HealthcareEmphasizing Pediatric Eye Care and Eye Health: Why Orthoptists Play a Critical Role in Pediatric Ophthalmology Clinics

Too often, a child’s eyes are evaluated only after a concern develops or at a routine physical exam. However, taking a proactive approach to pediatric eye health is essential. Healthy eye care plays an important role in a child’s development, learning, and overall well-being. Providing comprehensive pediatric eye care extends beyond the pediatrician.

Children with vision concerns should be assessed and cared for by a team of specialists, including pediatric ophthalmologists, orthoptists, and other eye care providers. By working  together, they can detect, diagnose, and manage vision conditions as early as possible

Vision care can be more complicated than one might think. When someone thinks of an “eye doctor,” they are probably thinking of an optometrist — the type of doctor who performs general eye exams and prescribes corrective lenses, such as glasses or contact lenses. If someone has experienced an eye injury or eye disease, such as cataracts, glaucoma, or macular degeneration (among others), they might have seen an ophthalmologist.

However, there is another vision care professional who is important for treating certain eye conditions: an orthoptist.

An orthoptist is an allied eye-care professional who specializes in the evaluation, diagnosis, and non-surgical management of disorders. Orthoptists are highly trained in examining conditions related to pediatric vision disorders, such as strabismus and amblyopia, as well as visual problems related to neurologic disease. These may include diplopia (double vision), cranial nerve palsies, and nystagmus.

Orthoptists work closely with ophthalmologists, especially pediatric ophthalmologists and neuro-ophthalmologists. In the United States, orthoptists are certified through the American Orthoptic Council and practice in academic medical centers, children’s hospitals, ophthalmology groups, and specialty private practices.

Why regular eye exams are an important part of pediatric eye care

The American Association of Certified Orthoptists (AACO) has issued guidelines suggesting how a child’s vision should be tested during their developmental stages. These guidelines recommend having a vision screening every 1-2 years through primary care/school after age 5.

Many people may not realize the effects vision issues can have on children. Studies have demonstrated the effects of vision impairment on children’s performance in school and also proposed that decreased vision can lead to behavioral issues because of their difficulty concentrating or inability to focus on things they cannot see.

Orthoptists perform specialized vision testing alongside the ophthalmologist to help diagnose and treat conditions. Since access to orthoptists may be limited, it is not practical for every child to receive this degree of specialized testing. This is exactly why routine vision screenings by their healthcare team or primary eye care provider are so important.

Orthoptists emphasize the importance of early detection and intervention for eye conditions, while the vision system is still developing. Early intervention for amblyopia is important to prevent permanent vision loss before it becomes too difficult to address. Because the visual system is still developing, proper timely intervention gives the greatest opportunity for successful outcomes.

Regarding treatment, orthoptists can help manage amblyopia follow-ups and non-surgical treatment plans. Working adjunctively with ophthalmologists, they serve as physician extenders in pediatric and neuro-ophthalmology settings to manage patients of all ages. In pediatric care, orthoptists’ specialized, child-friendly techniques allow them to obtain reliable diagnostic information from infants and young children comfortably.

Get a referral to an orthoptist for vision screening for binocular vision problems

Although orthoptists are a fundamental part of vision care for patients with binocular vision disorders, many patients and parents do not know about the type of specialized vision care they offer. Education about these professionals and their importance in vision care is the first step in ensuring that patients receive the eye care they need.

Internationally, orthoptics is a well-established profession, though public awareness remains relatively limited. Yet for many patients, especially children with strabismus or amblyopia, the orthoptist may be the clinician who performs the most detailed vision assessment they receive.

“If your child has been suffering from vision difficulties such as lazy eye, talk with your primary care provider or pediatric ophthalmologist about a referral to an orthoptist,” says Amanda Yonkers, Certified Orthoptist and Director of Continuing Education at the American Association of Certified Orthoptists. “These eye care professionals will conduct in-depth testing, offer non-surgical treatment options, and refer to an ophthalmologist for surgery if necessary.”