An orthoptist is a non-surgical healthcare practitioner trained in orthoptics.  This is the science of diagnosing and treating defects in eye movements and binocular vision.  It involves correcting visual axes of the eyes not correctly coordinated for binocular vision due to defects in optic musculature or faults in the visual habits.  These binocular disorders include amblyopia, diplopia and strabismus. The abnormal vision conditions include refractive errors, eye movement control problems, central vision acuity and depth perception.  He is trained to administer the rigors of vision therapy, also known as vision training, a group of proven exercise and techniques that aim to correct and improve binocular, oculomotor and perceptual disorders.

Education and Training

To become an optometrist require attending an optometry program or school. But prior to admission, students must complete a college degree, preferably in the sciences, from accredited colleges or universities.  Thereafter, they can take 2-year post-graduate degree in orthoptics in accredited training programs which include classroom and clinical work as well as the associate internship. During the internship, students fall under the direct supervision of an ophthalmologist and a certified orthoptist.  Apart from an introductory course on the morphology and physiology of the eye, students get to learn the dynamics of eye muscles, the principles of ophthalmology, fundamental ocular pharmacology, diagnostic techniques and therapeutic correction techniques.

On completion, they need to pass the written and practical certification administered by the American Orthoptic Council. There are currently 15 accredited orthoptic training program in the US and Canada, according to the American Association of Certified Orthoptists.  Not all orthoptic programs require a 4-year college degree prior to admission, but if you plan to be certified, you need one.

Orthoptic Practice

Orthoptists generally work together with or under the supervision of ophthalmologists to perform comprehensive vision testing and several clinical procedures to provide patients suffering from eye muscle and vision problems with a full range of non-surgical therapeutic options.  This can include visual training to improve eye movement control, sustaining focus at far and simultaneous focus at far, sustaining focus at near and simultaneous focus at near, central vision and depth perceptual awareness.  Some of the major eye exercises prescribed include near point convergence such as pencil push-ups, Cawthorn Cooksey exercises that alleviate vestibular problems like dizziness, base-out prism reading and stereogram card reading, computerized training for fusional vergence, wearing of convex and convex lenses for refractory correction.

Orthoptists provide therapy exercises for convergence insufficiency conditions where patients suffer asthenopia or eyestrain, eye fatigue and discomfort, and double vision (diplopia) when reading or doing near-field work.  This is among the most common binocular disorder.

Intermittent extropia is another condition orthoptic vision therapy can address.

In addition, they often take an active role in community and collegiate education programs in training ophthalmology students as well as patients, participate in clinical research and in the publication of scientific articles related to the discipline.

A Short History

The term orthoptics is rooted in the Greek word ortho for straight and optikas for vision, so that the word literally means straight vision.

Orthoptists and ophthalmologists work togethers in rehabilitating patients with binocular dysfunction.  Both disciplines have introduced a wide variety of techniques for the improvement of binocular function in the 1930s.  Mary Maddox, the daughter of an English ophthalmologist, can be considered the first pioneer orthoptist.  It has since evolved as a health care profession that has been harnessing scientific studies and developments in diagnosing the managing patients as well as post-surgical patients with strabismus and other specific pediatric binocular eyes disorders.

Orthoptic binocular disorders generally have lower occurrences with wide variations in presentation so that they were often outside the competence of optometrist in eyeglass or spectacle shops or too trivial for ophthalmologists confronting the more demanding surgical tasks. It was for this reason that orthoptists started working in hospitals and evolved to their importance in today's society.