Prism Glasses

January 23, 2008 at 12:17 pm

Hello Brie:

I have CIDP, and it has severely damaged by 6th cranial nerves, thus I have had double vision all day, every day since 2004. It started slowly as a minor nuisance, but late 2005 I had a big flare which caused severe physical disability and an incredible uptick in the level of double vision. A neuro-opthalmologist measured my esotropiea (deviation from fused vision) at 45 dioptres. He called it a crazy level of deviation. Strabismus surgery was not an option due to the risk of another flare reversing the correction, and the deviation was way too severe to correct with prisms.

Finally, about 12 months later the double vision reduced to a 15-20 dioptre deviation that remained stable with essentially no major further recovery expected in the near-term, and I was prescribed prism glasses so that I could finally drive again. I also use hand controls to drive. I only wear the prism glasses when I am driving or when I am a passenger in a car. They are too distorting for regular, all day use. But, for driving they allow me to fuse a single image and since you are focusing on objects further away while driving, the distorting aspects of prisms are manageable. I could not safely drive without them.

If your double vision is deemed stable and “non-recovering” you could have orbital strabismus surgery. Botox injections are another approved therapy. However, if the double vision is not stable, gets worse then improves, or is just healing slowly – then, time is really the only remedy. Patching also does not work for me, as both eyes are crooked, and if I patch one eye, I feel like I’m going to walk crooked and right into the ground.