Prism use in adult diplopia

Area of Science:

• Ophthalmology
• Neuro-ophthalmology
• Vision Science

Background:

• Diplopia (double vision) in adults can significantly impair quality of life.
• Prismatic correction is a common, non-invasive method to manage diplopia by redirecting images.
• Restoring binocularity through prisms can be challenging depending on the underlying cause of diplopia.

Purpose of the Study:

• To review and summarize the efficacy of prismatic correction in adult patients experiencing diplopia.
• To analyze satisfaction rates with prisms based on the specific etiology of diplopia.

Main Methods:

• Systematic review of studies reporting outcomes of prismatic correction for adult diplopia.
• Analysis of patient satisfaction data stratified by the cause of diplopia (e.g., vertical deviations, horizontal deviations, specific conditions).

Main Results:

• Overall patient satisfaction with prismatic correction for diplopia is approximately 80%.
• Highest satisfaction rates were observed in patients with skew deviation (100%) and fourth nerve palsy (92%).
• Lowest satisfaction rates were found in patients with orbital blowout fractures (8%) and convergence insufficiency (50%).

Conclusions:

• Prismatic correction is a valuable tool for managing adult diplopia, but outcomes are etiology-dependent.
• Careful patient selection, managing expectations, and consistent follow-up are crucial for successful prism use.
• Further research may be needed to optimize prism strategies for challenging cases like those with thyroid eye disease or orbital fractures.