Certified Ophthalmic Medical Technologist (COMT) Practice Exam

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When performing prism alternate cover testing, how should the prism be held?

  1. At a 45-degree angle

  2. In the frontal plane for plastic prisms

  3. Horizontally over the eye

  4. Over the eye at the same angle as the deviation

The correct answer is: In the frontal plane for plastic prisms

The correct method for holding the prism during prism alternate cover testing is in the frontal plane for plastic prisms. This positioning allows for an accurate assessment of the eye’s alignment and fixation while maintaining the proper visual axis through the prism. Holding the prism in the frontal plane ensures that the refractive effect is applied correctly to the optical path, allowing for the measurement of any deviations in alignment. Positioning the prism in the frontal plane minimizes any unintended effects that could arise from tilting the prism or holding it at an angle. By keeping it flat, the test focuses solely on the deviation, thereby providing reliable information on the phorias or tropias present in the patient. This approach is essential to gather valid data for clinical evaluation and treatment planning for strabismus or other eye alignment issues.

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