Turkiye Klinikleri Journal of Ophthalmology

.: REVIEW
Oftalmolojide Prizmaların Güncel Kullanımı
Current Use of Prisms in Ophthalmology
Esra ŞAHLIa, Aysun İDİLa
aAnkara Üniversitesi Tıp Fakültesi, Göz Hastalıkları ABD, Görme Araştırmaları ve Az Görme Rehabilitasyonu Birimi, Ankara, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2020;29(2):158-68
doi: 10.5336/ophthal.2019-70396
Article Language: TR
Full Text
ÖZET
 Prizma, tepe noktasında kesişen iki yüzeyin oluşturduğu kırıcı bir ortamdır. Prizmaların pozisyonu tabanlarına göre adlandırılır. Prizmalar, ışığı tabanlarına doğru kırarlar ve görüntü prizmanın tepesine doğru yer değiştirir. Prizmaların gücünün belirlenebildiği üç temel pozisyon vardır. Bunlar, prentice pozisyonu, minimum sapma ve frontal düzlem pozisyonudur. Prizmalar tanısal amaçla binoküler tek görmenin değerlendirilmesinde, kayma miktarının ölçülmesinde, retinal uyumluluğun değerlendirilmesinde ve simülasyon yapan hastanın belirlenmesinde kullanılır. Ayrıca; biyomikroskop, aplanasyon tonometresi, foropter ve indirekt oftalmoskop gibi cihazların içinde bulunur. Tedavi amacıyla kullanılan prizmalar, klasik cam prizmalar ya da frensel prizmalar şeklinde olabilir. Cam prizmaların gücü arttıkça kalınlığı, ağırlığı ve aberasyonları artar. Bu nedenle ancak 8Δ'ye kadar gözlük camına monte edilebilirler. Fresnel prizmalar, aynı kırma açısına sahip birbirine paralel küçük prizmaların oluşturduğu plastik bir membran şeklindedir. Gözlük camına kolayca yapıştırılabilirler. Prizmaların tedavi amacıyla kulanım alanları heteroforyalar, diplopi, anizometropi ve anormal baş boyun pozisyonu varlığıdır. Az gören hastalarda da tercih edilen retinal alan relokasyonu amacıyla, yüksek dioptrili yakın gözlükleriyle birlikte ve alan genişletici olarak prizmalardan faydalanılabilir. Homonim hemianopsi, tünel görme ve monooküler görmesi olan hastalar için geliştirilmiş çeşitli prizmatik gözlük tasarımları mevcuttur.

Anahtar Kelimeler: Prizma; heteroforya; diplopi; alan genişletici prizmalar
ABSTRACT
 A prism is defined as a portion of refracting medium bordered by two plane surfaces which are inclined at a top. When prescribing a prism the orientation is indicated by the position of the base. When the prisms refract the light towards its base, the image is moved toward its top. There are 3 primary position in which the power of a prism may be specified. These are the position of minimum deviation, the prentice position and the frontal plane position. Prisms are used for assessment of binocular single vision, measurement of squint, assessment of retinal correspondance, and assessment of simulated blindness. There are prisms in several optical instruments such as bio microscope, applanation tonometer, phoropter, and indirect ophthalmoscope. The types of therapeutical prisms are classical glass prisms, and Fresnel prisms. As the strength of the glass prisms increases, the thickness, weight and aberrations increase. For this reason, they can only be mounted on the eyeglass up to 8Δ. Fresnel prisms consist of plastic sheets of parallel tiny prisms of identical refracting angle. They can be easily adhered to the glass. Therapeutical prisms are used for treatment of heterophoria, diplopia, and anisometropia and in the presence of abnormal head neck position. Prisms can be utilized in preferred retinal locus relocation, in hyperopic near glasses, and as a field expansion in patients with low vision. There are several designs of prism glasses developed for homonim hemianopia, tunnel vision, and monocular vision.

Keywords: Prism; heterophoria; diplopia; prisms for field expansion
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