Effectiveness of prisms in the management of diplopia in patients due to diverse etiologies

Purpose: To study the effectiveness of prisms in the management of diplopia from different etiologies and over a broad range of ocular misalignment. Methods: In this retrospective cohort study, resolution of diplopia in 94 patients who were prescribed prisms was studied. Results: Among 94 patients, 88% reported complete or partial resolution of double vision (95% confidence interval: 84.1% to 95.6%) with highest improvement noted in the divergence insufficiency and skew deviation group (100%) compared to 64% improvement noted in patients with convergence insufficiency. More than 85% of patients who were prescribed greater than 10 diopters of prism and those with oblique prism prescriptions also reported resolution of diplopia. Eighty-nine percent of the cohort continued with prism use and 11% opted for strabismus surgery. Conclusion: In this study, prisms were effective in alleviation of diplopia over a broad range and for different etiologies of double vision.