Comparison of simultaneous prism and cover test (SPCT) and prism and alternate cover test (PACT) measurements with final power of Press-On prism power dispensed
{"title":"Comparison of simultaneous prism and cover test (SPCT) and prism and alternate cover test (PACT) measurements with final power of Press-On prism power dispensed","authors":"Alex Christoff CO, COT","doi":"10.1016/j.jaapos.2024.103918","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the association of strabismic angle obtained by simultaneous prism and cover test (SPCT) and prism alternate cover test (PACT) with the final power of Press-On prism used in adults with symptomatic strabismus.</p></div><div><h3>Methods</h3><p>The medical records of consecutive patients seen by a single orthoptist at an urban, tertiary care hospital over a 36-month period were reviewed retrospectively. All subjects had been prescribed Press-On prism for diplopia after evaluation with SPCT and PACT measurements at distance fixation. Prism dispensed was chosen by the patient using a trial Press-On prism set.</p></div><div><h3>Results</h3><p>A total of 244 charts were reviewed. Of these, 108 adult patients had prism dispensed, and 32 had both SPCT and PACT measurements. Mean SPCT measurement was 7<sup>Δ</sup> (median, 6<sup>Δ</sup>; range, 3<sup>Δ</sup>-14<sup>Δ</sup>); mean PACT, 13<sup>Δ</sup> (median, 11<sup>Δ</sup>; range, 8<sup>Δ</sup>-20<sup>Δ</sup>). The mean prism power dispensed was 7<sup>Δ</sup> (median, 6<sup>Δ</sup>; range, 1<sup>Δ</sup>-15<sup>Δ</sup>); this was not significantly different from mean SPCT (<em>P</em> = 0.35). There was a large difference (6<sup>Δ</sup>) between mean PACT measurements and mean prism dispensed (<em>P</em> < 0.001). At follow-up of 1 year, 21 patients (66%) remained in prism. Nine patients (4%) elected to undergo eye muscle surgery, 7 with horizontal strabismus, 6 of whom had SPCT measurements of >10<sup>Δ</sup> and PACT measurements of >15<sup>Δ</sup>.</p></div><div><h3>Conclusions</h3><p>Press-On prism power used was more closely tied to the angle of strabismus obtained by SPCT. Overall success rate of Press-On prism was good when the prism power dispensed was close to the SPCT measurement, suggesting that it is reasonable to initiate treatment with a weaker prism, approximating the SPCT measurement, building up only if there are continuing symptoms.</p></div>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1091853124001885","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
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Abstract
Purpose
To investigate the association of strabismic angle obtained by simultaneous prism and cover test (SPCT) and prism alternate cover test (PACT) with the final power of Press-On prism used in adults with symptomatic strabismus.
Methods
The medical records of consecutive patients seen by a single orthoptist at an urban, tertiary care hospital over a 36-month period were reviewed retrospectively. All subjects had been prescribed Press-On prism for diplopia after evaluation with SPCT and PACT measurements at distance fixation. Prism dispensed was chosen by the patient using a trial Press-On prism set.
Results
A total of 244 charts were reviewed. Of these, 108 adult patients had prism dispensed, and 32 had both SPCT and PACT measurements. Mean SPCT measurement was 7Δ (median, 6Δ; range, 3Δ-14Δ); mean PACT, 13Δ (median, 11Δ; range, 8Δ-20Δ). The mean prism power dispensed was 7Δ (median, 6Δ; range, 1Δ-15Δ); this was not significantly different from mean SPCT (P = 0.35). There was a large difference (6Δ) between mean PACT measurements and mean prism dispensed (P < 0.001). At follow-up of 1 year, 21 patients (66%) remained in prism. Nine patients (4%) elected to undergo eye muscle surgery, 7 with horizontal strabismus, 6 of whom had SPCT measurements of >10Δ and PACT measurements of >15Δ.
Conclusions
Press-On prism power used was more closely tied to the angle of strabismus obtained by SPCT. Overall success rate of Press-On prism was good when the prism power dispensed was close to the SPCT measurement, suggesting that it is reasonable to initiate treatment with a weaker prism, approximating the SPCT measurement, building up only if there are continuing symptoms.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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