Orthoptics

Orthoptics refers to a discipline dealing with the detection, diagnosis and management of patients with eye disorders such as nystagmus, binocular vision, and amblyopia.^[1]
The word orthoptics comes from the Greek words ortho meaning "straight" and optikas meaning "vision".^[2] Orthoptists are allied health care professionals who specialize in orthoptic treatment, but also have an ever expanding role in eye care. Orthoptists are involved in the early detection and monitoring of eye disease, which is vital protection against vision loss and sight problems ^[3]

History of Orthoptics

Orthoptics is a well-recognized and established allied health profession with a long history. French ophthalmologist Louis Emile Javal, began using ocular exercises to treat strabismus (eye turns) and described the practice of orthoptics in his writings in the late 19th century. Mary Maddox pioneered the orthoptic profession and was the first documented orthoptist. She was trained by her father (an ophthalmologist) in response to increasing patient demand and time needed to examine and treat patients. Mary started her own practice in London in the early 1920s and her first hospital clinic opened at the Royal Westminster Hospital in 1928.^[3][4] The first Australian hospital clinic with orthoptists was established at the Alfred Hospital in Melbourne in 1931.

Education

Whilst orthoptic programs commenced as hospital-based traineeships, Bachelor and Masters programs in Orthoptics are now offered in many countries. Post-graduate programs such and Professional Doctorates and PhDs are also available. Currently approximately 17 orthoptic programs are offered around the world. Whilst orthoptic programs differ in many regards, graduates qualify with outstanding competencies in the assessment, diagnosis and management of ocular disorders. More information regarding Orthoptic Education can be found on the International Orthoptic Association website.

Science – Orthoptic Journals

Orthoptists make a significant contribution to research in eye health care and publish in many well-renowned ophthalmology journals. In addition, most orthoptic associations organize an annual conference and publish a national journal consisting of advancements and research developments in eye health care. Every four years the International Orthoptic Association also organizes a worldwide Congress. A variety of orthoptic journals and their table of contents can be found on the International Orthoptic Association website. The University of Liverpool also offers a search facility of various orthoptic journals that date back to the 1940s and the transactions of related meetings.

Current orthoptic practice

Orthoptists are mainly involved with diagnosing and managing patients with binocular vision disorders which relate to amblyopia, extraocular muscle balance such as with version, refractive errors, vergence, accommodation imbalances, (positive relative accommodation, negative relative accommodation) and pathological causes. They work closely with ophthalmologists to ensure that patients with eye muscle disorders are offered a full range of treatment options. According to the International Orthoptic Association, professional orthoptic practice involves the following:^[5]

• Primary activities
  • Ocular motility diagnosis & co-management^[6]
  • Vision screening
  • Assessment of special needs^[7]
  • Assessment and rehabilitation in neurological disorders^[8]
• Secondary activities
  • Low Vision assessment and management^[9][10][11]
  • Glaucoma assessment & stable glaucoma management^[12]
  • Biometry (includes sonography work)^[13][14]
  • Fundus photography & screening^[15]
  • Visual electrodiagnosis^[16]
  • Retinoscopy and refraction, such as using a phoropter to assess refractive errors^[17]
• Further activities
  • Specific outpatient waiting list initiatives to reduce the delay for children referred to the eye clinic (filter screening)^[18]
  • Joint multidisciplinary children’s vision screening clinics (orthoptics/optometry)^[19]
  • Organisation/prioritisation of the strabismus surgical admissions list according to agreed criteria
  • Assistance with surgical procedures

See also

References