On any given day, an orthoptist is likely to find themselves partnering with families and children to guide them through common conditions such as amblyopia and strabismus, or more complex conditions associated with systemic disease, disability and diseases that result in permanent vision impairment. With a firm foundation in evolving scientific evidence, these allied health professionals work with ophthalmologists and ophthalmic registrars to ameliorate the consequences of eye and vision disorders.
Eye disease is confronting for families and children.
Building a sense of trust and establishing open lines of communication is key to managing any disease and when it comes to working with children, doing so take a particular set of skills.
Sue Silveira, a representative of Orthoptics Australia, says this is a skill set orthoptists have well and truly developed.
Our ability to monitor disease development and effectively communicate change with the patient and family can be critical to the person’s long-term visual acuity
“Orthoptists are particularly adept at making their young patients feel comfortable and safe. We set up child-friendly environments to minimise the child’s fear of clinical situations, and adopt a play-based approach to assessment so that children often don’t even realise they are being tested,” Ms. Silveira told mivision. “We make assessments fun, relaxed and friendly. We take the assessment to the child so we can gain maximum clinical information whilst making the experience enjoyable for both the child and their family.”
With the special needs of children and families in mind, Ms. Silveira said, orthoptists work closely with ophthalmologists to tailor management plans that are appropriate and realistic to achieve for children and their busy families.
She uses the example of managing a child diagnosed with amblyopia or a delay in their visual development due to the need to wear glasses or the presence of an eye turn. “This can be very challenging, especially in the initial stages when the child’s vision is reduced. We need to make sure that the management plan is realistic in terms of what a child will tolerate and the best environment for their treatment, for example, wearing a patch. This plan also needs to be flexible, both for the child and the busy family they are a part of.
She said support is critical. “We advise parents on how to encourage their child to wear their glasses and patch and we also counsel the child. Importantly, we spell out the consequences for the child’s visual development if the treatment plan is not followed. It is vital that parents understand why their child needs treating, how best to manage the process and the consequences of not following the management plan,” said Ms. Silveira. “This is because most of the management will be carried out by the people who support the child – that is, the parents, along with grandparents and carers such as teachers.”
Management of an eye disease such as amblyopia is longterm, often traversing the early years of a child’s life when they are least likely to cooperate with assessment and treatment due to their age and level of understanding. In the process, a close bond often forms and, Ms. Silveira says, the orthoptist can become a vital support person for the child and family. This close relationship and long-term insight into the child’s vision conditions can also make the difference when it comes to saving sight.
“Our ability to monitor disease development and effectively communicate change with the child and family can be critical to the child’s long-term visual acuity,” said Ms. Silveira. “Without prompt and intensive treatment, the child may not have their vision restored.”
“It is this holistic approach to optimising each child’s vision and eye function as they become an adult that motivates us, as orthoptists, to push the boundaries of clinical excellence, by modifying the treatment to best suit each child and their family, the environment and the diagnostic needs of the assessment.
“Without our expert skills, the assessment and care of children is at risk of falling short of the expectations of the child and their family,” she added.
