Feature, Orthoptics Australia

OAW 2021: Blindness, low vision and the orthoptic assessment

Nabill Jacob orthoptist awareness week OAW

Chances are a patient will see an orthoptist when first referred to Vision Australia. Our orthoptists are specialists in low vision and blindness and can functionally assess a patient’s vision, recommend and prescribe low vision aids, as well as provide practical advice and options to the patient, their families and the referring practitioner, among others.

In most cases, a vision assessment will be the first service a patient will undergo with an orthoptist. This assessment sets a baseline for understanding their functional and practical vision. The first thing the orthoptist will do is compare the patient’s vision with that of the referring ophthalmologist or optometrist in case there has been any deterioration.

Nabill Jacob.

Our orthoptists have the time to assess the functional vision of a patient carefully and accurately and have at hand various aids and magnifiers to trial. The focus will always be on the individual needs of the patient such as watching TV, reading, studying and playing sport.

That said, many are generally concerned about reading and doing things up close so the orthoptist will spend considerable time assessing near vision.

An orthoptic assessment consists of multiple tests, including visual acuity, contrast sensitivity and visual fields, as well as determining how lighting impacts the patient’s vision. The orthoptist may go on to prescribe a visual aid and make recommendations tailored to the person’s needs at school, home, university or the workplace.

The orthoptist often explains what is happening with their vision. An important part of the orthoptic assessment is to help the client and their family better understand the underlying eye condition, its implications and subsequent visual consequences.

Visual loss can be overwhelming for a patient and their family and it’s important for orthoptists to understand their feelings, opinions and experiences in order to assess their needs and act accordingly. We emphasise all options available and reassure them that as a client of Vision Australia they will be supported during their life journey with a visual impairment.

Nabill Jacob with a patient at Vision Australia.

The orthoptist has access to slit lamps, ophthalmoscopes, Bjerrum and Humphrey visual field analysers. Should the orthoptist observe any major visual changes or indications that may need further assessment by their referring practitioner, they will immediately be asked to see their eye practitioner.

The orthoptic assessment at Vision Australia is based on a client-centred approach and is holistic in nature and as such the assessment doesn’t end when a patient’s functional vision has been determined.

When a patient is unable read or see things up close, that client may also have problems taking care of themselves with tasks such as cooking, dressing, grooming, shopping, socialising and keeping fit and healthy.  Therefore, an initial orthoptic assessment will, in many cases, lead to them being referred to one of Vision Australia’s suite of 12 specialised services such as an occupational therapist for self-management and activities of daily living providers.

It may also include an orientation and mobility specialist to help them move around their house, community school workplace and even assisting them to join the Vision Australia library where they access thousands of publications via a Wi-Fi enabled device or their smart phone.

They will also be presented with the latest technologies to consider, along with their funding option for services and aids. The orthoptist will help identify if a particular service or a mix of services will help them reach their goals.

For many people who are living with vision loss, they’re concerned about what they can’t do. The orthoptist wants to show them what’s possible, and getting them the right support is a major step in that.

While orthoptists play a major role in supporting people who are blind or have low vision, they will always recommend people get regular vision checks, especially as patients’ get older. The earlier we can begin supporting clients with magnification or other strategies, the more effective we will be in helping them live the life they choose.

ABOUT THE AUTHOR: Nabill Jacob is the Clinical Relationship Manager at Vision Australia and Orthoptics Australia board member. He’s been a senior orthoptist at St Vincent’s Hospital Sydney, corneal transplant coordinator at the Save Sight Institute and worked in private practices in Sydney.

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