Orthoptics: Focus on your future

In the Thirties an eye specialist wanted someone to do specific tests to assess his patients' binocular vision (how the eyes work together as a pair) so he trained his daughter to become the first orthoptist. The profession has developed since then and orthoptists are now involved in assessing binocular vision, eye coordination, eye movements and many other visual functions.

Visual function is a term used to describe all the components of what we call vision. Vision is the interpretation of our world from information received by the eyes and processed by the brain. Light is reflected off objects in the world and this reflected light passes into the eyes and is focused, by the front of the eye and the lens inside the eye, onto the retina (the innermost layer of the eye). When light falls onto the retina this creates a chemical reaction which causes nerve impulses to pass back along the optic nerve and eventually reach the part of the brain concerned with vision. The brain then processes this information to provide you with information of the size of the object, the shape of the object, the colour of the object, its distance from you, its distance from objects surrounding it, and even whether it's moving or stationary. All this information requires the use of different visual systems, each of which can be assessed individually. Any defect of these systems or functions can produce visual problems. Defects can occur at any age. If we have good vision we take this for granted but reduced vision will affect your quality of life.

What attracted you to orthoptics?

I had always been interested in science and medicine but only found orthoptics four months before I did my A-levels. I spent a day in a clinical orthoptic department and by the end of the day realised I'd found the career for me. What I remember being impressed by was how every patient was different; the success of the orthoptist's investigation relied on her ability to interpret what she noticed about the patient's eyes and listen to what the patient reported.

How do you study to become an orthoptist?

Liverpool and Sheffield universities are the only institutions offering the degree programme in orthoptics at the moment. The programmes are honours degrees with the lectures delivered at the universities but also containing block clinical placements of two-, three- or four-weeks in approved clinical departments all over the UK. The degree qualification is recognised all over the world and allows entry to the Register of Orthoptists, essential to practice in the UK.

What are the entry requirements?

The entry requirements differ slightly with Liverpool asking for a minimum of three Cs at A-level, stipulating that one of the subjects must be biology. Sheffield asks for 3 Bs but does not specify which subjects, although one should be a science subject.

What sort of employment opportunities are there?

Most orthoptists practice in the NHS and will obtain a post in the UK soon after graduating. There is a clinical career progression but orthoptists can develop into teaching as a clinical tutor or in a university setting. Many orthoptists undertake research that can lead to further education. As the degree is recognised all over the world there are opportunities to work abroad too.

What sort of people do you work with?

An orthoptist's skills can be used in conjunction with the eye care team, stroke team and the paediatric development team. But there are, of course, other areas too.

What does your job involve?

The British and Irish Orthoptics Society is the professional body of orthoptists. All orthoptists can join the society and by getting involved in its work are involved in the profession's development. I was elected to chair the education committee and part of that role is to answer all queries relating to the education of orthoptic undergraduates.

What advances could there be in orthoptics in the future?

Many orthoptists are applying their knowledge of the visual system to other areas of visual physiology. Orthoptists now lead cataract care teams as well as glaucoma teams and units concerned with defects in reading skills. My own research has taken me into sport and also the role of binocular vision in everyday tasks. This extended role of orthoptists will continue as the NHS develops, and managers realise the various skills orthoptists have and how they can be best used within the NHS.

Gail Stephenson is head of education at the British and Irish Orthoptics Society