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Bradford Teaching Hospitals Foundation Trust

Orthoptic and Low Vision Services

Orthoptics

Young girl having eye testOrthoptics is derived from a Greek word meaning “straight eyes”. An orthoptist assesses how people use their eyes together as a pair (binocular function). If they do not demonstrate binocular function the orthoptist will investigate the cause. The main stay of orthoptic work is investigating children with eye muscle imbalance (squint). Therefore, it is important that they are knowledgeable in visual development and have a good rapport with youngsters.

Adults can also acquire an eye muscle imbalance caused by diabetes or trauma (to give just two examples). They may experience double vision (diplopia) and the orthoptist will investigate and help determine the route cause of the problem. Orthoptists liaise with ophthalmologists (eye doctors) who decide on further investigations such as blood tests, CAT scan or MRI scan. 

Bradford has 8 full time orthoptists, 4 part time orthoptists, 2 health care assistants and a clerical assistant.

Bradford’s orthoptic department has an extended role in that we provide:

1. Low Vision Aid clinics

2. Visual fields (perimetry)

3. Orthoptic school screening

4. Outreach Glaucoma clinic

5. Outreach pre-op cataract assessment clinic

6. Community Orthoptic clinics

7. Community orthoptic assessment of adults with learning disability

Low Vision Services

 

Elderly women having eye testThis takes a holistic approach to the patient’s needs. The first appointment is one hour so that the orthoptist can take time to assess the patient’s lifestyle and particular needs in terms of lighting, magnifiers and/or other gadgets to help with everyday living. The service has links with Social Services and the local centre for the blind & partially sighted at Morley Street.

Visual field assessments are a frequently requested test in an ophthalmology out-patient department. They are most commonly used in the assessment of glaucoma but can often be requested to help determine neurological problems. Automated machines are used by the orthoptists and orthoptic health care assistants and support the ophthalmologist’s management of the patient.

We provide a comprehensive school screening programme for all children in reception classes across the Bradford & Airedale district. This complies with the most recent recommendations from the National Screening Committee. Feed back from schools is very positive in terms of the improved concentration and ability of those children who are found to need glasses.

The outreach clinic at Windhill Medical Centre enables stable glaucoma patients to have their review appointments at their local centre. Photographing the back of the eye (fundus photography), testing the eyeball pressure (intraocular pressure testing) and visual fields assessment are carried out on these patients by the orthoptist.

The outreach clinic at Westwood Park was originally set up as a pre-operative cataract clinic to support the ophthalmologist. The orthoptist takes measurements to decide what strength lens might be needed after the cataract is removed (biometry). This now provides visual fields clinics as well.

Our community orthoptic clinics at both Horton Park and Bradford University provide an alternative for patients to be seen outside the hospital out-patient environment. It is generally the school age children followed up from the reception class screening that are seen in these clinics. We have strong links with the university optometry department.

Our community orthoptist was one of the first to set up a service at Waddiloves Health Centre where adults with learning disabilities could access a multidisciplinary team of professionals for various health and social needs. Many such adults find the out-patient environment too stressful to cope with. A number of adults were found to have never had an eye test because they were deemed not able to comply with testing. Our community orthoptist has the skills, patience and experience in a calm and relaxed environment to successfully test these vulnerable adults and has some remarkable stories of people gaining better vision through intervention at Waddiloves. This has enhanced their everyday life and in some cases improved behaviour and communication.

 

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