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Management of Binocular Diplopia Due to Maculopathy with Combined Bangerter Filter and Fresnel Prism

From the W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.

Correspondence: Requests for reprints should be addressed to: Ida L. Iacobucci, C.O., W. K. Kellogg Eye Center, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105.

Purpose: To describe treatment of binocular diplopia due to maculopathy with a combination of Bangerter foil and Fresnel prism.

Methods and Case Report: A protocol for prescribing a combination of Bangerter foil and Fresnel prism is described. A series of three patients in whom a Bangerter foil or prism alone were ineffective for binocular diplopia due to maculopathy, along with a detailed case report of one of these patients, illustrates how a combination of both were used to treat the diplopia.

Conclusions: Fogging is presumed to relieve binocular diplopia due to maculopathy by inducing a functional central scotoma in the affected eye. In some patients, prism correction is needed in addition to a Bangerter foil to eliminate diplopia, possibly by impoving superimposition of the scotoma in the affected eye and the fovea of the sound eye.

Key words: dragged-fovea diplopia syndrome, diplopia, Bangerter foil, Fresnel prism