Prescribing
OOLS - Online Optom Learning Series - Session 125 (02nd May 2021)
Here we bring you the 00th session of our online learning series which was live on 02nd May 2021 at 06:30pm IST.
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All about this Session:
Dr. Liat Gantz, an optometrist, and an optometry educator and researcher, begins by explaining the key points from an evidence-based practice paper for prescribing prisms. We learn about prescribing prisms using the following pointer
1. Verifying no prism adaptation (Vergence Adaptation) (05:30)
The normal eye adapts when prisms have used the front of the eye. We learn how we measure dissociated phoria and how the eye will adapt to prisms(vergence adaptation). We are warned not to correct such phoria as the eye would adapt to the prisms. Next, we learn what happens when the visual system does not adapt to prisms and how such patients can be prescribed prisms. We learn a step-by-step method of prescribing prisms in practice.
2. Treat only in the presence of binocular vision anomalies (14:00)
We learn in detail about the three categories of binocular vision vergence anomalies
a. Distance and near phoria are nearly the same (16:05)
i. Basic Exophoria - we learn why distance phoria is not the case where prisms should not be the first choice of treatment.
ii. Basic Esophoria - Dr. Gantz, also explains the treatment for near phoria which includes prisms, reading glasses, and vision therapy
b. Distance phoria is higher than the near phoria (24:10)
i. Divergence Insufficiency - we learn about the symptoms and treatment options with the best option being base out prisms
ii. Divergence Excess – Convergence exercises are probably the best treatment plan for these patients.
c. Near phoria is higher than distance phoria (29:10)
i. Convergence Insufficiency – vision therapy is the most effective treatment for convergence insufficiency
ii. Convergence Excess – we learn that the best solution for convergence excess is reading glasses.
3. Clinician Discretion – no set of definitive rules (33:05)
Dr. Gantz explains that there are no right criteria for prescribing prisms.
4. Varying Approaches (criteria) (33:15)
We learn about the four different approaches for horizontal prisms which includes
a. Sheard’s criteria (33:50)
b. Saladin’s criteria (42:25)
c. Percival criteria (46:15)
d. Associated Phoria (52:50)
We also briefly learn about the approaches to prescribing vertical prisms
5. Treat only when indicated (60:45)
We learn when and when not to prescribe prisms with a few rules.
Dr. Gantz ends the session with a sample binocular vision anomaly case and explains all the different prescribing criteria for this one case. The session ends with a question and answers session with the live audience.
References: https://bit.ly/3hzyPLi
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We would like to thank Dr. Liat Gantz for this wonderful session where she explained in detail about how as a clinician we should be confident in measuring and prescribing prisms for our patients who are suffering from the squint.
We thank all the participants who attended the lecture and asked a few important questions so that we learn and go home with a great message.
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Online Optom Learning Series(OOLS) is managed by S.K. Optics.
OOLS is accredited by the Optometry Council Of India (OCI), Integrated Philippine Association of Optometrist (IPAO), Philippine Society of Public Health, and Occupational Optometry (PSPHOO), and Optometry Vietnam.
Education Supported by SEGi University Online
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Credits -
Intro Video Music by Diego Nava - You Got Jazz
Outro Music by X Ray Vision - Slynk
Video Editor -
Wondershare Filmora 9