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Ophthalmology & Optometry/adjusting to glasses with prisms


My 16 y.o. daughter has been in eye therapy for 18 months, now has glasses that are strictly prisms. She puts them on and sees rainbows, says her depth perception is off and that they make her eyes cross. She has alternating esotropia and saccadic deficiency. Has trouble with double vision, especially in right gaze. She also has a divergence insufficiency .According to the paper the prism "was increased until 16pdBO resulted in Worth 4 dot". Why are the glasses so uncomfortable for her, she can't even wear them for a minute. will she get used to this? or does she need a different prescription? Will surgery help?

Dear Sue.   16 pd BO prism is certainly quite a bit and indicates that your daughter has a fusion and binocularity problem of misaligned eyes.  When this occurs,  she will either get Diplopia ( double vision) , either permanent or intermittent, or suppression, the brain's compensatory action of shutting down the vision in one eye to avoid Diplopia .  This can be accompanied by eyestrain  and headaches  and ocular fatigue.  The treatments a available for her condition are visual therapy , prism eyeglasses or surgery .   what's best for her is best answered by her eye doctor.   Eyeglasses can be rehabilitative
And certainly takes getting used to.  Good luck.   Dr Ken

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Any and all questions with regard to ocular ailments, eye diseases as cataracts, glaucoma, macular degeneration, diabetic retinopathy, etc , eye and visual sympomatology, eyeglasses, contact lenses, low or subnormal vision, pediatric vision conditions,and special and unique ailments will be discussed.


36 years of clinical experience in opticianry and therapeutic optometry. Still in private practice with special interests in vision conditions, diagnosing and treating ocular ailments, prescibing treatment plans which include medicine, eyeglasses, and contact lenses primarily. Although surgery is not within the realm of my area of expertise, I co-manage many pre and post -op surgical cases which include Lasik and PRK procedures.

New Jersey Society of Optometric Physicians American Optometric Association

B.A.,1968, Hunter College of the City University of New York B.S.,1970, Pennsylvania College of Optometry O.D.,1973, Pennsylvania College of Optometry Therapeutic Pharmaceutical Administration Certification, New Jersey 1992

Awards and Honors
Clinical Efficiency Award, 1973, Pennsylvaania College of Optometry

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