Orthoptist

Orthoptics is an ophthalmic sub specialty, pertaining to the evaluation, diagnosis and treatment of patients with disorders of the binocular vision and eye movements. These are the people who have crossed eyes, double vision and or lazy eyes. Orthoptist have post secondary education and have to become certified by the orthoptic board.  The majority of orthoptists work in a pedriatic settings, however, adult strabismus ( diplopia / double vision) due to strokes, tumors, multiple sclerosis, Parkinson’s disease, and trauma, just to name a few, is an orthoptic field in demand, especially down here in Florida with the large retirement community.

What an orthoptist can do to help.

A lot of our patients are being referred to us for a sudden onset of diplopia/ double vision of unknown etiology. Diplopia occurs when ARROYO_SRI06one or sometimes more extra ocular eye muscles do not work together to keep the eyes in focus. This is often caused by TIAs (mini strokes) or space occupying lesions in the brain or eye socket. After examining the patient and ordering the appropriate diagnostic tests ( CT, MRI, lab work) to rule out a stroke or tumor, a prism can usually be fitted on the patient’s glasses to improve symptoms. A prism is an optical device, which will trick the brain into thinking that the eyes are not out of alignment. Often, the  misfunctioning eye muscle will regain back it’s strength and the prism then can be removed. This process takes about 90 days from the onset of the double vision and several follow up appointments during this period are needed to adjust the prism strength accordingly to the improvement of motility.Some eye deviations (strabismus) can be treated with eye exercises that can be prescribed by the orthoptist.  If there is no improvement with prisms or exercises the orthoptist works in conjunction with the neuro-ophthalmologist to determine further treatment. This can be surgical, botulinum injections, or medication depending on the cause and the degree of deviation.

Jody Abrams, MD 

Oculoplastics/ Neuro-ophthalmology

Sarasota Retina Institute

Sarasota Florida 

 

Jody Abrams, MD, FACS
Oculoplastics/Neuro-ophthalmology
Sarasota Retina Institute
Sarasota, Florida 34239

Comments

  1. Margaret Mougey says:

    Hello, I am searching for a solution to double vison, or ‘ghost image’ which is a result of a detached retina followed by a scleral buckle, then fluid, inflamation and scar tissue. My local optometrist tried fitting me with a black out contact and I could not tolerate the contact in my eye – it caused too much irritation. He also tried to see if he could align my vision with a prism, however he is not a specialist and I’m not sure if he had the proper equiment to effectively fit the prism, therefore he didn’t think that it would work. Is there specialized equiment that would test more accurately for a prism. I have lived with this curse for almost four years and it affects everything that I do. It affects the way my brain processes things resulting in a sort of ‘brain fog’ or a delayed reaction to the way my brain processes image. I am desperate to find help. My retina doctor is Charles Gremillion and he is a surgeon that deals with diseases of the eye, but doesn’t do refractive work or any sort of corrective vision issues. Please let me know if you think that you could help me. Thank you in advance. Margaret Mougey

    • JAbramsMD says:

      Margaret
      There are lots of reasons for the double vision and this is not an uncommon thing to see after retinal sugery as the aligment of the eye can be shifted. We work with prisms daily to help patients like yourself get into single vision. If that does not help we also can look at surgical interventions to realign the eye, but often this is not needed. If you would like to come see us we can do a very through neurological workup on the eyes to look for the cause of the double vision and see what option would work best for you. Please feel free to call our main office at 941-921-5335 and schedule a time to come in and see myself and my orthoptist Rikki.

      Jody Abrams, MD
      Neuro-ophthalmologist/Oculoplastic Surgeon
      Sarasota Retina Institute
      Sarasota, Florida

      • Margaret Mougey says:

        Dr Abrams,
        Thank you for your response. I am happy that there is a possiblity of getting help!!! The next obstacle I have is the financial issue. I lost my job four years ago and I had cobra for a while but that has run out. Since I am only 58 years old, I am too young for Medicare and don’t quite qualify for Medicaid. My husband has a job but his income is low, however, it is over the limit to qualify for Medicaid. I exhausted all possibilities of getting help from local organizations such as Blind Services, the Kiwanis Club and the Department of Vocational and Rehabilitation Services. I have to be totally blind to qualify for Blind Services, the Kiwanis Club said that I had to be referred by Blind Services and the Department of Vocational and Rehabilitation Services said that they couldn’t help me either. I am stuck – there is no other option. Whatever treatment I have gotten since my cobra ran out, has either been Pro Bono or at a reduced rate and set up on a payment program. Maybe that is why I haven’t gotten the proper help – most people aren’t willing put forth the effort unless they are well compensated and I get that….they are in the business of making money. There are only a select few who are willing to go the extra mile. If you can’t help me, I will certainly understand. When I call to make the appointment, is there someone I should talk to about the finances? Thanks again for your kind response!!! Cautiously optimistic – Margaret Mougey

        • JAbramsMD says:

          Margaret
          If you will call our office and talk with Janet I am sure we can make arrangements to get you the help you need through our clinic. We are always willing to work with patients so they can get the treatment they need no matter their financial status.

          Jody Abrams, MD
          Neuro-ophthalmologist/Oculoplastic Surgeon
          Sarasota Retina Institute
          Sarasota, Florida

          • Margaret Mougey says:

            Dr Abrams
            Thanks for your help – I will call your office and make an appointment. I am looking forward to meeting you and hopeful that you can find a solution to my eye problems.

            Margaret Mougey

  2. shreenivas says:

    Dr Jody Abrams, MD
    I am having a conginial cataract , had an IOL placed when I was about 10 year old (now 33). Since
    then I have double vision (only when both eyes are open) , The IOL was posterior , now my cataract in left eye
    is growing and my surgen feels that I may need IPL in left eye too in future.

    The placement of the lens in the right eye initially caused double vision , I would like to see if this is something
    you have come across and that can be fixed , Thank you for reading this

    • When the double goes away with one eye closed that is a from a misalignment of the eyes. I recommend to patients they get the best vision out of both eyes as this will help with alignment. After this is done (wether cataract surgery or glasses help) then if there is still double vision, strabismus surgery or even some times prism in the glasses can correct the problem.

      I hope this helps.

      Jody Abrams, MD

Trackbacks

  1. […] the workup shows the likely cause (sometimes easily seen with measurements, and sometimes other test are needed) then possible treatment can be prescribed. The treatment can […]

  2. […] a misalignment of the eyes. Strokes that affect the brainstem can cause ocular misalignments. Be taking accurate measurements the location of the stroke can be identified prior to any imaging. Then depending on the extent and […]

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