Fresnel Prism on my 3 year old’s glasses

Glasses – Check

Occlusion – Check

Surgery – Check

Prism Adaptation – Check

Hmmm… is there something related to little ones in glasses that we haven’t tried yet????   Not that I know of!  We went to the ophthalmologist on Friday due to Elliana’s eyes becoming more over corrected. (major bummer) It appears that she is reacting atypically.  As time progresses her eyes are turning in more rather than becoming straighter as traditionally happens.  She now has a Fresnel prism placed on her glasses.  My first question was, “What is that?”  I understand that it similar to the prisms used in the exams.  I asked how it is different than a lens.  It does not affect the distance at which the light focuses on the back of the eye, rather bounces light in a different way (sorry, still not sure on this.)  Googling Fresnel Prisms on glasses has me just  about as confused.  The article Management of Strabismus and Amblyopia: a Practical Guide byBy John A. Pratt-Johnson, Geraldine Tillson says that “Occasionally, a patient with an acquired esotropia and the full optical correction in place may have a much larger angle esotropia on the prism cover test than appears to be present at a casual glance…the prism estimated as needed to neutralize the deviation is inadequate and more and more prism is required.”  It sounds like this treatment is rare.  We pretty much put a stick on prism over her strong eye because it may act as an occluder.  We go back on Friday for more tests and the article says something about testing for fusion with a synoptophore or the Whorth four-dot test. None of which I know anything about.  Unfortunately, we also have to put atropine drops in both of her eyes for the next 3 days in order to get a good read on her vision this Friday.  Since she is older and more verbal about her eyes – she is NOT a happy camper and has expressed her distaste for the eye drops and has screamed all morning.  2 more mornings of drops.  Wish me luck and let me know if you know anything else about the prisms!

5 responses to “Fresnel Prism on my 3 year old’s glasses

  1. Elliana is beautiful, and I hope she adjusts well to the new treatment! I wish I had advice or experience, but I’m fairly new to the world of kids in glasses… Best wishes to you two!!!


  2. Hi Elliana! You are blessed to have parents who are close monitoring your condition. I am a mom to a daughter who had been diagnosed with strabismus when she was 9 months old. After glasses, patching for about 2 months, she underwent surgery. However, 3 weeks post surgery, her eyes started to drift in again. She was advised to wear bifocals on her latest checkup. I pray she’ll respond well with this glass. God bless you Elliana.


  3. They also use prisms for nystagmus. It helps to keep the eyes steady and center/align the null point. If you research nystagmus you will be able to find a lot of information on prisms. Mia has a null point to the right and left, we call it her side stare. If she wore prisms, it would help to realign her null point to the center and also steady her wobble. I’m not sure if these prisms are used the same for the 2 different eye disorders.


  4. The very best of luck with the prism. Elliana is so pretty and really suits her glasses. To my untrained eye, her eyes look great too. 🙂 you are doing a great job.


  5. Thanks everyone… after 3 days of atropine and a VERY crabby child, they were able to get really good measurements and think that her perscription needs to be changed again (weakened this time) to -1, -7 and that hopefully, will help with straightening her eyes since it will be undercorrected and make her brain work a little harder. We are on to the new lenses and in a week or so will put the prism back on. I am not sure what to think as the last couple days she has been peeking under them. I am wondering if this is still the atropine effect wearing off.


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