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Re: Double vision [IP]



In a message dated 4/26/08 8:38:01 AM, email @ redacted writes:


> I'm not sure what Andy A. was talking about with the prisms, but if I look
> to the extreme left (no patch) I have single vision. As I look to the right
> you can see my right eye doesn't travel along. I guess that's the result of
> the 6th nerve palsy.
> 

The prism is a way of realigning the images so you see just one. There are 2 
methods for treating binocular diplopia - the kind you have when both eyes are 
open. Since this type of diplopia, as in 6th nerve palsy, only occures when 
the brtain receives 2 images becasue the eyes are pointing 2 different 
 directions. So, the 1st method - make the patient Monocular - wear the patch!
Second
way - align the images. Two ways of aligning the image - turn your head in a 
direction that does allow both eyes to move into the same position (eg both 
 looking left). This is what happens when you look to the left Jan. The R 6th
nerve
innervates the muscle that turns the eye out,   toward your ear. If the R 
side is paralysed, it won't allow the R eye to turn toward your ear, but the L 
 eye still turns to your R, toward your nose - so you see double. If you look to
the L, both eyes can turn that direction - single vision. The second way, 
 instead of aligning the eyes, is to align the images. Prism does that, it moves
 the apparent position of the image. In more permanaet conditions (strabismus)
we
gind the prism into a lens to deviate the image. Wtih diabetic type temporary 
paralysis, we can place a temporary prism on the lens to change theimage 
position.
I hope that wasn't too confusing. If it was and anyone would like 
 clarification, please feel free to email me off the mailing list at
email @ redacted

Andy


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