Skip to main content

Prescribing Prisms

  • Living reference work entry
  • First Online:
Albert and Jakobiec's Principles and Practice of Ophthalmology

Abstract

Prisms are a noninvasive tool used to manage diplopia in patients, especially when their strabismus is small and comitant. Prisms can be used for horizontal, vertical, or oblique (but not torsional) strabismus. Ground-in prisms provide the best image quality and cosmetic appearance. Fresnel prisms are best for strabismus that is thought to be temporary or for larger deviations.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Similar content being viewed by others

References

  1. Hatt SR, Leske DA, Liebermann L, Holmes JM. Successful treatment of diplopia with prism improves health-related quality of life. Am J Ophthalmol. 2014;157(6):1209–13.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Tamhankar MA, Ying GS, Volpe NJ. Success of prisms in the management of diplopia due to fourth nerve palsy. J Neuroophthalmol. 2011;31(3):206–9.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Veronneau-Troutman S. Fresnel prisms and their effects on visual acuity and binocularity. Trans Am Ophthalmol Soc. 1978;76:610–53.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Jackson JL. Nonsurgical management of diplopia after orbital decompression surgery. Am Orthopt J. 2012;62:29–33.

    Article  PubMed  Google Scholar 

  5. Wylie J, Henderson M, Doyle M, Hickey-Dwyer M. Persistent binocular diplopia following cataract surgery: aetiology and management. Eye (Lond). 1994;8(Pt 5):543–6.

    Article  Google Scholar 

  6. MacDonald IM, Reed GF, Wakeman BJ. Strabismus after regional anesthesia for cataract surgery. Can J Ophthalmol. 2004;39(3):267–71.

    Article  PubMed  Google Scholar 

  7. Woo GC, Lovasik JV. Fresnel prism correction for trauma-induced diplopia. Ophthalmic Physiol Opt. 1985;5(1):59–62.

    Article  CAS  PubMed  Google Scholar 

  8. Stavis M, Murray M, Jenkins P, Wood R, Brenham B, Jass J. Objective improvement from base-in prisms for reading discomfort associated with mini-convergence insufficiency type exophoria in school children. Binocul Vis Strabismus Q. 2002;17(2):135–42.

    PubMed  Google Scholar 

  9. Flanders M, Sarkis N. Fresnel membrane prisms: clinical experience. Can J Ophthalmol. 1999;34(6):335–40.

    CAS  PubMed  Google Scholar 

  10. Tamhankar MA, Ying GS, Volpe NJ. Prisms are effective in resolving diplopia from incomitant, large, and combined strabismus. Eur J Ophthalmol. 2012;22(6):890–7.

    Article  PubMed  Google Scholar 

  11. Prism Adaptation Study Research Group. Efficacy of prism adaptation in the surgical management of acquired esotropia. Arch Ophthalmol. 1990;108(9):1248–56.

    Article  Google Scholar 

  12. Tamhankar MA, Ying GS, Volpe NJ. Effectiveness of prisms in the management of diplopia in patients due to diverse etiologies. J Pediatr Ophthalmol Strabismus. 2012;49(4):222–8.

    Article  PubMed  Google Scholar 

  13. Godts D, Mathysen DG. Distance esotropia in the elderly. Br J Ophthalmol. 2013;97(11):1415–9.

    Article  PubMed  Google Scholar 

  14. Clark RA. Strabismus: sixth nerve palsy. Knights Templar Eye Foundation, Pediatric Ophthalmology Education, American Academy of Ophthalmology; 2015, October 14. Available from: https://www.aao.org/disease-review/strabismus-sixth-nerve-palsy

  15. Kushner BJ. Conservative management of intermittent exotropia to defer or avoid surgery. J AAPOS. 2019;23(5):256. e1–e6.

    Article  PubMed  Google Scholar 

  16. Scheiman M, Cotter S, Rouse M, Mitchell GL, Kulp M, Cooper J, et al. Randomised clinical trial of the effectiveness of base-in prism reading glasses versus placebo reading glasses for symptomatic convergence insufficiency in children. Br J Ophthalmol. 2005;89(10):1318–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Scheiman M, Gwiazda J, Li T. Non-surgical interventions for convergence insufficiency. Cochrane Database Syst Rev. 2011;3:CD006768.

    Google Scholar 

  18. Barh A, Swaminathan M, Mukherjee B. Orbital fractures in children: clinical features and management outcomes. J AAPOS. 2018;22(6):415. e1–e7.

    Article  PubMed  Google Scholar 

  19. Ceylan OM, Uysal Y, Mutlu FM, Tuncer K, Altinsoy HI. Management of diplopia in patients with blowout fractures. Indian J Ophthalmol. 2011;59(6):461–4.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kushner BJ. Management of diplopia limited to down gaze. Arch Ophthalmol. 1995;113(11):1426–30.

    Article  CAS  PubMed  Google Scholar 

  21. Ehrenberg M, Nihalani BR, Melvin P, Cain CE, Hunter DG, Dagi LR. Goal-determined metrics to assess outcomes of esotropia surgery. J AAPOS. 2014;18(3):211–6.

    Article  PubMed  Google Scholar 

  22. Chang YH, Melvin P, Dagi LR. Goal-determined metrics to assess outcomes of exotropia surgery. J AAPOS. 2015;19(4):304–10.

    Article  PubMed  Google Scholar 

  23. Haller T, Furr BA. Fresnel prism use among orthoptists. Am Orthopt J. 2014;64:71–5.

    Article  PubMed  Google Scholar 

  24. Harrad R. Management of strabismus in thyroid eye disease. Eye (Lond). 2015;29(2):234–7.

    Article  CAS  Google Scholar 

  25. Serra A, Dell’Osso LF, Jacobs JB, Burnstine RA. Combined gaze-angle and vergence variation in infantile nystagmus: two therapies that improve the high-visual-acuity field and methods to measure it. Invest Ophthalmol Vis Sci. 2006;47(6):2451–60.

    Article  PubMed  Google Scholar 

  26. Dell’Osso LF. Development of new treatments for congenital nystagmus. Ann N Y Acad Sci. 2002;956:361–79.

    Article  PubMed  Google Scholar 

  27. Spielmann A. Clinical rationale for manifest congenital nystagmus surgery. J AAPOS. 2000;4(2):67–74.

    Article  CAS  PubMed  Google Scholar 

  28. Smith HJ, Dickinson CM, Cacho I, Reeves BC, Harper RA. A randomized controlled trial to determine the effectiveness of prism spectacles for patients with age-related macular degeneration. Arch Ophthalmol. 2005;123(8):1042–50.

    Article  PubMed  Google Scholar 

  29. Lee AG, Perez AM. Improving awareness of peripheral visual field using sectorial prism. J Am Optom Assoc. 1999;70(10):624–8.

    CAS  PubMed  Google Scholar 

  30. Peli E. Field expansion for homonymous hemianopia by optically induced peripheral exotropia. Optom Vis Sci. 2000;77(9):453–64.

    Article  CAS  PubMed  Google Scholar 

  31. Jung JH, Peli E. No useful field expansion with full-field prisms. Optom Vis Sci. 2018;95(9):805–13.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Bowers AR, Keeney K, Peli E. Randomized crossover clinical trial of real and sham peripheral prism glasses for hemianopia. JAMA Ophthalmol. 2014;132(2):214–22.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Pollock A, Hazelton C, Rowe FJ, Jonuscheit S, Kernohan A, Angilley J, et al. Interventions for visual field defects in people with stroke. Cochrane Database Syst Rev. 2019;5:CD008388.

    PubMed  Google Scholar 

  34. Hatt SR, Leske DA, Klaehn LD, Kramer AM, Iezzi R Jr, Holmes JM. Treatment for central-peripheral rivalry-type diplopia (“Dragged-Fovea Diplopia Syndrome”). Am J Ophthalmol. 2019;208:41–6.

    Article  PubMed  PubMed Central  Google Scholar 

  35. De Pool ME, Campbell JP, Broome SO, Guyton DL. The dragged-fovea diplopia syndrome: clinical characteristics, diagnosis, and treatment. Ophthalmology. 2005;112(8):1455–62.

    Article  PubMed  Google Scholar 

  36. Veverka KK, Hatt SR, Leske DA, Brown WL, Iezzi R Jr, Holmes JM. Causes of diplopia in patients with epiretinal membranes. Am J Ophthalmol. 2017;179:39–45.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kelly SP, Storey JK. Mobility spectacles for ankylosing spondylitis. BMJ. 1989;298(6689):1704.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Suttle CM, Asper LJ, Sturnieks D, Menant J. Negligible impact on posture from 5-diopter vertical yoked prisms. Invest Ophthalmol Vis Sci. 2015;56(5):2980–4.

    Article  PubMed  Google Scholar 

  39. Reinecke RD, Simons K, Moss A, Morton G. An improved method of fitting resultant prism in treatment of two-axis strabismus. Arch Ophthalmol. 1977;95(7):1255–7.

    Article  CAS  PubMed  Google Scholar 

  40. Gutmark R, Irsch K, Guyton DL. Prescribing prisms. Focal Points: Clinical Modules for Ophthalmologists. Am Acad Opthalmol. 2011;XXIX(10).

    Google Scholar 

  41. OptiCampus. Compounding prisms calculation; 2019. Available from: http://opticampus.opti.vision/tools/compounding.php

  42. Cobb CH. Analysis of clinical approximation in applying Prentice’s rule to decentration of spherocylinder lenses. Ophthalmic Physiol Opt. 1984;4(3):265–73.

    Article  CAS  PubMed  Google Scholar 

  43. West CE, Hunter DG. Displacement of optical centers in over-the-counter readers: a potential cause of diplopia. J AAPOS. 2014;18(3):293–4.

    Article  PubMed  Google Scholar 

  44. Harris WF. Prismatic effect in bifocal lenses and the location of the near optical centre. Ophthalmic Physiol Opt. 1994;14(2):203–9.

    Article  CAS  PubMed  Google Scholar 

  45. Roodhooft J, Van Rens G. A prism is a useful tool in the treatment of vertical diplopia. Bull Soc Belge Ophtalmol. 1998;268:215–22.

    CAS  PubMed  Google Scholar 

  46. Garber NR, Kirdulis T. Slab-off prisms. J Ophthalmic Nurs Technol. 1989;8(4):139–42.

    CAS  PubMed  Google Scholar 

  47. Jobson Medical Information. Slab-off, reverse slab-off and bi-centric grinding 20/20 magazine; 2014. Available from: https://www.2020mag.com/article/slaboff-reverse-slaboff-and-bicentric-grinding

  48. Lindsay RG, Crock GW. A bitoric rigid contact lens with base down prism to eliminate binocular vertical diplopia. Clin Exp Optom. 2005;88(1):55–7.

    Article  PubMed  Google Scholar 

  49. Sulley A, Hawke R, Lorenz KO, Toubouti Y, Olivares G. Resultant vertical prism in toric soft contact lenses. Cont Lens Anterior Eye. 2015;38(4):253–7.

    Article  PubMed  Google Scholar 

  50. Remole A. Determining exact prismatic deviations in spectacle corrections. Optom Vis Sci. 1999;76(11):783–95.

    Article  CAS  PubMed  Google Scholar 

  51. Garber N. Advanced manual lensometry: a self-learning guide for evaluating multifocal and specialty lenses, progressive lenses, prisms, and rigid contact lenses. J Ophthalmic Nurs Technol. 2000;19(5):240–7; quiz 8–9.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David G. Hunter .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Griffith, J.F., Hunter, D.G. (2021). Prescribing Prisms. In: Albert, D., Miller, J., Azar, D., Young, L.H. (eds) Albert and Jakobiec's Principles and Practice of Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-90495-5_237-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-90495-5_237-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90495-5

  • Online ISBN: 978-3-319-90495-5

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics