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Virtual Prism Adaptation Therapy: Protocol for Validation in Healthy Adults
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Prism Success in Patients with Diplopia and Retinal Pathology.

Mariam Tadross1, Kara M Cavuoto1, Michelle M Falcone1

  • 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

Clinical Ophthalmology (Auckland, N.Z.)
|June 9, 2026
PubMed
Summary

Prisms effectively treated binocular diplopia in patients with retinal conditions, with over 65% experiencing relief. However, frequent prism adjustments were needed, emphasizing personalized prescription trials for optimal outcomes.

Keywords:
binocular diplopiadiplopiaprismsretinal pathology

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Area of Science:

  • Ophthalmology
  • Vision Science

Background:

  • Binocular diplopia is a common visual disturbance.
  • Retinal pathologies can lead to or exacerbate binocular diplopia.
  • Prism correction is a potential management strategy for diplopia.

Purpose of the Study:

  • To assess the efficacy of prisms in managing binocular diplopia in patients with retinal pathologies.
  • To identify clinical factors influencing the success of prism treatment for diplopia.

Main Methods:

  • Retrospective chart review of patients (≥18 years) with binocular diplopia and retinal pathology (2012-2022).
  • Included patients prescribed prisms with at least one follow-up visit.
  • Compared subjective prism prescriptions with measured ocular deviations and analyzed treatment success factors.

Main Results:

  • Seventy patients (mean age 73.5 years) were included, primarily with epiretinal membranes or prior retinal detachment.
  • Prism therapy eliminated diplopia in 65.7% of patients, but 43.5% required prism adjustments.
  • Prescribed horizontal prisms were lower than measured deviations; vertical prisms varied by distance and near viewing.

Conclusions:

  • Prisms are effective in resolving diplopia for a majority of patients with retinal pathologies.
  • Frequent prism adjustments indicate the need for careful, individualized prism prescription and titration.
  • No significant associations were found between treatment success and patient age, visual acuity, or retinal pathology type.