Orthoptics

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Orthoptics is a profession allied to medicine whose primary remit is the diagnosis and non-medical management of strabismus (squint), amblyopia (lazy eye) and eye movement disorders. [1] The word orthoptics comes from the Greek words ortho meaning "straight" and optikas meaning "vision" and much of the practice of orthoptists concerns refraction and muscular eye control.[2] Orthoptists are trained professionals who specialize in orthoptic treatment, but generally without any medical qualifications. With specific training, in some countries orthoptists may be involved in monitoring of some forms of eye disease, such as glaucoma, cataract screening and diabetic retinopathy [3]

History of Orthoptics[edit]

Orthoptics has a long history in supporting ophthalmic care. 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[edit]

While orthoptic programs began 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. While orthoptic programs differ, students learn to assess, diagnose and manage ocular disorders. More information regarding orthoptic education can be found on the International Orthoptic Association website.

Science – Orthoptic Journals[edit]

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[edit]

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 and negative relative accommodation). 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
  • 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[edit]

References[edit]

  1. ^ International Orthoptic Association document "professional role"
  2. ^ http://www.tcos.ca/about_orthoptics.html
  3. ^ a b Vukicevic, M., Koklanis, K and Giribaldi, M. Orthoptics: Evolving to meet increasing demand for eye service. In Insight news. March 2013: Sydney, Australia.
  4. ^ Helveston, EM (2005). "Visual training: current status in ophthalmology". American journal of ophthalmology 140 (5): 903–10. doi:10.1016/j.ajo.2005.06.003. PMID 16310470. 
  5. ^ http://www.internationalorthoptics.org/download/1160331924_3.1._pr_01_rev_06.doc
  6. ^ McCarry, B (1999). "Orthoptists' Current Shared Care Role in Ophthalmology". Br Orthopt J 56: 11–18. 
  7. ^ K.Fitzmaurice, H Maclean "A Method of Assessing Visual Performance Applicable to Multi-Handicapped Children." Trans. IXth IOC, 1999 Ed.Cynthia Pritchard, Marli Kohler, Dagmar Verlohr, p 111-5.
  8. ^ Fowler, MS (1991). "Orthoptic Investigation of Neurological Patients Undergoing Rehabilitation". Br Orthopt J 48: 2–7. 
  9. ^ Enrica Colombo: The Orthoptist Visual-Therapist. Trans. VIIth IOC 1991, Ed G.Tillson, p 365.
  10. ^ Fujita, J.; Aoki, S. et al. (2000). "Orthoptists in Low Vision Clinic". J.O.J. 28: 239–243. 
  11. ^ Fitzmaurice, K. (1999). "Low vision rehabilitation: An update". Australian Orthoptic Journal 34: 9–14. 
  12. ^ Amano, M.; Yamaguchi, N. et al. (1999). "Glaucoma Screening in Health Checkups". J.O.J. 27: 153–158. 
  13. ^ http://www.australianorthopticboard.org.au/Registration/Registration.html
  14. ^ Edwards, RS et al. (1999). "The Role of Orthoptists in Biometry". Br Orthopt J 56: 19–21. 
  15. ^ Georgievski, Z; Koklanis, K; Fenton, A; Koukouras, I. (2007). "Victorian orthoptists' performance in the photo evaluation of diabetic retinopathy". Clinical & Experimental Ophthalmology 35 (8): 733–738. doi:10.1111/j.1442-9071.2007.01576.x. 
  16. ^ JW Weiss, M Munck, E Muller-Feuga: The Orthoptist and Electro-Oculography. Trans. Vth IOC 1983, Ed.AP Ravault, Marlis Lenk, p 373-79
  17. ^ http://www.ranzco.edu/orthoptists-and-prescribing-in-nsw
  18. ^ VK Lantau et al: State of the Rotterdam Amblyopia Screening Project. Trans. IXth IOC, 1999 Ed.Cynthia Pritchard, Marli Kohler, Dagmar Verlohr, p 39-45.
  19. ^ G.Schalit et al: A New Model for the Evaluation and Management of Strabismus, Amblyopia and Refractive Error in Children. Trans. IXth IOC, 1999 Ed.Cynthia Pritchard, Marli Kohler, Dagmar Verlohr, p 357.