Therapeutic Outcomes of Prism Glasses for Diplopia Unrelated to Strabismus Surgery

Hye Seong Hwang; Mi Young Choi

doi:10.3341/jkos.2018.59.8.766

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Hwang and Choi: Therapeutic Outcomes of Prism Glasses for Diplopia Unrelated to Strabismus Surgery

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(8): 766-772.

Published online: 14 August 2018

DOI: https://doi.org/10.3341/jkos.2018.59.8.766

Therapeutic Outcomes of Prism Glasses for Diplopia Unrelated to Strabismus Surgery

Hye Seong Hwang, MD, Mi Young Choi, MD, PhD

Department of Ophthalmology, Chungbuk National University College of Medicine, Cheongju, Korea.

Address reprint requests to Mi Young Choi, MD, PhD. Department of Ophthalmology, Chungbuk National University Hospital, #776, 1sunhwan-ro, Seowon-gu, Cheongju 28644, Korea. Tel: 82-43-269-6146, Fax: 82-43-269-6148, mychoi@chungbuk.ac.kr

Received 29 March 2018 Revised 23 May 2018 Accepted 18 July 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the therapeutic results of the patients wearing the prism glasses due to strabismus with diplopia unrelated to strabismus surgery.

Methods

Between May 2002 and October 2016, this retrospective study evaluated medical records of 23 patients who were wearing prism glasses due to strabismus with diplopia unrelated to strabismus surgery. The patients failed to adjust to the prism glasses and stopped within 3 months were defined as the adaptation failure group. The patients wearing prism glasses for 3 months or more was defined as adaptation success group. In the prism adaptation success group, he patients who underwent strabismus surgery during follow up were defined as treatment failure. Data were collected the types and causes of strabismus, the deviation angle at starting treatment of prism glasses and last visits, best corrected visual acuity, Titmus stereo test and Worth 4 dot test.

Results

Of the total 23 patients, 18 patients had horizontal strabismus, four patients had vertical strabismus and one had horizontal and vertical strabismus. The causes of strabismus were acute acquired comitant esotropia (12 patients), paralytic strabismus (9 patients), and thyroid associated ophthalmopathy (two patients). There was no significant changes in deviation angle as well as the prism diopter of prism glasses after prism glasses treatmet. The prism glasses-adaptation group was 70%, and 31% of them were performed strabismus surgery. There was no reduction in visual acuity in all patients. Among the prism glasses adaptation group, 33% of the prism glasses-adaptation group had poor binocular function.

Conclusions

In the strabismus patients with diplopia unrelated to strabismus surgery 70% of the patients adapted prism glasses more than 3 months and 31% of them required strabismus surgery. Therefore, prism glasses treatment may be one of the non-surgical approaches in the strabismus patients with diplopia unrelated to strabismus surgery.

Keywords: Diplopia, Prism glasses, Strabismus

Figures and Tables

Figure 1

Comparison of deviated angle between before and after wearing prism glasses. There was no significant changes in deviation angle after prism glasses treatmet.

Table 1

Comparisons of patient characteristics according to prism glasses adaptation

BCVA = best-corrected visual acuity; logMAR = logarithm of minimal angle of resolution; S.E. = spherical equivalent; PD = prism diopter.

^*Determined using the Mann-Whitney test; ^†Determined using the Fisher's exact test.

Table 2

Types and causes of strabismus

^*Determined using the Fisher's exact test.

Table 3

Therapeutic result according to type of strabismus

Table 4

Changes of the visual acuity after using Fresnel prism

Values are presented as mean ± SD unless otherwise indicated.

BCVA = best-corrected visual acuity; logMAR = logarithm of minimal angle of resolution.

^*Determined using the paired t-test.

Notes

This work was supported by the research grant of the Chungbuk National University Hospital in 2018.

^{Conflicts of Interest} The authors have no conflicts to disclose.

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