No data available that match "Orthoptics"



No data available that match "Orthoptics"



(1/41) Anomalies of binocular function in patients with longstanding asymmetric keratoconus.

AIMS: To study binocular function in patients with longstanding asymmetric keratoconus. METHODS: In 20 adult patients with longstanding asymmetric keratoconus managed with a scleral contact lens a full clinical and orthoptic assessment was performed with and without the scleral contact lens in the poorer eye. RESULTS: All 20 patients had a corrected acuity of at least 6/9 in their better eye. With the scleral lens in situ the acuity of the poorer eye ranged from 6/6 to 6/60 and without the lens from 6/18 to hand movements. Patients were aged from 18 to 68 years and had worn a scleral contact lens for between 3 and 106 months. Without the contact lens in their poorer eye all patients had a small exotropia and all showed suppression, with the exception of one patient who had a right hypertropia with diplopia. With the scleral lens in situ 12 patients had an exophoria or esophoria, six a microexotropia, and two a manifest exotropia with suppression. CONCLUSIONS: Binocular function breaks down in some adult patients with longstanding asymmetric keratoconus. This is probably caused by longstanding unilateral visual deprivation. There are similarities to the breakdown of binocular function seen in some patients with a longstanding dense unilateral adult onset cataract who can develop intractable diplopia following cataract surgery.  (+info)

(2/41) Quantifying relative afferent pupillary defects using a Sbisa bar.

AIM: To compare the Sbisa bar (Bagolini filter bar) with neutral density filters (NDF) in quantifying relative afferent pupillary defects (RAPD). METHODS: 11 patients with a RAPD were graded and a neutral density filter bar was used to quantify the RAPD. This was repeated using the Sbisa bar. The Sbisa bar (Bagolini filter bar) is used by orthoptists to quantify density of suppression in amblyopia and is of a similar construct to NDFs. Before this clinical part of the study the luminance for each filter was measured, which enabled a direct comparison to be made. RESULTS: In the analysis of patients with RAPD a high correlation was found when comparing the Sbisa and NDF bars r = 0.95. This was statistically significant (p = <0.001). Correlation was also high when the luminance values for the filters were substituted for the clinical readings (r = 0.92; p=<0.001). CONCLUSION: The Sbisa bar is a comparable instrument to the NDF bar in measuring RAPD. Its availability in the clinical situation makes it a practical choice.  (+info)

(3/41) The assessment and management of strabismus and amblyopia: a national audit.

AIMS: To determine what systems are in place within ophthalmic services for the assessment and management of children suspected of having amblyopia and strabismus. To find out what methods are used for the assessment of these children. METHODS: A questionnaire-based study auditing 288 orthoptic departments in the UK. RESULTS: Responses were received from 75% orthoptic departments. Most hospitals employ more than one system for the assessment of strabismus and amblyopia, which is generally dependent on route of referral. These include 'orthoptic assessment without refraction' (66%), 'combined orthoptist and ophthalmologist assessment' (66%), while 22% have an entirely orthoptist/optometric system. Ophthalmologists are involved in the initial assessment in 145 units (67%), whereas some units involve an ophthalmologist only if response to treatment is poor (15%), or if surgery is required (6%). Fourteen per cent of units reviewed all children, with discharge criteria being based on normal visual acuity (52%), accurate visual acuity (39%) and a normal orthoptic assessment (42%). Seventy-six per cent of units review some children, commonly as a result of family history (55%), parental concern (43%), poor co-operation (30%) and young age (72%). In the absence of squint or amblyopia children are discharged at the first visit, in only 8% of units. There is considerable variation in the tests used to assess visual acuity. LogMAR-based tests (eg EDTRS) are not routinely used in 75% of units. CONCLUSION: Different systems exist for the assessment and management of squint and amblyopia across the country. While much of this variation is to be expected given their possible aetiologies, some could be reduced to produce a more cohesive service. There is also considerable scope for rationalising the tests used to screen infants and children for amblyopia and strabismus.  (+info)

(4/41) Economic evaluation of orthoptic screening: results of a field study in 121 German kindergartens.

PURPOSE: The purpose of this study was to analyze the cost-effectiveness of an orthoptic screening program in kindergarten children. METHODS: An empiric cost-effectiveness analysis was conducted as part of a field study of orthoptic screening. Three-year-old children (n = 1180) in 121 German kindergartens were screened by orthoptists. The number of newly diagnosed cases of amblyopia and amblyogenic factors (target conditions) was used as the measure of effectiveness. The direct costs of orthoptic screening were calculated from a third-party-payer perspective based on comprehensive measurement of working hours and material costs. RESULTS: The average cost of a single orthoptic screening examination was 12.58 Euro. This amount consisted of labor costs (10.99 Euro) and costs of materials and traveling (1.60 Euro). With 9.9 children screened on average per kindergarten, average labor time was 279 minutes per kindergarten, or 28 minutes per child. It consisted of time for organization (46%), traveling (16%), preparing the examination site (10%), and the orthoptic examination itself (28%). The total cost of the screening program in all 121 kindergartens (including ophthalmic examination, if required) was 21,253 Euro. Twenty-three new cases of the target conditions were detected. The cost-effectiveness ratio was 924 Euro per detected case. Sensitivity analysis showed that the prevalence and the specificity of orthoptic screening had substantial influence on the cost-effectiveness ratio. CONCLUSIONS: The data on the cost-effectiveness of orthoptic screening in kindergarten may be used by such third-party payers as health insurance or public health services when deciding about organizing and financing preschool vision-screening programs.  (+info)

(5/41) Identification of infants with significant refractive error and strabismus in a population screening program using noncycloplegic videorefraction and orthoptic examination.

PURPOSE: The second Cambridge Infant Vision Screening Program examined whether screening for accommodative errors by using videorefraction without cycloplegia could effectively serve as a first stage of screening for refractive errors, measured by standard cycloplegic retinoscopy. The screening also included an orthoptic examination for detection of strabismus. METHODS: All infants born in the Cambridge (UK) Health District, over a 2-year period, were invited for screening. Of those 5142 (76%) with mean age 8.1 +/- 0.8 months (SD) attended and received noncycloplegic videorefraction and an orthoptic examination. All those with a focusing error or orthoptic problem, as well as a randomly selected sample of visually normal control subjects, were invited to follow-up a month later for cycloplegic retinoscopy, repeat noncycloplegic videorefraction and orthoptic examination. RESULTS: Of the 5142 screened, 514 had a focusing error or orthoptic problem (positives). Four hundred thirty-nine of these and 284 visually normal control subjects (negatives) attended follow-up. A refractive or orthoptic condition was confirmed in 59.0% of the positive cases, whereas infants in 96.8% of the negative cases were confirmed normal. Adjusting for the proportions of the population represented by those infants seen at follow-up, sensitivity for the screening procedure was calculated at 0.67 and specificity at 0.96. Detailed results are presented in terms of the different conditions detected at screening (far, near, and anisometropic focus and orthoptic error), distribution of greatest axes at screening, and a comparison of initial videorefraction with repeat videorefraction and cycloplegic retinoscopy. CONCLUSIONS: A noncycloplegic screening procedure, simpler to perform than cycloplegic screening, succeeded in detecting a large proportion of infants with significant ametropia, particularly those with significant hyperopia, which is considered to be a strabismogenic and amblyogenic risk factor.  (+info)

(6/41) Role of orthoptic treatment in the management of intermittent exotropia.

30 patients of intermittent ACDS were studied prospectively for a period of 8 weeks to 1 year to evaluate the role of orthoptics in the management of these cases. In patients with convergence insufficiency and a maximum deviation of 25 PD or less the orthoptic treatment was found to be effective in offering symptomatic relief and improving binocular functional status. A reduction in the maximum angle of deviation by 4 PD to 8 PD was observed in 4 patients. Even though the basic angle of deviation remained unchanged in most of the patients, significant functional and symptomatic improvement was obtained in 64% to 85.7% of these cases. The long term stability of these results remains to be studied. In patients with a deviation of more than 25 PD there was no significant improvement in symptoms or reduction in maximum angle of deviation. In 6(37.5%) of these patients some improvement in the fusional range could be demonstrated on the synoptophore without any symptomatic relief.  (+info)

(7/41) Contrast sensitivity function of sound eye after occlusion therapy in the amblyopic children.

To verify the changes of mesopic and photopic contrast sensitivity function of sound eye whose visual acuity was kept the same after occlusion therapy in the amblyopic children. Fourteen sound eyes of amblyopic children (mean; 7.67 years; S.D., 1.50 years) who kept their visual acuity the same after the occlusion therapy were tested. The children had 6 hours of part-time patch therapy for 3 months prior to this examination. Among 14 amblyopic children, 8 were anisometric and 6 were strabismic amblyopes. Using the visual capacity analyzer which measures the minimal contrast level at from low to high spatial frequencies, the contrast sensitivity of sound eye was measured, under both photopic and mesopic condition, before and after 3 months of occlusion therapy. Comparing the contrast sensitivity of sound eye after the occlusion therapy to that before the occlusion, there was no statistical difference in photopic condition. When it comes to mesopic condition, the contrast sensitivity decreased at the intermediate spatial frequency level (3-13 c.p.d, p=0.028) after the occlusion therapy. The occlusion caused statistically significant decrease in mesopic contrast sensitivity, when the visual acuity was not changed after the occlusion therapy. It may indicate that mesopic contrast sensitivity can be considered as a useful tool for early detection of hidden occlusion amblyopia.  (+info)

(8/41) Comparison of Harms tangent screen and search coil recordings in patients with trochlear nerve palsy.

Harms tangent screen, a subjective measurement method of three-dimensional binocular alignment, was compared with search coil recording. Twenty-three patients with unilateral trochlear nerve palsy were measured in nine gaze positions. The two methods correlated best for the horizontal gaze deviation, the vertical gaze deviation, and the vertical incomitance, but there was no correlation for the results of torsional incomitance. Using Harms tangent screen, torsional deviation underestimated the torsional incomitance measured by the search coils. Therefore, central torsional fusional mechanisms or alignment error in the Harms tangent screen are assumed.  (+info)


is orthoptics a successfull career?


  • i have enrolled in orthoptics course in melbourne but i am so confused still that is it a good career field or not will i get a nice job or not
  • yes orthoptics gives you good job prospects. its a lot of hard work though. and you will need a lot of patience as many of your patients will be very young children and babies so you should be happy to work around them. Its one of those jobs where every day is different and the work you will be doing will make a big difference in many peoples lives. good luck with your new course all the best


Fashion disaster or ok?


  • I'm going for a walk up the hill behind our house today, and it's sunny so I want to dress lightly, and I also have a problem with my feet so, long story cut short, I have to wear orthoptics, therefore trainers, so I have a question: dark blue trainers with some light trousers - disaster or ok?
  • It is ok


Brow and/or eye ptosis (droop) cause astigmatism/help?


  • I am not sure why more of this isn't readily available through searches, but very little information seems to have gone into the 'cause' of regular astigmatism and less into irregular astigmatism. At any rate, it would seem logical to me that eye lid and eye brow ptsosis (or drooping) would be a logical cause, over time. If one has pressure on the cornea for many years.. (or decades) it seems very logical that the cornea would change in shape to some degree as the pressure invariably increases as the skin continues to droop/sag and muscles weaken (if that happens to be the cause of the ptosis). So first,.. (I doubt this was taught in school.. as I have run across very little evidence for or against).. but isn't it feasible some acquired (non congenital) astigmatism both regular AND irregular be caused by this pressure on the eye? Think about orthoptics to help 'temporarily' reshape the cornea.. now apply that to a permanent pressure that never goes away. I don't see how it can be denied. Now, if any accept that this idea is feasible as a cause for 'some'.. not all of course (as disease of the cornea, congenital defects, etc can cause this as well).. of the cases of astigmatism.. Wouldn't it also be logical that the common eye lid lift (or excess skin removal) -- (and/or brow lift) help *over time* to reduce the acquired astigmatism.. and potentially reverse it to some degree. Remove the pressure, the cornea is likely to rebound a little, and is probably dependent on the individual and age of how much. Optometrist, Ophthalmologists, Free-thinkers,.. anyone : I would enjoy your thoughts on the matter. Thanks,
  • I guess it's possible. Doesn't astigmatism increase with age? That would make sense. I don't know if removing the pressure would make it bounce back though. I think once your eyes are screwed up, they are pretty much stuck with laser eye surgery of some type. Plus, I don't know if enough pressure could be removed just a brow or eye lid lift. But I honestly know nothing about this, so don't trust me. It sounds like something that could be researched more. :)


Diagnosed with esotropia, I got a free consultation for vision therapy, and am curious about any alternatives.?


  • Measured at 10 eso (0 is the median), my eyes are unable to converge or diverge well, if at all, to work together stabilizing a single image. My focusing, saccading, tracking, and visual memory are all very high, as they are the eyes working independently processing information--however, I'm prone to fatigue and eye strain now in my adulthood. The price I was quoted for therapy was $4500, and my health and vision insurance do not cover treatment for surgery or orthoptics. Are there any in home treatments, computer software, eye exercises that I might be able to do independently, to achieve like or same results? Please and thank you!!
  • The chances are very high that by now your brain has made significant adaptations that result in a deep suppression of the deviating eye by the brain. What that means is, I would be VERY surprised if orthoptics (vision training) would straighten your eye. The only effective treatment would be surgical. Surgery would not cause the brain to be able to integrate both eyes simultaneously but it would give you a good cosmetic solution. Sorry, but that's unfortunately about all you can do now other than accept it and deal with it.