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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