Orthoptics is a paramedical discipline within the field of ophthalmology that detects and improves functional visual problems. These are often the result of inappropriate or incorrect use of the way of seeing and looking. The patient receives individual treatment from the orthoptist to use his eyes and vision in a different, better way. This treatment often consists of various exercises and training. Patients of all ages come to the orthoptist with various eye problems. An orthoptist only acts after consultation with and/or in collaboration with an ophthalmologist so that any abnormalities and/or disorders of the eye are already known.
- History of orthoptics
- Orthoptist: Treatment of all kinds of eye problems
- Low vision rehabilitation in the visually impaired
- Method: Detect and improve eye problems through training
- Professional associations
History of orthoptics
The French ophthalmologist Louis Émile Javal (1839-1907) laid down the basic principles of orthoptics. He came into direct contact with strabismus (crossed eyes) in his family, and looked for a less invasive and risky solution than surgical intervention, which at the time was not always successful. One of the solutions was to perform a specific set of exercises, a kind of “kine” or gymnastics for the eyes. Since this “training” of the eye muscles was very intensive, ophthalmologists began to entrust these tasks to “orthoptic” assistants. It was the Englishman Ernest Maddox who initiated the first specialists in orthoptics. Naturally, the surgical techniques were refined and perfected, but the usefulness of the orthoptist had already been proven. His field of work was expanded and orthotics evolved into a full-fledged paramedical profession.
Orthoptist: Treatment of all kinds of eye problems
The non-medical treatment of strabismus (medical term is “strabismus”) is still one of the most important tasks of the orthoptist. One of the other tasks is to re-educate a “lazy” eye; he also analyzes and treats various problems in the field of monocular and binocular functions (coordination of the work of both eyes), which may cause the child to have reading and learning problems. Finally, he acts in the context of the rehabilitation of visually impaired people.
The orthoptist not only treats babies and small children with strabismus, but he also deals with patients with other eye problems and eye movement disorders. Sometimes these are congenital but sometimes also acquired. Some examples of patients who come to the orthoptist are patients with diabetes mellitus, glaucoma, brain damage, neurological disorders, … Patients who have just had a stroke (insufficient blood supply to the brain) or patients who have just undergone eye surgery. also go to the orthoptist. For example, a cataract patient who has just undergone surgery calls on the orthoptist to learn to deal better with the suddenly improved vision. The intervention of an orthoptist is also useful for a number of other visual problems such as concentration problems, double vision, dizziness, closed eye, headache, difficulty adapting to glasses (for example with progressive lenses), tired eyes, eye pain, irritation. , red eyes, watery eyes, frequent blinking of the eyelids, blurred vision during prolonged fixation, double vision, … These difficulties often have their origins in convergence insufficiency (poor convergence in which close viewing is made difficult by poor cooperation of the eyes), whether or not accompanied by a latent deviation of the visual axes or by a disorder of the combined motor skills. In that case, he reduces or remedies these problems with orthoptic treatment, whether or not combined with wearing appropriate glasses.
Low vision rehabilitation in the visually impaired
An orthoptist is committed to the rehabilitation training of visually impaired patients. Visually impaired people learn to make optimal use of their remaining vision thanks to the orthoptist. The orthoptist examines together with the patient what problems there are. In doing so, he proposes solutions or options to circumvent the difficulties, of course adapted to the patient and his living conditions. He takes various elements into account (contrasts, colors, font size of a document, lighting, …). Visually impaired people sometimes also benefit from the training exercises to learn to see differently, but this is not possible for everyone. That is why visually impaired people sometimes use other technical and technological aids such as magnifiers, TV magnifiers, computer magnification systems, etc.). This seems simple, but it requires a lot of time, motivation, concentration and practice from the patient. In addition, the orthoptist suggests simple adjustments such as markings and tactile landmarks and looks at the patient’s reading and body position so that he can possibly optimize this. For example, macular degeneration creates a “black spot” in the center of the image. The orthoptist then teaches the patient to use a fixation point at the edge of the spot as a starting point, which makes vision easier. With the tips from the orthoptist, reading speed improves and fatigue and other complaints disappear.
Method: Detect and improve eye problems through training
The orthoptist usually first carries out some examinations so that he is able to draw up a treatment plan. It measures contrast sensitivity, visual acuity (both near and far), color perception, the quality of the perceived image, ocular motor skills, the cooperation between the two eyes, the adaptability when switching from a light to a dark environment, the depth perception, the visual field, reading comfort. For the treatment, the orthoptist focuses on the functional elements (adaptation, coordination between both eyes, visual acuity), the motor skills (stimulating the muscles, stimulating the combined motor skills, fixating, following with the eyes , jerking movements, vergences) and perception (facial space, localization, eye-hand coordination).
Professional associations
The Dutch Association of Orthoptists (NVvO) is active in the Netherlands. In Belgium you can contact the professional association Belgian Orthoptic Association
Orthotics are of paramount importance for promoting a better quality of life in both adults and children with eye problems.
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