Prism use in adult diplopia.
OBJECTIVE
Prismatic correction to restore binocularity in adult diplopia can be challenging. This review summarizes the results of prismatic correction in adults based on the cause of diplopia.


RESULTS
Satisfaction with prismatic correction is achieved in approximately 80% of all adult patients with diplopia when combining the causes. Of patients with vertical diplopia, skew deviation and fourth nerve palsy have the highest satisfaction rates, 100 and 92%, respectively. Patients with thyroid eye disease and orbital blowout fractures associated with diplopia had the lowest satisfaction rates, 55 and 8%, respectively. With regard to horizontal deviations, patients with decompensated childhood strabismus with a combination of horizontal and vertical deviations and patients with convergence insufficiency had the lowest satisfaction rates, 71 and 50%, respectively.


CONCLUSIONS
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.
Department of Pediatric Ophthalmology, Wills Eye Institute, Philadelphia, Pennsylvania 19107, USA. kbgunton@comcast.net
Kammi B
KB
Gunton
Aʼsha
A
Brown
D000328:Adult; D004172:Diplopia / Q000503:physiopathology / Q000628:therapy*; D005139:Eyeglasses; D006801:Humans; D055095:Optics and Photonics; D015348:Vision, Binocular / Q000502:physiology