Prisms and Palsies: Lessons from the 3D Vision Clinic Course # 40025


James Kundart OD, MEd, FAAO, FCOVD-A


General Optometry

COPE Course ID:

41931 GO

Expiration Date:

June 24, 2017

Qualified Credits:

Course has expired


This course covers how to diagnose eye muscle palsies and how to treat them with prism. Both congenital and acquired strabismic causes of diplopia and near-diplopia are covered, as well as prism prescribing techniques called associated phorometry.


  • To discuss the different grades of Oculomotor (CN III) palsy, how they manifest in our patients, as well as causes and treatments.
  • To explore how Abducens (CN VI) palsy sometimes manifests as binocular blur and divergence insufficiency, the sometimes ominous cause, and how to treat the divergence problems that come from it.
  • To review the common causes and symptoms of Trochlear (CN IV) palsy and why the Parks Three Step is unnecessary.
  • To cover the difference between dissociated and associated phorometry for prescribing prism, and how to prescribe forced choice prism with and without a digital phoropter.


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Maddox Rod, no longer the standard for prescribing prism (see podcast)