On Detached Right Retina’s and Prism Use…
I am treating a patient for marked right leg and hip pain (testing has ruled out significant pathology) who has a detached right retina (operated on 3 times). She has been told her optical nerve is not that good and her vision is slim to none out of that right eye. She has a mid-line shift to the right. My question is: Are prisms indicated in this kind of a case? I want to know before contacting her retinologist about this approach.
Prisms might be initiated but it would be very unconventional. I would consider sending her to a neuro-optometrist or an optometrist that works with head injury, stroke rehab, etc. I also would caution on the assumption she’s in a right midline shift. I’ve had similar patients with right eye limited sight, and in their attempt to see more on the right because of right eye limitations, they move strongly into a left VMS pattern and Base Right prisms work well. You may need to take a clinic pair of 4 to 6 adjustable prisms and experiment to achieve better neutrality and symmetry.
Previous E-Mails
