Orthoptics

Orthoptists are responsible for the diagnosis and treatment of squint and abnormal eye movements. Their role involves checking that patients have the best possible vision in each eye, as well as good 3D vision when they use their eyes together as a pair. The majority of an orthoptist’s work will be with the young who could have a lazy eye and need to wear a patch, for example, or with the old who could have difficulty controlling their eye movements.

At the diagnosis stage, orthoptists work very closely with ophthalmologists, who specialise in the medical and surgical management of eye conditions, to plan any treatment that might involve surgery. They will also work with the wider healthcare team, including doctors and optometrists who perform eyesight tests and prescribe corrective lenses. Once an assessment has been made, measurements will be taken and a treatment plan formed for the patient, which could involve eye exercises or the addition of prisms to a patient’s glasses to control double vision.

Most orthoptists are hospital-based so patients will be referred to them by healthcare staff or GPs. However, some orthoptists do work in the community – for example, visiting primary schools to conduct vision tests to assess whether children have any difficulties with their vision that will need to be treated. Career progression can be through specialisation, so orthoptists could choose to specialise in working with children, with older children who have reading difficulties, with stroke patients or with glaucoma patients. Orthoptists can also go into teaching and management positions.

New developments

Agenda for Change has created more opportunities for orthoptists, especially at the top end of the scale with the introduction of consultant roles for those who are highly specialised. The orthoptics degree has also opened up the possibility of completing academic research and changes in the provision of healthcare in the NHS has meant that orthoptists can now choose to work in different fields, allowing them to expand their area of expertise.

Skills required

Orthoptists need to be able to communicate well with people of all ages and backgrounds as most of their time will be spent dealing with patients face to face. They need to be methodical, accurate and enjoy taking measurements, and be able work in a pressurised environment in order to meet NHS targets. Orthoptists should be able to motivate themselves to work on their own but should also be able to work well as part of a team – something which is vital to patient care. Finally, orthoptists need to have good eye sight, be dextrous and be able to manipulate the instruments they’ll be using to diagnose conditions.

Starting out

For those starting out, the good news is that there is no shortage of vacancies available. Graduates are qualified to see patients on their own immediately after graduation, but most will join an orthoptics department where they will be supervised by a more senior member of staff. They will also have a mentor who can be approached for guidance or for advice about how to treat particular cases.

In brief

• Best bits
  The interaction with patients, often over a number of years. The balance of being able to use science to aid people in their daily lives.
• Worst bits
  Not having total management of a patient’s care can be frustrating. Having to move jobs to achieve career progression.
• Don’t bother if...
  ... you don’t have a logical mind.
  ... you don’t like working in a structured environment.

CHRIS TIMMS is principal orthoptist at MOORFIELDS EYE HOSITPAL NHS TRUST. She achieved a diploma in orthoptics from the Royal Berkshire Hospital, Reading in 1973 and has over 30 years’ experience in the area.