OK, my patient/aunt has some kind of progressive orbitopathy (that I have to farm out to someone who knows his/her/xe's stuff) with a wicked newer esotropia and vertical tropia. She's successfully been in prism along the way in her journey (about 6^ BO OD and OS--no vertical) but it's getting worse.

I need to deliver about 7 BO OD and OS, and now about 7 BU OD and 7 BD OS, in order to achieve binocular fusion.

Is this do-able? Any tips?

(Want a new outside Rx?)
(Want a new aunty?)