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What does the orthoptist do for adult patients? Part 1

The orthoptist works with the general ophthalmologist, the adult squint ophthalmologist, the neuro-ophthalmologist and sometimes with the other consultants at Clinica London, such as glaucoma and retinal specialists, to help assess the vision and motility in adult patients. Most commonly, the orthoptist helps to measure squints (strabismus) in adult patients, where one eye or other deviates and turns inwards or outwards, upwards or downwards.

Consecutive Exotropia

Adults can suffer from squints despite having had surgery to correct the condition as a child. This is known as consecutive exotropia, where the lazy eye drifts slightly outwards over time. Most commonly an adult with consecutive exotropia is someone who had an in-turning squint and wore glasses as a child or even had eye muscle squint surgery. As an adult they are very embarrassed by the out-turning eye as anyone who is talking to them cannot tell where they are looking, as the two eyes face a different direction.

Thyroid eye disease and other medical conditions

Adult patients who have thyroid eye disease (Grave’s ophthalmopathy), or who have had neuro-surgery or complicated eye or ear surgery, can suffer from double vision and the orthoptist will measure this. Thus the orthoptist will help the ophthalmologist to plan the patient’s care by doing eye position and motility measurements.

Eye and orbit trauma

The orthoptist helps to measure eye motility problems following accidents causing injuries such as an orbital floor blowout fracture, where the bony support of the eye socket is fractured, and there is double vision.

How does the orthoptist measure squint (strabismus)?

The orthoptist specifically measures the level of vision in each eye, the size of the squint (strabismus), eye fixation and excludes double vision using objects to follow, prisms and cover tests.


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