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NEW
YEAR
2014
PRISMS
&
ITS OPHTHALMIC USES
Dr. Rutvi R. Sadatia
Prism
Definition
It
REFRACTING/APICAL
OF THE PRISM
A line bisecting the angle
APEX
The
BASE
The
opposite surface
Refraction by a prism
Light
Rays
base.
Determined
by 3 factors
The
Image formation
If
Although
The
If
In
Positions
2
primary positions
1.
2.
Notation
1.
Prism Diopter
.Prism
.One
2.
.The
.2=1
3. The centrad
This
The
But
Uses
1.Diagnostic
2.therapeutic
3.Instruments
4.Miscellaneous
Diagnostic
1.Assessment of squint & heterophoria
unmounted prisms
Trial lens set prisms
Prism bars
Krimskys test
AC, Prisms,
baseout, of increasing
power are placed before
the fixating eye until
the light reflex is centered
on the cornea of the deviating
eye.
D, Optical principles of the
prism reflex test
A,
Distance (6m) in
D
Near(33 cm) in D
Convergence
14-20
35-40
Divergence
5-8
15-20
Vertical vergence
2-4
2-4
for microtropia
4 D placed base out before the deviating eye causes no
movement as the image remains within the suppression
scotoma
When placed before the normal eye,movement occurs
Therapeutic
1.Convergence insufficiency
2.To relieve diplopia
Convergence insufficiency
The
Done
on synaptophore
Pt.s eyes
Exercise
Pt
Exercise
To relieve diplopia
In
Prisms
Fresnel
prisms:
It
It
The
Press-On
The
Because
Prism Aberrations
Chromatic
Asymmetrical
2. permanent wear
Permanent
Rays
The
Use
P=FD
P=
Priscription of prisms
The
To correct
convergence-base
out
Divergence-base in
Hypertropia-base down
Hypotropia-base up
Instruments
1. Applanation tonometer
2. Indirect ophthalmoscope
3. Slit lamp microscope
4. Keratometer
5. Operating microscope
6. Synaptophore
7. Haidingers brush
8. Koppes goniolens
Miscellaneous
1. recumbent spectacles
To allow a pt lying in bed to keep the reading matter on
his chest
2.hemianopic spectacles
A prism of 8 dioptre is used with base towards the blind
side
3.low visual aids
Base in prisms are incorporated in binocular magnifier
References
Clinical
Frank
American academic of ophthalmology 20122013
Strabismus simplified-pradeep sharma
Refraction & optics- N C Singhal