Prisms in the treatment of diplopia with strabismus of various etiologies

Purpose: We aimed to study the success of prism in regard to diplopia resolution score and associated factors in patients presenting with symptomatic diplopia arising from various etiologies. Methods: In this descriptive, retrospective study diplopia resolution among 31 patients who were prescribed prism were analyzed. Results: Fifty?four patients were evaluated for diplopia and 31 were included for the study done over 3 years. The mean follow?up was 15 months. Esotropia, exotropia, and hypertropia were seen in 39%, 51%, and 19.4% of patients, respectively. Furthermore, 71% received Fresnel prism and 29% were given ground glass prism. The mean prism power prescribed was 13.3 PD. 87% had complete resolution of diplopia; 96.8% continued usage of prism. High success rates were seen among patients with decompensated strabismus, sixth and fourth nerve palsy. Horizontal prism and oblique prism in the form of Fresnel prism yielded complete resolution of diplopia (P = 0.028). There was no association between the success of prism and etiology (P 0.058), history of trauma (P = 0.212), and type of deviation (P = 0.387). The study showed that oblique Fresnel prism can be considered for combined deviation. Conclusion: Our study showed prism to be effective in alleviating diplopia over a varied range of etiologies

Effect of fresnel press-on prisms combined with mental image network training on binocular visual function of the postoperative concomitant strabismus / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To discuss the effect of fresnel press-on prisms combined with mental image network training on binocular visual function recovery of the postoperative concomitant strabismus(CS). <p>METHODS: Totally 120 postoperative children with CS were selected from January 2015 to January 2018 in our hospital. According to the random digital table method, they were divided into the combination group and the prism group, 60 cases in each group, the prism group was given fresnel press-on prisms treatment, the combination group was given mental image network training on the basis, the visual function recovery of the two groups was compared. <p>RESULTS: After 6mo treatment, binocular visual machine visual function and Titmus near stereopsis visual function in both groups were significantly higher than before, and the binocular visual machine visual function and Titmus near stereopsis visual function in the combination group were significantly higher than those in the single press group, the difference was statistically significant(all <i>P</i><0.05). The long distance fusion function normal rates in the combination group and the prism group were significantly higher than those before treatment, the long distance fusion function normal rate in the combination group was significantly higher than that in the prism press group, the difference was statistically significant(93.3% <i>vs</i> 70.0%, <i>P</i><0.05). <p>CONCLUSION: Fresnel press-on prisms combined with mental image network training can effectively promote the binocular visual function recovery of the postoperative children with CS, which is worth for further clinical promotion.

Insuficiencia de convergencia: opciones terapéuticas en dos féminas / Convergence inadequacy: therapeutic options in two women

Se presentan 2 casos clínicos de féminas de 49 y 25 años, que acudieron a la consulta de Optometría en la Facultad de Enfermería y Tecnología de la Salud "Dr. Juan Manuel Páez Inchausti" de Santiago de Cuba, por presentar marcado cansancio visual durante el trabajo prolongado e intolerancia a la nueva corrección óptica. Se efectuó una evaluación optométrica integral, que mostró en ambos casos una insuficiencia de convergencia. Por las características de las pacientes, se decidió indicar prisma inducido por descentración del centro óptico en la que presentaba presbicia, y continuar la adaptación de la nueva corrección óptica, además de ejercicios de convergencia, en la afectada más joven. Con estos procedimientos se eliminaron los síntomas en ellas.

Two case reports of 49 and 25 years women are presented that went to the Optometry Service of "Dr. Juan Manuel Páez Inchausti" Nursing and Health Technology Faculty in Santiago de Cuba, due to a marked visual fatigue during the lingering work and intolerance to the new optic correction. A comprehensive optometric evaluation was made that showed in both cases a convergence inadequacy. Due to the characteristics of the patients, it was decided to indicate prism induced by unfocused optic center in the one presenting presbyopia, and to continue the adaptation of the new optic correction, besides convergence exercises, in the younger affected patient. With these procedures the symptoms were eliminated in them.

Variantes terapéuticas del estrabismo restrictivo / Therapeutic variants of restricted strabismus

INTRODUCCIÓN: El estrabismo restrictivo es la secuela más frecuente de la orbitopatía tiroidea. Ocurre por el desplazamiento de los músculos hacia los senos perinasales. El objetivo de este trabajo fue determinar la terapéutica más eficaz para eliminar la diplopia en posición primaria de mirada y de lectura. MÉTODOS: Se realizó un estudio descriptivo, prospectivo y longitudinal a 15 pacientes con estrabismo restrictivo, en el período comprendido de mayo de 2006 a febrero de 2007. RESULTADOS: Con el uso de prismas se resolvió la diplopia en el 67 por ciento de los casos. En el 20 por ciento fue con cirugía y en el resto con la combinación de ambos tratamientos, lo cual representó el 93 por ciento de efectividad terapéutica. En uno de los casos con estrabismo posterior a la cirugía descompresiva orbitaria no se pudo eliminar la diplopia. DISCUSIÓN: Los investigadores consultados coinciden en que esta entidad predomina en el sexo femenino. La mayoría de los pacientes con estrabismo restrictivo ligero y moderado resuelven la diplopia con la utilización de prismas. CONCLUSIONES: El uso de prismas es la terapéutica más utilizada y efectiva. El estrabismo posterior a la cirugía descompresiva evoluciona peor que en los no operados previamente.

INTRODUCTION: Restricted strabismus is the most common sequelae of thyroid-related orbitopathy. This occurs when the muscles are displaced into the perinasal sinuses. The objective of this paper was to determine the most effective therapy to eliminate diplopia in primary look and reading positions. METHODS: A longitudinal prospective and descriptive study was conducted in 15 patients with restricted strabismus, from May 2006 to February 2007. RESULTS: the use of prisms solved diplopia in 67 percent of cases; surgery eliminated this problem in 20 percent of cases whereas the rest was corrected with the combination of both methods, reaching 93 percent of therapeutic effectiveness. Diplopia did not disappear in one of the cases with strabismus after decompressive orbital surgery. DISCUSSION: The interviewed researchers agreed that this entity prevailed in the female sex. Most of the patients with mild and moderate restrictive strabismus solved their diplopia with the use of prisms. CONCLUSIONS: The use of prisms is the most effective treatment. The evolution of strabismus after decompressive surgery was worse than before the operation.

Prismas inducidos por descentraciones ópticasen los lentes de venta libre con el referente delentes oftálmicos y evaluación del confort visualen pacientes présbitas mayores de 40 años / Prisms induced by optical descentrations in the lenses of free sale with reference of ophthalmic lenses and evaluation of the visual comfort in presbyope patients over 40 years

Objetivo: determinar la distancia entre los centros ópticos de los lentes de venta libre con el referente de lentes oftálmicos y evaluar el confort visual.Materiales y métodos: 50 pacientes présbitas usuariosde corrección únicamente para visión próxima. A cada paciente se le realizó un examen optométrico inicial y se le prescribieron inicialmente lentes de venta libre o lupas magnificadoras y posteriormente lentes oftálmicos prescritos. A los 15 días de usar las lupas magnificadoras y al tiempo de usar los lentes oftálmicos de calidad óptica conocida, se realizó un control en el que se otorgó al paciente una encuesta para diligenciar de acuerdo a su experiencia con el tiempo de uso de las lupas y los lentes oftálmicos, con el fin de analizar y comparar posibles síntomas al usar las dos formas de corrección visual y explicandola razón por la cual el paciente tiene dificultades en la adaptación de su prescripción óptica. A todos los lentes se midió el poder, los centros ópticos y a la vez las descentraciones ópticas que generan prismas inducidos en cada uno de los lentes. Se compararon entre sí y con la encuesta para determinar cuál de estos produjo mayor inconfort visual y astenopía.Resultados: se encontró, al comparar las descentracionesy prismas inducidos entre los dos tipos de lentes, una diferencia estadísticamente significativa (p < 0.05) para prisma base externa y prisma base inferior. No se encontraron diferencias estadísticas para prisma base interna entre los grupos comparados.Conclusiones: En este estudio se ratifica que el uso de los lentes de venta libre no cubre de la misma manera la necesidad visual de cada paciente, de dondenace la diferente sintomatología e intolerancia a dichos lentes.

Objectives:Materials and Methods: 50 patients présbitas users only for vision correction next. Each patient is carried out an initial examination optometrists and prescribedinitially lenses or magnifying glasses Magnificoand then prescribed ophthalmic lenses. After 15 days of using the magnificent and magnifying glasses at the time using the optical quality of ophthalmic lenses known, took place controls where the patient was given a survey that diligence according to their experience with the usage time of magnifying glasses and ophthalmic lenses, in order to analyze and comparepossible symptoms when using the two forms of visual correction and explaining why the patient has difficulty in adapting their prescription optics. All lenses were measured power, optical centers and turn off the lenses that generate prisms induced in each of the lenses. Were compared with each other and with the survey to determine which of these visualand produced more uncomfortable astenopia.Results: we found a statistically significant differencewhen comparing the prisms off and induced betweenthe two types of lenses.Conclusions: this study confirms that the use of nonprescription lenses do not cover the same way the visual need of each patient and hence arises the different symptoms and intolerance to such lenses.

Prismoterapia en el preoperatorio de las exotropias intermitentes y su efecto en el post operatorio en niños entre 2 Y 11 años de edad / Prims therapy in the pre-operative results of the intermittent exotropies and its effect on the postoperative results in children between 2 and 11 years old

El propósito del estudio fue comparar la influencia de la prismoterapia en el resultado post operatorio de las exotropias intermitentes con seguimiento de un año. Se realizó un estudio prospectivo en 28 niños de 2 a 11 años de edad, examinados en el Departamento de Oftalmología de la Clínica Colsubsidio durante un año, con exotropias intermitentes primarias entre 20 y 40 dioptrías prismáticas. Como criterio de inclusión se tuvo en cuenta, la edad, el ángulo de la desviación y la presencia de exotropias intermitentes primarias. La muestra fue distribuida aleatoriamente en dos grupos, uno de los cuales fue prismado con prismas de Fresnel por 4 semanas, previas a la cirugía simétrica del estrabismo mientras el otro grupo no. Se evaluó el resultado postoperatorio en los dos grupos y se tuvo en cuenta la probabilidad de reintervenciones quirúrgicas. Los resultados clínicos fueron mejores en el grupo prismado, en cuanto a ángulo residual postoperatorio y a la respuesta de estereopsis. La posibilidad de reintervenciones fue menor en el grupo prismado. Estadísticamente no hubo una diferencia significativa en la respuesta de ambos grupos.

The purpose of this study was to compare theinfluence of prism therapy in the postoperativeresults of the intermittent exotropies with a year offollowing. Methods: a prospective study was carriedout to 28 children between 2 and 11 years old withprimary intermittent exotropies between 20 and 40prismatic diopters. Those children were examinedin the department of ophthalmology of the clinicaColsubsidio. Age, the angle of deviation, and thepresence of primary intermittent exotropies werethe eligibility criteria. The sample was randomlydistributed in two groups; the first one was treatedwith Fresnel prism for 4 weeks, before the symmetricsurgery of strabismus, while the second one did not.The post operative result was evaluated in both groupsand the probability of future surgical operations wastaken into account. Clinic results were better in thegroup treated with prism regarding postoperativeresidual angle and the response to stereopsis. Thepossibility of future surgical operations was lowerin this group. Statistically there were no significantdifferences in both groups response.