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Thread: Should mild phorias be corrected?

  1. #1
    Rising Star
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    Should mild phorias be corrected?

    I've seen doctors who prescribe prisms to at least 50% of their patients and other who think even moderate phorias need no prism correction at all.

    At what point would prisms be useful? Does it make any sense to give a mild exophore 1 BI prism if they have no complaints other than a slight chin lift?

  2. #2
    What's up? drk's Avatar
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    This is pretty in-depth.

    There is no easy answer without a long tutorial.

    Having said that, you don't treat asymptomatic patients.

  3. #3
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    Quote Originally Posted by Airegin View Post
    I've seen doctors who prescribe prisms to at least 50% of their patients.........
    I saw that with some accounts when I worked in a wholesale lab. Later I worked with a doc who diagnosed dry eye and prescribed Restasis to a huge percentage of his patients. If you brought in a glass of water as a patient, the diagnosis would be dry eye.
    Last edited by waynegilpin; 12-20-2020 at 05:17 PM.

  4. #4
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    Quote Originally Posted by drk View Post
    This is pretty in-depth.

    There is no easy answer without a long tutorial.

    Having said that, you don't treat asymptomatic patients.
    Well yes, asymptomatic patients definitely don't need correction. But what if the only symptom is just a slight discomfort or a minimal head tilt?

  5. #5
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    Quote Originally Posted by Airegin View Post
    Well yes, asymptomatic patients definitely don't need correction. But what if the only symptom is just a slight discomfort or a minimal head tilt?
    I think, no problem? so why we can create a new one?

    I think optometrist and Medical Doctor have to use prism with care.

    Anyway a very little prism that compensate minimal head tilt can be "delete" by the patient in few months, the patients may have adaptation to prism

  6. #6
    What's up? drk's Avatar
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    Discomfort is a vague symptom, so that would depend.

    Head tilt is not a sign of a phoria, unless it's a vertical deviation from a superior oblique palsy, in which case prism is partially helpful.

    Chin lift is not a sign of phoria, unless it's a "V-Pattern" exodeviation, which is rare.

  7. #7
    Ghost in the OptiMachine Quince's Avatar
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    50% does seem like a lot. I have worked with a doctor in the past that are very prism heavy in their diagnosis. There is obviously a place for it but it does seem that a small amount of docs aren't sure where to draw the line. That being said, I am not super educated in the mass use of prism.

    I remember when the 'gamer' glasses came out and was surprised to see that they (whatever brand I was researching at the time) had added prism (IN?) to their formula. This seemed strange to me to use this in mass production, non-rx lenses, but apparently the result was beneficial. If plano wearers are benefiting, would everyone?
    Have I told you today how much I hate poly?

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