Lindsay Gill: What is an Orthoptist?

Wednesday, October 2, 2013

What is an Orthoptist?

I took a career aptitude test in high school.  The results showed that I would be best in agriculture or transportation.  Better yet, combine the two and drive a vegetable truck!  The results came with the score of 99% accuracy, they said.

I ended up going a different "route."  I ended up becoming an Orthoptist.

Me, circa 1990? With a patch on my eye!
What's an Orthotic?  No, that's a shoe insert.  

What's an Orthopedic?  No, they get paid much more.

I explain to people that "orthodontist" means straight teeth, and "orthoptist" means straight eyes.  "But you're not a doctor," they respond.  Well that is correct, I'm not a doctor.

I work in an Ophthalmology practice along side Pediatric and Neuro Ophthalmologists.  We see adults with double vision, and little kids with crossing or drifting eyes.  We see babies with droopy eyelids or kids that fail school vision screenings.  I also have days where I see my own patients.  Training is 24 months after a Bachelor's degree, followed by a written and oral exam.

What should moms know?  Pediatricians are usually good about referring patients to us if they suspect a problem, or if they are unsure.  You may not know it, but they are checking the eyes at each appointment.  But when little ones come to us, we check for any crossing or drifting out of the eyes, and check for any strong eye preference by covering one eye at a time, as well as check for an eyeglass prescription with a dilated exam. Some crossing/drifting of the eyes is normal in infancy, but by six months you should see an Ophthalmologist if you continue to see this movement.

Otherwise, kids are screened at the Pediatrician and in school.  But sometimes moms know best so if you feel like something just isn't right or you have family history of eye problems, it's probably best to come in (talk to your Pediatrician).

Some terms that you might hear:

Lazy eye:  This could mean any of the following, it is not a technical term and is not specific.  If you have family history of "lazy eye," try to find out what type before bringing your child in.  

Amblyopia: a brain using the eyes unequally so that one eye is stronger than the other, even with glasses on.  This is time sensitive and must be addressed.  Amblyopia can be treated with patching or drops if caught young enough.

Dilation: drops that make the pupil large so the doctor can look at the back of the eye.

  • Retinoscopy:  Using lights and reflexes after dilation to get a child's glasses prescription without any input from the child.
    • Hyperopia:  a fancy name for far-sighted.
    • Myopia:  a fancy name for near-sighted.

Strabismus: any eye misalignment preventing the eyes from working together.
  • Esotropia:  eyes crossing inward.  Certain types of crossing can be corrected with glasses.  Other types must be surgically corrected.  
  • Exotropia:  eyes drifting outward.
  • Diplopia:  double vision which can be the result of an eye misalignment (but can also be from dryness, an incorrect glasses prescription etc.)
  • Pseudostrabismus: When the eyes appear to be crossed due to extra skin around the nose but are the eyes are actually straight (common in babies until the bridge of the nose forms).
Ptosis: drooping of an eyelid

Want to know more?  Leave a comment!  

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