ], the subjects included in this study were patients with AACE of 25 PD or less. Besides, the prisms ≤ 10 PD were pressed on the refractive lens of the dominant eye, and the prisms > 10 PD were distributed onto the lenses of both eyes in the present srtudy.…”

Section: Discussionmentioning

confidence: 99%

Prismatic treatment of acute acquired concomitant esotropia of 25 prism diopters or less

Feng

et al. 2022

BMC Ophthalmol

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Background This study aimed to assess the efficacy of prismatic treatment in a step-by-step manner to reduce prismatic strength in acute acquired concomitant esotropia (AACE) of 25 prism diopters (PD) or less. Methods In this retrospective comparative study, 36 patients with AACE with deviation angle ≤ 25 PD were treated with Fresnel prism in a step-by-step manner to reduce prismatic strength. The patients were divided into two groups according to whether they regained orthophoria and were weaned off the press-on prisms within 1 year: (1) the treatment-success group, which consisted of patients who had their esotropia eliminated and were weaned off the press-on prisms within 1 year after prism correction, and (2) the treatment-continuing group, which comprised patients who needed to continue wearing a Fresnel prism at 1 year after the beginning of prismatic correction because diplopia and esotropia still existed. Clinical characteristics and cooperation were analyzed and compared between groups. Results Fourteen of 36 patients (38.9%) were weaned off the prism and regained orthophoria and binocular single vision within 1 year after prismatic treatment. Compared with the treatment-continuing group, the treatment-success group showed smaller deviation at near and distant fixations (P = 0.024 and P = 0.006, respectively) measured at the beginning of prismatic correction, a shorter time from onset to prismatic treatment (P = 0.02), and a greater percentage of patients exhibiting good cooperation (P < 0.001). Conclusions Prismatic treatment in a step-by-step manner to reduce prismatic strength can lead to good outcomes of motor alignment and binocular function in patients with AACE of 25 PD or less. Patients showing good cooperation, smaller angle of esotropia, and shorter duration from onset to treatment tend to eliminate esotropia and be weaned off press-on prisms within 1 year after prismatic correction.

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“…Hirnnerven sowie Strabismus im Zusammenhang mit einer endokrinen Orbitopathie in aufsteigender Reihenfolge angegeben [3]. Andererseits scheint die Verordnung von Fresnel-Prismen sinnvoll, insbesondere in Situationen mit häufig nur zeitlich begrenzter Diplopie wie bei mikrovaskulär verursachten Abduzens-und Okulomotoriusparesen [2].…”

Section: Hintergrundunclassified

Prismen zur Blickverlagerung und Schielkorrektur bei Augenmotilitätsstörungen und Kopfzwangshaltung

Eppenberger

DiTaranto

Bücheler

et al. 2021

Klin Monbl Augenheilkd

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Zusammenfassung Hintergrund Das therapeutische Management von Motilitätseinschränkungen und begleitender Kopfzwangshaltung (KZH) stellt oft eine Herausforderung dar. Wir berichten über unsere Erfahrungen mit der Prismenapplikation. Patienten und Methoden Retrospektive Fallserie von 3 Patienten mit Augenmotilitätsstörungen und begleitender KZH, bei denen eine Behandlung mittels Prismenkorrektur erfolgte. Ergebnisse Ein 37-jähriger Mann mit traumatischer Okulomotoriusparese links mit leichter residueller Senkungseinschränkung und deutlicher Hebungseinschränkung zeigte nach Prismenausgleich der Hypotropie links (OS: 10^ Basis oben) ein Feld binokularen Einfachsehens (BES-Feld) nur im Abblick. Erst unter zusätzlicher Vorgabe von beidseits 10^ Basis oben gelang eine Verlagerung des BES-Feldes in die Primärposition. Ein 45-jähriger Mann mit Parinaud-Syndrom infolge eines Schädel-Hirn-Traumas und beidseitiger Hebungseinschränkung beklagte erhebliche Nackenbeschwerden bei ausgeprägter Kinnhebung. Zudem bestand bei Amaurose rechts eine sekundäre Exotropie. Unter Vorgabe von OS: 8^ Basis oben war der Patient bei Aufgabe der KZH auch subjektiv beschwerdefrei. Bei einer 69-jährigen Frau mit Abduzensparese links bestand eine Kompensation der Schielabweichung nur im äußersten Rechtsblick unter Einnahme einer ausgeprägten Linksdrehung von 20°. Mit OS: 20^ Basis temporal resultierte Doppelbildfreiheit ohne KZH in Primärposition. Schlussfolgerung Neben der Schielkorrektur kann auch die Blickverlagerung durch Prismen in verschiedenen klinischen Konstellationen therapeutisch hilfreich sein. Zur Reduktion der KZH erfolgt die prismeninduzierte Blickverlagerung prinzipiell in Richtung des Motilitätsdefizits.

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Prism use in adult diplopia

Abstract: Careful selection of patients for prismatic correction, management of patient's expectations, and continued follow-up to monitor the symptoms are critical to the successful use of prisms.

Cited by 28 publications

References 16 publications

Binocular Summation and Suppression of Contrast Sensitivity in Strabismus, Fusion and Amblyopia

Binocular Summation and Suppression of Contrast Sensitivity in Strabismus, Fusion and Amblyopia

Prismatic treatment of acute acquired concomitant esotropia of 25 prism diopters or less

Prismen zur Blickverlagerung und Schielkorrektur bei Augenmotilitätsstörungen und Kopfzwangshaltung

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