Can Prism Glasses Correct Double Vision Effectively?

Can prism glasses correct vision?

Hello Doctor: I have been experiencing double vision for about four years.
For the first one to two years, I only had double vision when I was particularly tired, but for the past one to two years, I have had double vision every day.
In November of last year, I went to the hospital for an examination, which confirmed that there were no abnormalities in my brain, and I was prescribed prism glasses with both eyes having Prism: 4, Base: out.
I have a few questions I would like to ask you: 1.
Can wearing prism glasses correct my vision and help me return to a state without double vision? 2.
Recently, even when wearing the prism glasses, I still experience double vision when I am tired.
Does this indicate that the angle of my esotropia has increased? Thank you for your assistance, Doctor.

KK, 20~29 year old female. Ask Date: 2016/05/22

Dr. Wang Zhangji reply Ophthalmology

1.
Irreversible.
2.
Possible.

Reply Date: 2016/05/22

More Info

Prism glasses can be an effective tool for managing double vision, also known as diplopia, particularly when the underlying cause is related to misalignment of the eyes, such as strabismus (crossed eyes). In your case, where you have been experiencing double vision for about four years, the use of prisms in your glasses is intended to help align the images seen by each eye, allowing for a single, coherent visual perception.

1. Can prism glasses correct double vision effectively?
Prism glasses work by bending light before it enters the eye, which can help to align the images seen by each eye. This is particularly useful in cases of binocular diplopia, where both eyes are open and the images are misaligned. The prescription you mentioned, with both eyes having a prism value of 4 and a base direction of "out," suggests that the prisms are intended to help correct an inward deviation of the right eye (esotropia). While prism glasses can significantly reduce or eliminate double vision for many patients, they may not completely resolve the issue for everyone. The effectiveness of the prisms can depend on various factors, including the degree of misalignment, the cause of the diplopia, and how well the brain adapts to the correction.

2. If I still experience double vision when tired, does this indicate an increase in the angle of my inward deviation?
Experiencing double vision, even while wearing prism glasses, especially when you are fatigued, can indicate that your eyes are becoming less coordinated as your muscles tire. This does not necessarily mean that the angle of your inward deviation has increased, but rather that your eye muscles may not be able to maintain proper alignment under stress or fatigue. It is common for individuals with strabismus to notice that their symptoms worsen with tiredness or prolonged visual tasks. This can be due to the muscles that control eye movement becoming fatigued, leading to a temporary increase in misalignment.

In addition to the use of prism glasses, it may be beneficial to explore other treatment options. Vision therapy, which involves exercises designed to improve coordination and control of the eye muscles, may be helpful. In some cases, surgical intervention may be considered if the misalignment is significant and does not respond to conservative treatments.

Furthermore, it is essential to have regular follow-ups with your eye care professional to monitor your condition and adjust your prescription as needed. If you notice any changes in your vision or if your symptoms worsen, it is crucial to seek medical advice promptly.

In summary, while prism glasses can be an effective means of managing double vision, they may not provide a complete solution for everyone. Monitoring your symptoms, especially during periods of fatigue, and maintaining open communication with your eye care provider will be key in managing your condition effectively.

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