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Do I need a prism on my glasses if I don't get double vision?

Is it necessary to have a prism on your glasses if you have been diagnosed by an orthoptist as having a weak superior oblique muscle in one eye requiring 3 down. However, there is no double vision to speak of. So should I wear a prism even if I don’t actually get double vision?

I’ve found there seems to be a difference of opinion. An orthoptist says that even though I’m not getting double vision, the brain is working hard to fuse the two images together, and that’s why I get headaches. Whereas, an optician has the opinion that if you don’t get double vision, there is no need for a prism. Who’s correct?

A little about me, after having a couple of operations to remove a corneal scar, I was still having problems with headaches wearing glasses. It transpired that I had anisometropia, I.e. an eye imbalance issue. It was at that point an orthoptist identified the weak superior oblique muscle. That helped, but headaches returned. Hence, I then had LASIK surgery on one eye to balance the eyes up.

All should now be well. No corneal scar, no anisometropia. But I still feel a bit fuzzy or nauseous when I wear glasses, either with or without the prism. I know I need to persevere, but at this stage, I don’t know if the prism is necessary when I don’t actually get double vision???

For info, I am 47 and have only really had problems with my eyes since 40, I guess when presbyopia kicked in.
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177275 tn?1511755244
If you put prism in your glasses your eye muscles and 'fusion centers" in the brain stop doing the work of keep your eyes together and the person usually has double vision all the time when the glasses are off.   If you don't get headaches except when you read it's possible you might get reading glasses with prism and wear them only when you read for long period of time. If you get headaches when you wake up, when you don't read or do near tasks eyes not likely the cause.
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177275 tn?1511755244
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