Prisms

SAFEET SHAHBAZ
Objectives
Definition
Notation of prisms
Uses in ophthalmology (diagnostic and therapeutic)
Types of prisms
Definition
A prism is defined as a portion of a refracting medium bordered by two plane surfaces which are
inclined at a finite angle.
The angle α between the two surfaces is called the refracting angle or apical
angle of the prism.
A line bisecting the angle is called the axis of the prism. The opposite surface is called the base
of the prism.
Positions of prisms
Position of minimum deviation
◦ Prism bar

Prentice position
◦ Trial lens
Image Formed by prism
Real images are thus deviated toward the base.
Virtual images are deviated toward the apex of the prism.
Power of Prisms
A prism of one prism dioptre power (1∆) produces a linear apparent displacement of 1 cm, of an
object situated at 1 m
Addition of Prisms
Pythagorean theorem:
“For a right triangle with sides a, b, and c, with c the hypotenuse, a2 + b2 = c2”
Uses of prisms
Diagnostic
Therapeutic
Instruments
Diagnostic
Measurement of angle objectively by prism cover test
Measurement of angle subjectively by Maddox rod
To assess likelihood of diplopia after proposed squint surgery in adults
Measurement of fusional reserve
The four-dioptre prism test
Assessment of simulated blindness
Therapeutic
Convergence insufficiency
To relieve diplopia
◦ Decompensated heterophorias
◦ Small vertical squint
◦ Some paralytic squints with diplopia in the primary position
◦ Small-angle strabismus following intraocular surgery
◦ Residual deviations following strabismus surgery

Age-related macular degeneration

Homonymous hemianopias
Instruments
Slit lamp microscope
Applanation tonometer
Keratometer
Risley Prism
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