Orthoptics

The Orthoptics service provides services to people of all ages. Orthoptists assess, investigate and help to treat squints, amblyopia (lazy eye), double vision, nystagmus (wobble of the eye). Orthoptists specialise in providing the ‘gold standard’ in testing children’s vision and in assessing for conditions relating to muscle inbalance.

In Tayside, Orthoptists carry out the pre-school eye test when a child is around 4 years old. Check out the Pre-school visual screening web page to find out more.

Orthoptists mainly work within ophthalmology outpaitents departments in the hospitals. We also work in a variety of other health settings such as:

  • Community Health Centres
  • Nurseries
  • Child Development Centres
  • Stroke Recovery

Areas we work in:

  • Children’s services including children with complex needs
  • Adult services including stroke and neurology
  • Maxillofacial

People can be referred in to this service via their GP, health visitor, optometrist and other health and social care professionals

Assessment

What will happen?

During your initial assessment, we will try to fully and clearly understand the problems you are facing and the concerns you have either for yourself or your child. Your vision will be assessed and a range of tests will be carried out in order to determine how well your eyes work together as a pair.  The orthoptist will also assess the function of your eye muscles.  All tests are non-invasive and could take 30 mins to 1 hour to complete.

What should I bring to the appointment?

If you wear glasses, please bring your most up to date pair. If you wear separate reading and distance glasses, please bring both.

Will I/my child receive treatment on the same day as my appointment?

This depends on what the orthoptist finds at the assessment.  If you are experiencing double vision for example, the orthoptist will be able to provide you with something which will make you feel a lot more comfortable on the day. However, if the orthoptist finds your child is seeing poorly or has a squint for example, it will be necessary to refer them to an ophthalmologist (eye doctor) or an optometrist for a glasses test and to check the health of the eye before treatment can begin.  This may occur on the same day as your appointment or the orthoptist will arrange for you to attend another day.

What to do if I need to cancel/change my appointment?

If you are unable to attend you/your child’s appointment, please let us know as soon as possible so we can offer someone else the appointment slot. In order to do this please call:

Dundee

For Ninewells Appointments – (01382) 740210 between 9am and 1pm, Monday to Friday
For Lochee or The Crescent Appointments (01382) 401440 between 8:30am and 4:30pm, Monday to Thursday

Angus

For Arbroath Appointments – (01241) 822555 between 9am and 2.pm, Monday to Friday
For Montrose Appointments – (01674) 817192
For Stracathro Appointments – (01356) 665131
For Whitehills Appointments – (01307) 475265

Perth

For PRI Appointments – (01738) 473730 or 473731 between 8:30am and 5pm, Monday to Friday

Visual field testing

What is a Visual Field?

Your field of vision is what you can see directly in front of you as well as above, below, and to the sides (the periphery) without moving your eyes.

Your best vision will normally be in the centre, with things gradually getting less clear the further out into the periphery they are. Some eye conditions, such as glaucoma, ocular hypertension and retinitis pigmentosa can affect your visual field. Certain neurological disorders, diabetes, and stroke, can also affect your visual field. The purpose of a Visual Field test is to:

  • To find any reduction in sensitivity within your field of vision
  • To assist the doctor in diagnosing and treating medical conditions that may affect or have affected your vision
  • To monitor any changes in your field of vision

It is quite common for chronic eye conditions such as glaucoma and ocular hypertension to have tests repeated at regular intervals to monitor any changes. Changes can be very gradual and a person may not detect them at all by themselves. The visual field test can pick up very small, subtle changes in the visual field so that treatment may begin before any significant visual loss occurs.

What happens at a Visual Field appointment?

You will have your visual field test done before you see the eye doctor. The visual field tests in NHS Tayside are carried out by orthoptic assistants. At your visual field test appointment the following will happen:

  • Visual acuity check:
    Your visual acuity (the sharpness of your vision) will be checked before the visual field test, so if you have glasses for distance (driving, television, bifocals, etc.) please bring them with you.
  • Visual Field test:
    Normally, each eye is tested separately. A special patch will be placed on the eye not being tested, but for best results both eyes should still remain open during the test. You will be given a buzzer to press and positioned at the visual field machine by the orthoptic assistant. You will be given instructions on how to do the test. On average, each eye will take approximately 3 – 7 minutes to complete the test, although some tests can take longer.
  • Test instructions:
    During the test, you should watch the orange light inside the machine. It is very important to try to keep your head and eye(s) as still as possible, but do blink normally so that your eye does not get dry.Fainter lights will begin to appear, one at a time, off to the sides. You will press the button whenever you see one of these lights.It is normal to have times where there are no lights to be seen. Sometimes the lights will be so faint that it may feel as if you are missing them. This is also normal . The test is measuring how faint a light you can detect, not how many. For a good result, it is more important to be accurate than fast.

    We will let you know when the test starts and stops. If you are uncomfortable at any time sitting at the machine, please tell us so we can adjust your position or even pause the test for you to rest.

    After the test is complete, the results will be passed to your doctor.

Will I get eye drops?

You will not get eye drops during the visual field test. If you are seeing the eye doctor or having photographs/scans of the eye on the same day you may have dilating eye drops after this test.

How long will the appointment take?

Please allow 45 minutes for your visual field appointment. Some tests take more time than others.

Why is my Visual Field appointment not at the same time as my Doctor appointment?

Unfortunately it is not always possible to have both appointments on the same day. Please keep your separate visual field appointment. It is important that the visual field results are available for the doctor to make a decision on your treatment when you see them.

What if I cannot keep my appointment?

If you need to change or cancel your visual field appointment time, please call the ophthalmology outpatient appointment office on 01382 740210 Monday to Friday between 8:30am and 1pm.

Treatment and Additional information

Does your child refuse to wear glasses or a patch?

Trying to get your child to wear glasses or an eye patch for the first time can be difficult. You are not the only one who is struggling and this leaflet provides some helpful advice.

Glasses should be worn all day until bed-time. A patch should be worn for the total number of hours each day your orthoptist has advised.

It is important that the same person takes on the role of getting your child to wear their glasses or eye patch as this lets your child see that the adult is in control.

This person needs to put the glasses or eye patch on your child. Do not ask your child if they would like to wear their glasses or patch, it must be you that decides it is time. Words that can be used are: “mummy says it’s time for your glasses/patch”. If your child removes their glasses or patch, simply say nothing but put their glasses or patch back on. You are in control. Do not give up; no matter how many times your child may remove their glasses or patch, you must be consistent and persevere.

Once the glasses or patch have been worn correctly, only you can take it off when it is time. Please do not let your child do this.

Try to distract your child by playing a game or an activity they enjoy. Give your child lots of praise for keeping their glasses or patch on. Try to explain to other family members and friends the importance of not drawing attention to the fact that your child is wearing their glasses or patch but to keep them distracted.

Sticker reward charts can also be helpful. Your orthoptist may have given your child a patch poster to use or you could use a reward chart.