How To Treat Graves' Disease

Prisms In Glasses

Some Graves' disease patients may have double vision, and prisms in glasses are typically recommended to correct this. With healthy vision, light hits the same part of the retina on each of a patient's eyes, allowing them to see a single image. Individuals with double vision see two images because light hits different places on each of the retinas. Prisms bend light, and inserting them in glasses redirects the light before it reaches the eye. It then hits the same location on each of the patient's retinas, and they see a single image. To prescribe the correct prism, an ophthalmologist may perform the Hirschberg test, which involves shining a light into each eye. The ophthalmologist will check to see if the corneal reflection appears in the center of the pupil. If it does not, this indicates the patient may benefit from having a prism in their glasses. The Krimsky test is used to determine the most appropriate prism for the patient's needs. While the patient looks at a light, the doctor places different prisms in front of the patient's eyes. Each prism has a different strength, and the correct prism will bring the patient's corneal reflection to the center of each pupil. Cover tests and the Maddox test could be used to find out more about the degree of a patient's double vision and decide which prism might be most effective. Prism prescriptions are given in prism diopters, and the prism can be placed into the glasses horizontally, vertically, or diagonally. Some patients need prisms in both lenses, and others only need a prism in one lens.

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