Eye exercises
Encyclopedia
Orthoptics is a discipline dealing with the diagnosis and treatment of defective eye movement and coordination (such as nystagmus), binocular vision
, and amblyopia
by eye care professional
s. There are five areas of treatment for orthoptic problems:
However the term orthoptics is sometimes used to refer simply to eye exercises which are a component of strabismic-related vision therapy
.
s who specialise in the diagnosis and management of binocular vision problems. Orthoptists are represented worldwide by the International Orthoptic Association
.
Orthoptics is usually studied as a primary or master's degree, or as a 2 to 4 years post graduate training course. Orthoptists usually work in close cooperation with Ophthalmologists, pediatricians
, and sometimes neurologists
. Continuing professional development and registration is required in most countries.
The orthoptic health care profession evolved and specialised as scientific development increased in the diagnosis, management and pre/post-surgical care of patients with strabismus
, binocular vision abnormalities and specific pediatric disorders. Because of their lower prevalence and variational presentation, these were beyond the realm of a primary eyecare consultation at a spectacle shop (where most Optometrists work) and beyond the Ophthalmologists' demanding surgical workload and practice. Hence, Orthoptists began to specialize in hospitals with these problems throughout more than 20 countries.
, 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:
Binocular vision
Binocular vision is vision in which both eyes are used together. The word binocular comes from two Latin roots, bini for double, and oculus for eye. Having two eyes confers at least four advantages over having one. First, it gives a creature a spare eye in case one is damaged. Second, it gives a...
, and amblyopia
Amblyopia
Amblyopia, also known as lazy eye, is a disorder of the visual system that is characterized by a vision deficiency in an eye that is otherwise physically normal, or out of proportion to associated structural abnormalities of the eye...
by eye care professional
Eye care professional
An eye care professional is an individual who provides a service related to the eyes or vision. It is a general term that can refer to any healthcare worker involved in eye care, from one with a small amount of post-secondary training to practitioners with a doctoral level of education.-Current...
s. There are five areas of treatment for orthoptic problems:
- corrective lensCorrective lensA corrective lens is a lens worn in front of the eye, mainly used to treat myopia, hyperopia, astigmatism, and presbyopia. Glasses or "spectacles" are worn on the face a short distance in front of the eye. Contact lenses are worn directly on the surface of the eye...
es (spherical, cylindrical lens, prismaticPrism (optics)In optics, a prism is a transparent optical element with flat, polished surfaces that refract light. The exact angles between the surfaces depend on the application. The traditional geometrical shape is that of a triangular prism with a triangular base and rectangular sides, and in colloquial use...
and Fresnel lensFresnel lensA Fresnel lens is a type of lens originally developed by French physicist Augustin-Jean Fresnel for lighthouses.The design allows the construction of lenses of large aperture and short focal length without the mass and volume of material that would be required by a lens of conventional design...
es) - strabismic-relatedStrabismusStrabismus is a condition in which the eyes are not properly aligned with each other. It typically involves a lack of coordination between the extraocular muscles, which prevents bringing the gaze of each eye to the same point in space and preventing proper binocular vision, which may adversely...
orthoptics as an "eye exercise" is limited to the treatment of eye coordination problems by increasing the range of binocular fusion. - eyepatchEyepatchAn eyepatch or eye pad is a small patch that is worn in front of one eye. It may be a cloth patch attached around the head by an elastic band or by a string, or an adhesive bandage. It is often worn by people to cover a lost or injured eye, but it also has a therapeutic use in children for the...
ing - pharmaceuticals, such as cycloplegics
- surgerySurgerySurgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
However the term orthoptics is sometimes used to refer simply to eye exercises which are a component of strabismic-related vision therapy
Vision therapy
Vision therapy, also known as visual training, vision training, or visual therapy, is a broad group of techniques aimed at correcting and improving binocular, oculomotor, visual processing, and perceptual disorders."-Historical development:...
.
Orthoptists
Orthoptists are Eye care professionalEye care professional
An eye care professional is an individual who provides a service related to the eyes or vision. It is a general term that can refer to any healthcare worker involved in eye care, from one with a small amount of post-secondary training to practitioners with a doctoral level of education.-Current...
s who specialise in the diagnosis and management of binocular vision problems. Orthoptists are represented worldwide by the International Orthoptic Association
International Orthoptic Association
The International Orthoptic Association represents over 20,000 orthoptists, in over 20 countries.- History :The International Orthoptic Association was formed in 1967 after the first International Orthoptic Congress. The British Orthoptic Association were the founding members. - Registration and...
.
Orthoptics is usually studied as a primary or master's degree, or as a 2 to 4 years post graduate training course. Orthoptists usually work in close cooperation with Ophthalmologists, pediatricians
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...
, and sometimes neurologists
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
. Continuing professional development and registration is required in most countries.
History
Orthoptists and ophthalmologists introduced a wide variety of techniques for the improvement of binocular function in the 1930s. The first pioneer was Mary Maddox, the daughter of an English ophthalmologist.The orthoptic health care profession evolved and specialised as scientific development increased in the diagnosis, management and pre/post-surgical care of patients with strabismus
Strabismus
Strabismus is a condition in which the eyes are not properly aligned with each other. It typically involves a lack of coordination between the extraocular muscles, which prevents bringing the gaze of each eye to the same point in space and preventing proper binocular vision, which may adversely...
, binocular vision abnormalities and specific pediatric disorders. Because of their lower prevalence and variational presentation, these were beyond the realm of a primary eyecare consultation at a spectacle shop (where most Optometrists work) and beyond the Ophthalmologists' demanding surgical workload and practice. Hence, Orthoptists began to specialize in hospitals with these problems throughout more than 20 countries.
Current orthoptic practice
Orthoptists are mainly involved with diagnosing and managing patients with binocular vision disorders which relate to amblyopiaAmblyopia
Amblyopia, also known as lazy eye, is a disorder of the visual system that is characterized by a vision deficiency in an eye that is otherwise physically normal, or out of proportion to associated structural abnormalities of the eye...
, extraocular muscle balance such as with version
Version (eye)
A version is an eye movement involving both eyes moving synchronously and symmetrically in the same direction.#Dextroversion / right gaze#Laevoversion / left gaze#Sursumversion / elevation / up gaze#Deorsumversion / depression / down gaze...
, refractive errors, vergence
Vergence
A vergence is the simultaneous movement of both eyes in opposite directions to obtain or maintain single binocular vision..When a creature with binocular vision looks at an object, the eyes must rotate around a vertical axis so that the projection of the image is in the centre of the retina in both...
, accommodation imbalances, (positive relative accommodation
Positive relative accommodation
Positive relative accommodation is a measure of the maximum ability to stimulate accommodation while maintaining clear, single binocular vision. This measurement is typically obtained by an orthoptist, ophthalmologist or optometrist during an eye examination using a phoropter...
, negative relative accommodation
Negative relative accommodation
Negative relative accommodation was proposed by Prof. Joseph Kearney of Oxford University in 1967, is a measure of the maximum ability to relax accommodation while maintaining clear, single binocular vision. This measurement is typically obtained by an orthoptist, ophthalmologist or optometrist...
) 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
International Orthoptic Association
The International Orthoptic Association represents over 20,000 orthoptists, in over 20 countries.- History :The International Orthoptic Association was formed in 1967 after the first International Orthoptic Congress. The British Orthoptic Association were the founding members. - Registration and...
, professional orthoptic practice involves the following:
- Primary activities
- Ocular motility diagnosis & co-management
- Vision screening
- Assessment of special needs
- Assessment and rehabilitation in neurological disorders
- Secondary activities
- Low Vision assessment and management
- GlaucomaGlaucomaGlaucoma is an eye disorder in which the optic nerve suffers damage, permanently damaging vision in the affected eye and progressing to complete blindness if untreated. It is often, but not always, associated with increased pressure of the fluid in the eye...
assessment & stable glaucoma management - Biometry (includes sonographySonographerSonographers are diagnostic medical professionals who operate ultrasonic imaging devices to produce diagnostic images, scans, videos, or 3D volumes of anatomy and diagnostic data. Sonography requires specialized education and skills to view, analyze and modify the scan to optimize the information...
work) - Fundus photography & screening
- Visual electrodiagnosis
- RetinoscopyRetinoscopyRetinoscopy is a technique to obtain an objective measurement of the refractive error of a patient's eyes. The examiner uses a retinoscope to shine light into the patient's eye and observes the reflection off the patient's retina...
and refraction, such as using a phoropterPhoropterA phoropter is an instrument commonly used by eye care professionals during an eye examination, containing different lenses used for refraction of the eye during sight testing, to measure an individual's refractive error and determine his or her eyeglass prescription.Typically, the patient sits...
to assess refractive errorRefractive errorA refractive error, or refraction error, is an error in the focusing of light by the eye and a frequent reason for reduced visual acuity.-Classification:...
s
- Further activities
- Specific outpatient waiting list initiatives to reduce the delay for children referred to the eye clinic (filter screening)
- Joint multidisciplinary children’s vision screening clinics (orthoptics/optometry)
- Organisation/prioritisation of the strabismus surgical admissions list according to agreed criteria
- Assistance with surgical procedures
See also
- Bates methodBates MethodThe Bates method is an alternative therapy aimed at improving eyesight. Eye-care physician William Horatio Bates attributed nearly all sight problems to habitual strain of the eyes, and felt that glasses were harmful and never necessary...
- Convergence insufficiencyConvergence insufficiencyConvergence insufficiency or Convergence Disorder is a sensory and neuromuscular anomaly of the binocular vision system, characterized by an inability of the eyes to turn towards each other, or sustain convergence.-Symptoms:...
- DiplopiaDiplopiaDiplopia, commonly known as double vision, is the simultaneous perception of two images of a single object that may be displaced horizontally, vertically, or diagonally in relation to each other...
- Dissociated Vertical DeviationDissociated Vertical DeviationDissociated Vertical Deviation is an ocular condition which occurs in association with a squint, typically Infantile Esotropia.- Mechanism :...
- EsotropiaEsotropiaEsotropia is a form of strabismus, or "squint", in which one or both eyes turns inward. The condition can be constantly present, or occur intermittently, and can give the affected individual a "cross-eyed" appearance...
- ExotropiaExotropiaExotropia is a form of strabismus where the eyes are deviated outward. It is the opposite of esotropia. People with exotropia often experience crossed diplopia. Intermittent exotropia is a fairly common condition. "Sensory exotropia" occurs in the presence of poor vision...
- Eye care professionalEye care professionalAn eye care professional is an individual who provides a service related to the eyes or vision. It is a general term that can refer to any healthcare worker involved in eye care, from one with a small amount of post-secondary training to practitioners with a doctoral level of education.-Current...
- EyepatchEyepatchAn eyepatch or eye pad is a small patch that is worn in front of one eye. It may be a cloth patch attached around the head by an elastic band or by a string, or an adhesive bandage. It is often worn by people to cover a lost or injured eye, but it also has a therapeutic use in children for the...
- GlassesGlassesGlasses, also known as eyeglasses , spectacles or simply specs , are frames bearing lenses worn in front of the eyes. They are normally used for vision correction or eye protection. Safety glasses are a kind of eye protection against flying debris or against visible and near visible light or...
- HaploscopeHaploscopeA haploscope is an optical device for presenting one image to one eye and another image to the other eye. The word derives from two Greek roots: haploieides, single and skopeo, to view. The word is often used interchangeably with stereoscope, but it is more general than that. A stereoscope is a...
- International Orthoptic AssociationInternational Orthoptic AssociationThe International Orthoptic Association represents over 20,000 orthoptists, in over 20 countries.- History :The International Orthoptic Association was formed in 1967 after the first International Orthoptic Congress. The British Orthoptic Association were the founding members. - Registration and...
- Pediatric ophthalmologyPediatric ophthalmologyPediatric ophthalmology is a sub-speciality of ophthalmology concerned with eye diseases, visual development, and vision care in children.-Training:...
- Pinhole glassesPinhole glassesPinhole glasses, also known as stenopeic glasses, are eyeglasses with a series of pinhole-sized perforations filling an opaque sheet of plastic in place of each lens. Similar to the workings of a pinhole camera, each perforation allows only a very narrow beam of light to enter the eye which reduces...
- StrabismusStrabismusStrabismus is a condition in which the eyes are not properly aligned with each other. It typically involves a lack of coordination between the extraocular muscles, which prevents bringing the gaze of each eye to the same point in space and preventing proper binocular vision, which may adversely...
- Vision therapyVision therapyVision therapy, also known as visual training, vision training, or visual therapy, is a broad group of techniques aimed at correcting and improving binocular, oculomotor, visual processing, and perceptual disorders."-Historical development:...