What is orthoptics?

A rare profession introduces itself:

Cover plate and fixing rod with children's pictures
Cover and fixation rod Copyright: Behrens, Julia, Eye Clinic, MHH

The orthoptist deals with the prevention, detection (diagnostics) and treatment (therapy) of

  • strabismus
  • visual impairments
  • Disorders of monocular and binocular vision
  • eye tremors
  • Eye movement disorders

 

Patients often come to us with the following complaints:

  • Strabismus
  • double vision
  • Eye muscle paralysis
  • Reduced vision on one or both sides
  • Eye-related head misalignment
  • eye tremor, headaches
  • reading disorders

The aim of orthoptics is to prevent and improve visual and strabismus disorders and their permanent damage. By restoring or maintaining monocular and binocular vision, orthoptics counteracts visual and perceptual deficits in daily life, resulting in better integration and a higher quality of life.

Link for further information from our professional association: https://orthoptik.de/


An orthoptic examination

Examination with the Bagolini tail test
Examination with the Bagolini tail test Copyright: Volkmann, Ingo, Eye Clinic, MHH

This examination covers many areas of vision.

Binocular vision is often tested at the beginning using the Bagolini tail test. This tests the coarsest aspect of binocular vision, i.e. the cooperation of both eyes.

 


Examination with the Titmus test
Examination with the Titmus test Copyright: Volkmann, Ingo, Eye Clinic, MHH

Next, stereo vision (a finer level of binocular vision, colloquially known as 3D vision) is tested. This can be tested using the Lang test and/or Titmus test, for example. The photo shows an examination with the Titmus test.


Examination with the alternating prism cover test
Examination with the alternating prism cover test Copyright: Volkmann, Ingo, Eye Clinic, MHH

The photo on the right shows an alternating prism cover test to assess the position of the eye and measure the squint angle. One eye is covered with a cover. If there is a misalignment, this is measured using prisms. To do this, the cover is held alternately in front of the right and left eye and the prism is held in front of the squinting eye. This is how the squint angle is measured.


Skiascopy (= the examiner holds a bar with glasses in front of the patient's eye and shines a lamp over it)
Skiascopy (determination of refraction) Copyright: Volkmann, Ingo, Eye Clinic, MHH

The motility of the eyes is also checked.

In many cases, especially in children, a skiascopy is also carried out. Before the examination, the pupil is dilated with eye drops and then the refraction (= spectacle values) is measured with a wide pupil. See photo on the right.

Many other examinations are selected according to the patient's judgment, clinical picture and cooperation. Age-appropriate examinations are carried out on children. An "eye test", which gives an indication of visual acuity, can be carried out on the youngest children from the age of 3 months.

For adults, other examinations can be carried out or evaluated in a different setting than for children.