{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T16:42:00Z","timestamp":1779900120402,"version":"3.53.1"},"reference-count":36,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>To track improvement in diplopia symptoms with strabismus-specific health-related quality of life (HRQOL) questionnaire across a treatment consisting of prism correction followed by vision therapy\/orthoptics when prism treatment alone has not succeeded.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Forty-eight participants with diplopia and a mean age of 62.45 were asked to complete an Adult Strabismus-20 (AS-20) questionnaire and a Diplopia Questionnaire (DQ) before and after prism correction. Inclusion criteria were diplopia reported on the DQ as \u201csometimes\u201d, \u201coften\u201d or \u201calways\u201d at reading or straight-ahead distance. The prism correction was classified as successful if the participant reported \u201cnever\u201d or \u201crarely\u201d on the DQ for reading and straight-ahead distance; and unsuccessful if the perceived diplopia worsened or remained the same. For all participants, mean initial AS-20 scores were compared with mean post-prism correction scores, taking into account AS-20 subscales (reading and general functions, and self-perception and interaction). Participants in the failed prism treatment subgroup subsequently underwent a programme of vision therapy wearing their prism correction, the results of which were again determined by participants\u2019 responses on the AS-20 questionnaire, completed before and after the vision therapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Five of the 48 participants dropped out of the study. Prism correction was classified as successful in 22 of 43 participants (51%), and unsuccessful in 21 (49%). Those participants for whom the prism correction was classified as a success showed a statistically significant improvement (<jats:italic>p<\/jats:italic> = 0.01) in both reading and general functions. In the failed treatment subgroup, no significant change in AS-20 score was recorded for any of the domains (<jats:italic>p<\/jats:italic> = 0.1). After treatment with vision therapy\/orthoptics, however, 13 of the 20 participants in the unsuccessful prism correction subgroup (one of them dropped out the study) achieved binocular vision and statistically significant improvement in reading and general functions (<jats:italic>p<\/jats:italic> = 0.01).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Although effective prism correction of diplopia is correlated with enhanced HRQOL, prism correction alone is frequently not sufficient to achieve this objective. In these cases, vision therapy\/orthoptics treatment as a coadjutant to prism correction is shown to improve HRQOL.<\/jats:p>\n<\/jats:sec>","DOI":"10.7717\/peerj.17315","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T07:28:31Z","timestamp":1715239711000},"page":"e17315","source":"Crossref","is-referenced-by-count":3,"title":["Successful treatment of diplopia using prism correction combined with vision therapy\/orthoptics improves health-related quality of life"],"prefix":"10.7717","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6793-667X","authenticated-orcid":true,"given":"Juan Antonio","family":"Portela-Camino","sequence":"first","affiliation":[{"name":"Department of Optometry, Begira Ophthalmologic Clinic, Bilbao, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Departamento de F\u00edsica Te\u00f3rica At\u00f3mica y \u00d3ptica, 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