This paper describes the use of slab-off prisms for the treatment of vertical diplopia in the reading position. The following data were collected: main symptom complaint, visual acuity, refractive error, binocular vision including sensory fusion and stereoacuity, alternating cover test and prism trial prescription. A total of five patients were identified as having received this treatment; follow-up ranged from one month to four years. The majority (80%) were male with an average age of 72 years. All had good visual acuity in both eyes. The mean slab-off prism strength prescribed was 3 prism dioptres, ranging from 2–5 prism dioptres. The author acknowledged the limitations of the retrospective nature of the study, small sample size and short follow-up periods. This study does suggest slab-off prisms could be an effective non-surgical treatment for small angle vertical strabismus with diplopia in the reading position only.
Treatment of vertical diplopia in the reading position
Reviewed by Lauren Hepworth
Slab-off prism for symptomatic, vertical heterophoria in the reading position.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
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