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HandWiki. Prism Fusion Range. Encyclopedia. Available online: https://encyclopedia.pub/entry/37729 (accessed on 24 September 2026).
HandWiki. Prism Fusion Range. Encyclopedia. Available at: https://encyclopedia.pub/entry/37729. Accessed September 24, 2026.
HandWiki. "Prism Fusion Range" Encyclopedia, https://encyclopedia.pub/entry/37729 (accessed September 24, 2026).
HandWiki. (2022, December 02). Prism Fusion Range. In Encyclopedia. https://encyclopedia.pub/entry/37729
HandWiki. "Prism Fusion Range." Encyclopedia. Web. 02 December, 2022.
Prism Fusion Range
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The prism fusion range (PFR) or fusional vergence amplitude is a clinical eye test performed by orthoptists, optometrists, and ophthalmologists to assess motor fusion, specifically the extent to which a patient can maintain binocular single vision (BSV) in the presence of increasing vergence demands. Motor fusion is largely accounted to amplitudes of fusional vergences and relative fusional vergences. Fusional vergence is the maximum vergence movement enabling BSV and the limit is at the point of diplopia (double vision). Relative fusional vergence is the maximum vergence movement enabling a patient to see a comfortable clear image and the limit is represented by the first point of blur. These motor fusion functions should fall within average values so that BSV can be comfortably achieved. Excessive stress on the vergence system or inability to converge or diverge adequately can lead to asthenopic symptoms, which generally result from decompensation of latent deviations (heterophoria) or loss of control of ocular misalignments. Motor anomalies can be managed in various ways, however, in order to commence treatment, motor fusion testing such as the PFR is required. The PFR involves placing a prism bar in front of an eye. In a patient with BSV, a natural shift of the eye occurs. When measuring horizontal fusion ranges, base in prisms assess fusional divergence while base out prisms assess fusional convergence. The vertical fusional vergence amplitude can also be measured with base up and base down prisms although the horizontal PFR is typically the main focus when testing. When performing the PFR, prism strengths are increased, placing greater demand on the vergence system, eventually resulting in a break point accompanying diplopia. Break point, recovery and blur are key aspects of this assessment. The break point occurs at the loss of BSV, recovery point when BSV is regained from break and blur point is at the loss of comfortable BSV. These stops can be subjectively indicated when the patient notices a double or blurred image. Both subjective and objective measurements can be considered however the examiner's objective observation is the gold standard.

binocular loss of control anomalies

References

  1. Weddell, L. (2010). "Investigative techniques in binocular vision.". http://www.optometry.co.uk/uploads/articles/cetarticle_2611.pdf. 
  2. Diagnosis and Management of Ocular Motility Disorders [John Wiley & Sons]. Retrieved from http://reader.eblib.com.au.ez.library.latrobe.edu.au/(S(xqbcohzqur2arh512r1n55kr))/Reader.aspx?p=1527854&o=155&u=XfNeubn2d7CBZKqnbMXY9g%3d%3d&t=1442499641&h=F78AFAD18023BB379B95676070F3C06B9EA28BA2&s=21338196&ut=492&pg=1&r=img&c=-1&pat=n&cms=-1&sd=1#
  3. Howard, I. P. (Ed.). (2012). Perceiving in Depth, Volume 1: Basic Mechanisms. [Oxford University Press]. Retrieved from https://books.google.com.au/books?id=TCmuuVc54jwC&pg=PA507&lpg=PA507&dq=fusional+divergence+before+convergence&source=bl&ots=PqK67ELqOZ&sig=uGZ6-OLcYprn1hjOFzMYpqpwegY&hl=en&sa=X&ved=0CEQQ6AEwBWoVChMI3oHEtKH-xwIVih2UCh1LuwAh#v=onepage&q=fusional%20divergence%20before%20convergence&f=false
  4. Kanski, Bowling, Nischal, & Pearson, J., B., K., & A. (2011). Clinical Ophthalmology. Edinburgh: Elsevier/Saunders. ISBN 9780702055720. 
  5. Care of the Patient with Accommodative and Vergence Dysfunction. Retrieved from https://www.aoa.org/documents/CPG-18.pdf
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