Name of the Procedure:

Slab Off Prism, Glass or Plastic, Per Lens (HCPCS Code V2710)

• Common name: Slab off prism lens
• Technical term: Vertical prism correction via slab off technique in ophthalmic lenses

Summary

A slab off prism procedure involves adding a prism to an eyeglass lens to correct double vision or vertical imbalance when looking through different prescriptions in bifocal or progressive lenses.

Purpose

Medical Conditions:

• Vertical Heterophoria: Misalignment of the eyes when looking at objects at different distances.
• Anisometropia: Significant difference in prescription strength between the two eyes.

Goals:

To provide clearer, more comfortable vision by reducing or eliminating double vision (diplopia) and vertical image disparity.

Indications

• Patients experiencing vertical double vision when wearing multifocal lenses.
• Those with a history of discomfort or imbalance in vision due to unequal lens prescriptions.

Preparation

• Comprehensive eye examination.
• Prescription update to ensure accurate lens adjustments.
• No specific fasting or medication adjustments unless instructed by a healthcare provider.

Procedure Description

1. Lens Fabrication: A specialized procedure where a prism is ground into one of the lenses.
2. Measurement: Accurate prismatic power is measured before slab off.
3. Grinding Process: Skilled technicians grind the lens to create the prism effect.
4. Fitting: The modified lens is fitted into the patient’s eyeglass frame.
   • Tools: Lens grinder, precision measuring tools.
   • Anesthesia: Not required, as this is a non-invasive optical correction procedure.

Duration

The fabrication and fitting process may take several days to a week, depending on the optical lab’s processing time.

Setting

Typically performed in an optical lab and fitted at an ophthalmologist’s or optometrist’s office.

Personnel

• Optometrist or ophthalmologist for examination and prescription.
• Optical lab technicians for lens fabrication.
• Optician for final fitting and adjustments.

Risks and Complications

• Common Risks: Initial discomfort or adaptation period.
• Rare Complications: Improper prism power leading to persistent vision issues.

Management:

Adjustments to the lens grinding process or prescription may be required to address complications.

Benefits

• Significant reduction in double vision and image disparity.
• Improved visual comfort when using bifocal or progressive lenses.
• Benefits typically noticed within a few days of wearing the corrected lenses.

Recovery

• Post-Procedure Care: Regular follow-up visits to ensure lens effectiveness.
• Recovery Time: Immediate, though adaptation to the new lens may take a few days.
• Restrictions: No specific restrictions; follow advised usage and care for eyewear.

Alternatives

• Fresnel Prisms: Removable prism applied to the lens.
• Lined Bifocals: Separate segments for different prescriptions.
• Contact Lenses: Particularly for those who prefer not to wear eyeglasses. ##### Pros and Cons:
• Fresnel Prisms: Easily adjustable but less aesthetically pleasing.
• Lined Bifocals: May not address vertical imbalance effectively.
• Contact Lenses: May not be suitable for all patients and maintenance is required.

Patient Experience

• During Procedure: Non-invasive, no discomfort as the prism grinding happens externally.
• After Procedure: Initial period of adaptation; some patients may experience temporary discomfort.
• Pain Management: Not applicable as the procedure is non-painful.

Patients can expect improved vision clarity and comfort after a short adaptation period. Regular follow-ups ensure optimal lens performance and vision correction.