Koh Kyung Min, Samuel Kim Ungsoo
Department of Ophthalmology, Kim's Eye Hospital, Youngdeungpo 4th 156, Youngdeungpo-gu, Seoul 150-034, Republic of Korea.
Case Rep Ophthalmol Med. 2013;2013:187459. doi: 10.1155/2013/187459. Epub 2013 Apr 23.
A 65-year-old male patient complained of diplopia after a cataract surgery. He had esotropia of 18 prism diopters (PDs) at distant and near deviation, and therefore, we performed the Hess screen test to identify any abnormal eye movement. However, the indicator was found to be out of bounds, and therefore, the test could not be completed. Therefore, the test was subsequently performed with a 20 PD base-out Fresnel prism, and an abduction deficit was observed in the right eye, but not in the left eye. Therefore, we speculated that the patient had abducens nerve palsy in the right eye. The results obtained in the present study imply that performing the Hess screen test with the Fresnel prism may be very useful in diagnosing ambiguous abnormalities in patients with extraocular movement. The Hess screen test can be performed for patients with a strabismus of greater than 15 PD by using a Fresnel prism. Thus, a Fresnel prism may be useful for performing both the Hess screen test and Lancaster screen test.
一名65岁男性患者在白内障手术后出现复视。他在远距离和近距离斜视时均有18棱镜度（PD）的内斜视，因此，我们进行了赫斯屏试验以确定是否存在任何异常眼动。然而，发现指示器超出范围，因此测试无法完成。随后，使用20 PD底向外菲涅耳棱镜进行测试，右眼观察到外展不足，而左眼未观察到。因此，我们推测该患者右眼展神经麻痹。本研究获得的结果表明，使用菲涅耳棱镜进行赫斯屏试验可能对诊断眼外肌运动异常的患者非常有用。对于斜视大于15 PD的患者，可以使用菲涅耳棱镜进行赫斯屏试验。因此，菲涅耳棱镜可能对进行赫斯屏试验和兰卡斯特屏试验都有用。
