Orthoptics

Orthoptics is a profession allied to the eye care profession. Orthoptists are the experts in diagnosing and treating defects in eye movements and problems with how the eyes work together, called binocular vision. These can be caused by issues with the muscles around the eyes or defects in the nerves enabling the brain to communicate with the eyes. Orthoptists are responsible for the diagnosis and non-surgical management of strabismus (cross-eyed), amblyopia (lazy eye) and eye movement disorders. The word orthoptics comes from the Greek words ὀρθός orthos, "straight" and ὀπτικός optikοs, "relating to sight" and much of the practice of orthoptists concerns disorders of binocular vision and defects of eye movement. Orthoptists are trained professionals who specialize in orthoptic treatment, such as eye patches, eye exercises, prisms or glasses. They commonly work with paediatric patients and also adult patients with neurological conditions such as stroke, brain tumours or multiple sclerosis. 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. For children, there is evidence that orthoptics is more effective at treating convergence insufficiency than home-based pencil or computer training; for adults the effectiveness is less evident. Orthoptics has a long history in supporting ophthalmic care. French ophthalmologist Louis Emile Javal began using ocular exercises to treat strabismus (squint) 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, Ernest E. Maddox, in response to increasing patient demand and time needed to examine and treat patients. Ernest Maddox was a reputed ophthalmologist as well as the inventor of various instruments for investigating binocular vision. Mary Maddox started her own practice in London in the early 1920s and her first hospital clinic opened at the Royal Westminster Hospital in 1928.