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Eye Care Archive (Expert Forum)
Alignment issue
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
Alignment issue
by irishdrumrboy, May 16, 2007 12:00AM
Good afternoon,
I’ve had this problem with my eyes for just about as long as I can remember. Basically, when I look right with both eyes, one of them wanders, depending on which one I focus. Naturally, my vision goes double when this happens. It doesn’t happen looking left, only right. I’ve grown accustomed to compensating by shutting one eye or just turning my head (like when driving, etc..) My forward and left vision is fine and I experience no double vision looking forward or looking left. I finally got good eye insurance, so I decided after many years to get it checked out. The eye doctor prescribed me eyeglasses with prisms. My question is about the prisms: It seems to me that the prisms are simply tricking my eyes. Now when I look right, my vision doesn’t go double, but my eye still wanders. This is not at all what I wanted. I want them to line up properly. I guess I am just fishing for a second opinion on my options. Will the prisms eventually help with this? Does this sound like something only surgery will fix? Is this something that can’t be fixed?
Thanks in advance.
I’ve had this problem with my eyes for just about as long as I can remember. Basically, when I look right with both eyes, one of them wanders, depending on which one I focus. Naturally, my vision goes double when this happens. It doesn’t happen looking left, only right. I’ve grown accustomed to compensating by shutting one eye or just turning my head (like when driving, etc..) My forward and left vision is fine and I experience no double vision looking forward or looking left. I finally got good eye insurance, so I decided after many years to get it checked out. The eye doctor prescribed me eyeglasses with prisms. My question is about the prisms: It seems to me that the prisms are simply tricking my eyes. Now when I look right, my vision doesn’t go double, but my eye still wanders. This is not at all what I wanted. I want them to line up properly. I guess I am just fishing for a second opinion on my options. Will the prisms eventually help with this? Does this sound like something only surgery will fix? Is this something that can’t be fixed?
Thanks in advance.
Doctor's Answer
by Forum-OD-MP, May 17, 2007 12:00AM
this sounds like an oculr movement problem with adduction or abduction (depending one which eye goes which direction) like duane's syndrome:
http://www.revoptom.com/HANDBOOK/oct02_sec6_1.htm
yes, the prism just 'trick' your eyes...you are completely right. but thats probably all you can do. surgery as an adult is usually only indicated when the eyes are not aligned in 'primary gaze' or when you are looking straight ahead. if you only get the 'wandering' when you are looking off to the side, it is unlikely that surgery will help ,either.
http://www.revoptom.com/HANDBOOK/oct02_sec6_1.htm
yes, the prism just 'trick' your eyes...you are completely right. but thats probably all you can do. surgery as an adult is usually only indicated when the eyes are not aligned in 'primary gaze' or when you are looking straight ahead. if you only get the 'wandering' when you are looking off to the side, it is unlikely that surgery will help ,either.
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i agree that a visit to a pediatric ophthalmologist is probably not a bad idea.
the forum ophthalmologist stated the following:
"Prisms glasses do not work well on incommitant strabismus"
that is completely true. i completely agree with that statement. but guess what? surgery doesnt usually work well in adults with incommitant strabismus, either. but of course the surgeons will recommend surgery and the non-surgeons will recommend prisms. both are viable options, neither is likely to work all that well in anyone over about age 8 IMO.
but a visit to a surgeon is not a bad idea. you've tried the prisms and are not all that satisfied, now go hear the other side. i'd be wary of any surgeon who promised he/she could fix this quickly and easily, however. it is my understanding that surgery is not usually indicated nor successful in duane's syndrome and the like.