The Orthoptic department specialises in the detection and evaluation of eye muscle abnormalities, otherwise known as strabismus. The eye care professional trained for the investigation of strabismus and eye movement disorders is the orthoptist. The orthoptist will provide all the required measurements and information for accurately treating a squint, and if necessary by a small corrective operation performed by the ophthalmologist.
Strabismus may result in social problems and low self-esteem. Fortunately, strabismus can be easily corrected with a safe operation. According to the severity of the condition, it may be necessary to perform several operations in order to obtain the desired effect. The best binocular vision result is attained when the child is operated on at a young age.
Strabismus occurs when the eyes are not pointing in the same direction. This is a fairly common condition, present in 2-5% of children and adults. It may be convergent (inward) or divergent (outward), according to the direction of the eye. It can be permanent (tropia) or intermittent (phoria).
Strabismus affects adults and children in different ways. In adults, the ocular misalignment results in double vision, which can be treated with a small prism on a pair of glasses fitted by either an orthoptist or an optometrist. In children, on the other hand, the visual system in the brain is plastic and it quickly learns to adjust and to cope with the double vision by ignoring the image from the strabismic eye. This has the effect of leading to the underdevelopment of this eye and consequently to a reduction in its sharpness of vision, a condition called amblyopia.
Amblyopia, otherwise known as ‘lazy eye’, is a condition characterised by the reduction in the clarity of vision in a physically normal eye. It is the most common cause of vision disability in children.
In many cases, it does not cause any symptoms to the child and so it may remain untreated. It is recommended that children should undergo an Orthoptic examination for reliable evaluation of their vision, and their ability to use both eyes together as a pair (binocular vision) before the age of 3 to 5 years.
Amblyopia can be treated either by glasses, or frequently by wearing a patch on the better eye. Patching is a worldwide accepted treatment for amblyopia. If treated early, amblyopia can be reversible. The child wears the patch on the stronger eye in order to force the weaker eye to see and develop. The younger the child the better the result.
The patch can be worn at home, while the child is engaged in various activities, like colouring, doing homework, watching TV, playing computer games, eating or playing with toys. It can also be worn at nursery or school if there is the required enthusiasm, support and supervision from the teachers. Daily or weekly stickers and ‘star charts’ can be helpful for encouraging the child to wear the patch. Close co-operation between the parents, the orthoptist, the ophthalmologist and the teachers is vitally important.