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Quantification of Gaze-Dependent Corrective Errors With Fresnel Prisms: Implications for Strabismus Management
Eizo Tanaka1, Shin Morisawa1, Yuki Morizane1
1Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Investigative Ophthalmology & Visual Science
|May 27, 2026
Summary
Fresnel prisms used for strabismus management have gaze-dependent errors. These nonlinear optical effects vary with prism power and gaze direction, impacting treatment accuracy.
Area of Science:
- Ophthalmology
- Optics
- Biomedical Engineering
Background:
- Fresnel prisms are essential tools for managing strabismus.
- Current prism selection often overlooks gaze-dependent variations in deflection.
- Understanding these variations is crucial for effective strabismus treatment.
Purpose of the Study:
- To quantify gaze-dependent corrective errors introduced by Fresnel prisms.
- To analyze how errors vary with prism power, gaze direction, and application method.
- To visualize these errors across the visual field.
Main Methods:
- Fresnel prisms (10Δ-40Δ) were tested on a rotation stage.
- Laser deflection was measured on a tangent screen with horizontal/vertical gaze shifts (±30°).
- Two configurations (eyeward prism serration and outward prism serration) were compared using geometric modeling and Kriging interpolation.
Main Results:
- Significant corrective errors were found, dependent on prism power, gaze position, and configuration (P < 0.05).
- Prisms > 20Δ showed complex, spatially varying errors.
- Gaze shifts induced overcorrection or undercorrection, with vertical shifts creating unintended components.
Conclusions:
- Fresnel prisms exhibit nonlinear, gaze-dependent errors beyond primary gaze correction.
- These optical properties necessitate consideration for optimizing strabismus therapy.
- Awareness of these errors can improve diagnostic accuracy and treatment outcomes.
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