Orthoptists diagnose and treat anomalies of binocular vision. They examine, assess, and treat vision impairments, squint, amblyopia, and eye motility disorders. Orthoptists apply these methods in particular in pediatrics, neurology, neuro-ophthalmology, ophthalmology, orthoptics, optometry, plenoptic, and tribology, assessing functional diseases of the eye for improving functional disorders of the visual system. They also provide counseling, preventive measures, and training activities and may refract and prescribe glasses, such as prism corrective glasses.
Conduct comprehensive evaluations of patients’ ocular health, visual acuity, eye alignment, and binocular vision using a variety of clinical tests, assessments, and diagnostic tools. Gather information about patients’ medical history, symptoms, and visual complaints to guide diagnostic decision-making.
Assess ocular alignment and muscle balance to diagnose and characterize strabismus (eye misalignment) in patients of all ages. Perform cover tests, prism cover tests, alternate cover tests, and motility examinations to determine the type and magnitude of strabismus deviation.
Identify and manage amblyopia (lazy eye) through visual acuity testing, occlusion therapy (patching), penalization therapy (atropine drops), and vision therapy (orthoptic exercises). Monitor visual development and treatment response to promote amblyopia resolution and visual rehabilitation.
Evaluate binocular vision function, stereopsis (depth perception), fusion, and accommodation to assess patients’ ability to maintain single, clear, and comfortable vision. Use tests such as Worth 4-dot testing, Titmus stereotests, and near point of convergence (NPC) measurements to assess binocular vision status.
Prescribe and instruct patients in performing orthoptic exercises and vision therapy techniques to improve eye coordination, fixation, tracking, convergence, and accommodation. Develop individualized exercise programs tailored to patients’ specific visual needs and treatment goals.
Conduct visual field assessments to evaluate peripheral vision, visual field defects, and functional vision loss in patients with conditions such as glaucoma, optic nerve disorders, and neurological conditions. Use techniques such as confrontation testing, automated perimetry, and kinetic perimetry to assess visual field function.
Assess extraocular muscle function, eye movements, and gaze stability to diagnose and manage ocular motility disorders, including nystagmus, strabismus, and ocular motor disturbances. Perform smooth pursuit testing, saccade testing, and optokinetic nystagmus (OKN) testing to evaluate eye movement control.
Provide visual rehabilitation services to patients with visual impairments, binocular vision disorders, and low vision conditions. Recommend optical aids, prism glasses, and vision training strategies to optimize functional vision, visual comfort, and visual efficiency in daily activities.
Specialize in pediatric eye care and vision therapy for children with developmental vision disorders, learning-related vision problems, and visual processing difficulties. Collaborate with pediatric ophthalmologists, optometrists, educators, and therapists to address children’s visual needs and learning challenges.
Collaborate with ophthalmologists, optometrists, neurologists, pediatricians, and other healthcare professionals to provide comprehensive eye care and interdisciplinary management of ocular and visual disorders. Participate in multidisciplinary clinics, case conferences, and team meetings to coordinate patient care and treatment plans.
Educate patients, parents, and caregivers about eye health, vision disorders, treatment options, and visual hygiene practices. Provide guidance on the use of corrective lenses, eye patches, and vision therapy exercises to support visual development and rehabilitation goals.
Maintain accurate and detailed patient records, including clinical assessments, treatment plans, progress notes, and outcome measures. Adhere to legal and ethical standards for confidentiality, privacy, and recordkeeping in accordance with healthcare regulations.
Orthoptists work in a variety of healthcare settings, including hospitals, eye clinics, private practices, pediatric clinics, and academic medical centers. They may also provide outreach services in schools, community health centers, and rehabilitation facilities to assess and treat patients with visual disorders. The work environment may involve interacting with patients of all ages, from infants to elderly individuals, and collaborating with multidisciplinary teams of healthcare professionals.
A bachelor’s degree in orthoptics or a related field is typically required for entry into an orthoptic training program. Orthoptic training programs are usually postgraduate programs that combine academic coursework with clinical practicum experiences in orthoptic assessment and treatment. Completion of an accredited orthoptic training program and passing a national certification exam are required to become a certified orthoptist. Some orthoptists may pursue additional certification or specialization in areas such as pediatric orthoptics, neuro-orthoptics, or low vision rehabilitation. Continuous learning and participation in continuing education activities are essential for maintaining certification and staying updated on advancements in orthoptic practice.
ISCO skill level is defined as a function of the complexity and range of tasks and duties to be performed in an occupation. It is measured on a scale from 1 to 4, with 1 the lowest level and 4 the highest, by considering:
the nature of the work performed in an occupation in relation to the characteristic tasks and duties
the level of formal education required for competent performance of the tasks and duties involved and
the amount of informal on-the-job training and/or previous experience in a related occupation required for competent performance of these tasks and duties.
This knowledge should be acquired through learning to fulfill the role of orthoptist.
Hygiene in a health care setting: The procedures related to maintaining a hygienic environment within a health care setting, such as hospitals and clinics. These can range from hand washing to cleaning and disinfecting medical equipment and infection control methods.
Health care legislation: The patients` rights and responsibilities of health practitioners and the possible repercussions and prosecutions in relation to medical treatment negligence or malpractice.
Neurophysiology: The medical specialty which is concerned with the study of the nervous system functionalities.
Medical terminology: The meaning of medical terms and abbreviations, of medical prescriptions and various medical specialties and when to use it correctly.
Treatment of strabismus: The treatment administered in the case of strabismus in patients of all ages.
Health care occupation-specific ethics: The moral standards and procedures, ethical questions and obligations specific to occupations in a health care setting such as respect for human dignity, self-determination, informed consent and patient confidentiality.
Optics: The science that studies the elements and reaction of light.
Human physiology: The science that studies the human organs and its interactions and mechanisms.
Neurology: Neurology is a medical specialty mentioned in the EU Directive 2005/36/EC.
Pharmacology: Pharmacology is a medical specialty mentioned in the EU Directive 2005/36/EC.
Neuro-ophthalmology: The diseases of the nervous system that affect vision and control of eye movement.
Paediatrics: Paediatrics is a medical specialty mentioned in the EU Directive 2005/36/EC.
Orthoptics: The principles, assessment techniques and treatment of orthoptic practice.
Human anatomy: The dynamic relationship of human structure and function and the muscosceletal, cardiovascular, respiratory, digestive, endocrine, urinary, reproductive, integumentary and nervous systems; normal and altered anatomy and physiology throughout the human lifespan.
Medical informatics: The processes and tools used for the analysis and dissemination of medical data through computerized systems.
Types of strabismus: The characteristics of the various types of strabismus such as esotropia and hypertropia.
Psychology: The human behaviour and performance with individual differences in ability, personality, interests, learning, and motivation.
Pathology: The components of a disease, the cause, mechanisms of development, morphologic changes, and the clinical consequences of those changes.
Paediatric psychology: Study of how psychological aspects can influence and impact illnesses and injuries in infants, children and adolescents.
First aid: The emergency treatment given to a sick or injured person in the case of circulatory and/or respiratory failure, unconsciousness, wounds, bleeding, shock or poisoning.
Anaesthetics: Anaesthetics is a medical specialty mentioned in the EU Directive 2005/36/EC.
Educate on the prevention of illness: Offer evidence-based advice on how to avoid ill health, educate and advise individuals and their carers on how to prevent ill health and/or be able to advise how to improve their environment and health conditions. Provide advice on identifying risks leading to ill health and help increase the patients’ resilience by targeting prevention and early intervention strategies.
Empathise with the healthcare user: Understand the background of clients` and patients’ symptoms, difficulties and behaviour. Be empathetic about their issues; showing respect and reinforcing their autonomy, self-esteem and independence. Demonstrate a concern for their welfare and handle according to the personal boundaries, sensitivities, cultural differences and preferences of the client and patient in mind.
Test visual acuity: Test patients` visual acuity, perception of depth colour, and ability to focus and coordinate the eyes.
Diagnose problems of the visual system: Identify and diagnose problems of the visual system, such as those related to binocular vision, ocular motility, amblyopia or lazy eye, strabismus or squint, glaucoma, diabetic retinopathy, assessing the sensory state of the eye.
Manage healthcare users’ data: Keep accurate client records that also satisfy legal and professional standards and ethical obligations in order to facilitate client management, ensuring that all clients’ data (including verbal, written and electronic) are treated confidentially.
Receive patient referrals with eye conditions: Receive patient referrals from the eye casualty and neurology departments, eye clinics, general practitioners, health visitors and community clinics.
Deal with emergency care situations: Assess the signs and be well-prepared for a situation that poses an immediate threat to a person’s health, security, property or environment.
Conduct specialised orthoptic tests: Conduct specialised tests such as colour vision test, Ishihara, Farnsworth, D-15, Pseudo-isochromatic colour plates, ophthalmic photography and corneal light reflex testing, analysing the information obtained from these tests to determine the effects of general pathology on the eyes and effects of eye diseases.
Provide health education: Provide evidence-based strategies to promote healthy living, disease prevention and management.
Communicate effectively in healthcare: Communicate effectively with patients, families and other caregivers, healthcare professionals, and community partners.
Undertake healthcare examination: Assess the healthcare user’s physical state, taking detailed information on previous injuries, surgery, general health, resources and lifestyle into account.
Follow clinical guidelines: Follow agreed protocols and guidelines in support of healthcare practice which are provided by healthcare institutions, professional associations, or authorities and also scientific organisations.
Advise on healthcare users’ informed consent: Ensure patients/clients are fully informed about the risks and benefits of proposed treatments so they can give informed consent, engaging patients/clients in the process of their care and treatment.
Promote ocular health: Participate in activities that promote ocular health and prevent ocular problems.
Supervise orthoptic treatments: Supervise orthoptic treatments by using occlusion therapy for amblyopia, prism therapy, and exercises of convergence and fusional ability where indicated.
Comply with quality standards related to healthcare practice: Apply quality standards related to risk management, safety procedures, patients feedback, screening and medical devices in daily practice, as they are recognized by the national professional associations and authorities.
Listen actively: Pay attention to what other people say, patiently understand points being made, ask questions as appropriate, and not interrupt at inappropriate times; be able to listen carefully to the needs of customers, clients, passengers, service users, or others and provide solutions accordingly.
Apply health sciences: Apply a broad range of bio-medical, psycho-social, organisational, educational, and societal aspects of health, disease, and healthcare to improve healthcare services and to improve quality of life.
Adhere to organisational guidelines: Adhere to organisational or department specific standards and guidelines. Understand the motives of the organisation and the common agreements and act accordingly.
Perform vision rehabilitation: Maximise the remaining sight in people with low vision using rehabilitation strategies and magnification aids.
Promote inclusion: Promote inclusion in health care and social services and respect diversity of beliefs, culture, values and preferences, considering the importance of equality and diversity issues.
Interact with healthcare users: Communicate with clients and their carers, with the patient’s permission, to keep them informed about the clients’ and patients’ progress and safeguarding confidentiality.
Ensure safety of healthcare users: Make sure that healthcare users are being treated professionally, effectively and safe from harm, adapting techniques and procedures according to the person’s needs, abilities or the prevailing conditions.
Apply organisational techniques: Employ a set of organisational techniques and procedures which facilitate the achievement of the goals set. Use these resources efficiently and sustainably, and show flexibility when required.
Apply context specific clinical competences: Apply professional and evidence-based assessment, goal setting, delivery of intervention and evaluation of clients, taking into account the developmental and contextual history of the clients, within one`s own scope of practice.
Carry out orthoptic treatments: Carry out orthoptic treatments by using occlusion therapy for amblyopia, prism therapy, and exercises of convergence and fusional ability where indicated.
Work in multidisciplinary health teams: Participate in the delivery of multidisciplinary health care, and understand the rules and competences of other healthcare-related professions.
Accept own accountability: Accept accountability for one`s own professional activities and recognise the limits of one`s own scope of practice and competencies.
Provide therapy of the visual system: Apply suitable orthoptic, pleoptic and optic treatment methods, using equipment such as lenses (`training glasses`), prisms, filters, patches, electronic targets, or balance boards, and suggest and implement adaptation options or possibilities for coping with everyday life, supervising in-office reinforcement exercises and instructing the patient to execute at-home exercises.
This knowledge is sometimes, but not always, required for the role of orthoptist. However, mastering this knowledge allows you to have more opportunities for career development.
Pedagogy: The discipline that concerns the theory and practice of education including the various instructional methods for educating individuals or groups.
These skills and competences are sometimes, but not always, required for the role of orthoptist. However, mastering these skills and competences allows you to have more opportunities for career development.
Employ foreign languages in care: Communicate in foreign languages with healthcare users, their caregivers, or service providers. Use foreign languages to facilitate patient care according to the patient’s needs.
