Source
Padula Institute of Vision, 37 Soundview Road, Guilford, CT 06437, USA. wpadula@padulainstitute.com
Abstract
OBJECTIVE:
To demonstrate that Visual Midline Shift Syndrome (VMSS) following a cerebrovascular accident (CVA) can be corrected with yoked prisms.
RESEARCH DESIGN:
This randomized study describes how the use of yoked prisms affects visual midline and documents the influence of yoked prisms on improving postural orientation.
METHODS AND PROCEDURES:
Evaluation of VMSS and its correlation with postural lean during ambulation were studied in 30 post-CVA subjects and 30 controls.
EXPERIMENTAL INTERVENTIONS:
Yoked prisms were used to treat VMSS by correcting posture and balance.
OUTCOMES AND RESULTS:
Over 50% of post-CVA subjects showed positive visual midline shift (p < 0.001; 95% confidence interval [CI], 0.660.93 for right CVAs and p = 0.001; 95% CI, 0.61-0.93 for left CVAs). A statistically significant proportion of those with a positive shift showed a decrease in shift utilizing yoked prisms (p < 0.001; 95% CI, 0.73-0.97 for right CVAs and p = 0.001; 95% CI, 0.07-0.39 for left CVAs). Additionally, over 50% of CVA subjects developed lean or drift away from hemiparesis and many subjects showed increased weight-bearing on the hemiparetic side with yoked prisms.
CONCLUSIONS:
Yoked prisms are an effective means of treating VMSS in this population and may be useful in other neurological syndromes with visuo-spatial involvement.