The Observatory

A day in my life as an orthoptist

Liane Wilcox

Liane Wilcox examining a patient

A typical work day for me can involve assessing and treating patients with strabismus (turned eyes) in both children and adults as well as other eye problems that can result from strokes or traumatic hear injury in my private orthoptic practice.

My day starts early with a little five year old girl arriving before school to be treated for poor convergence (ability to turn her eyes inwards) which is giving her double vision and is affecting her ability to read. She has done well with her exercises and can now converge her eyes to 20 cms (which is much better than the previous 35 cms). We have lots of fun in the clinic while I continue to improve her convergence with lots of training.

My next three patients are people who had received head injuries from motor vehicle accidents. Two of the patients have cranial nerve palsy. They both require glasses which have been modified with prisms to control the double vision that they have and we go through some eye exercises (orthoptic treatment) to improve their ability to hold their eyes straight. The last of these patients is a lovely 19 year old boy who was hit by a car and was in a coma for four months.  He can control his double vision by turning his head to the side in an uncomfortable position. I am trying to improve this with the use of glasses and orthoptic treatment but know that eventually he may need surgery to improve the head posture and improve control of his eyes.

A lovely 38 year old lady turns up in the afternoon who had an operation to straighten her eyes as a child as her eyes turned out awards (intermittent exotropia). The surgery unfortunately caused her eyes to turn inwards. She can control this sometimes but does develop double vision for approximately 20 per cent of the day which she deals with by closing one eye. Her daughter pointed out recently that she does this frequently while driving. This has disturbed her and would like to trial some exercises to teach her better control of the eye. She does not want further surgery so is very motivated to perform some orthoptic treatment.

The day finishes with a few new assessments on children who have been referred with vision problems following the four year old vision screening program that is run by the NSW state government in pre-school centres. One of these children has a strabismus (turned eye) for which patching is required while the two other children have anisometropia (difference in glasses requirements in each eye) and as such need glasses to be prescribed. I see these patients in conjunction with an optometrist who works in my rooms. He has a special interest in children’s vision but is not a behavioural optometrist.

That’s the end of my rewarding day which is a typical day in my life as an orthoptist. 

Liane wrote this blog in celebration of World Orthoptic Day. More information about World Orthoptic Day and orthoptics can be found on the Orthoptics Australia website

Orthoptics Australia are a Vision 2020 Australia Supporting Member.

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About the Author

Portrait of Liane Wilcox

Liane Wilcox

Liane is a fully trained orthoptist who graduated in Orthoptics in 1985 from University of Sydney. She has worked in many areas of orthoptics and ophthalmology in both the private and public sectors, was a permanent lecturer at the School of Orthoptics for seven years and continues to lecture in a casual capacity for the University. In 2001 Liane commenced a private orthoptic practice in Castle Hill. This practice specialises in the treatment of eye movement conditions and strabismus in both paediatric and adult patients, as well as eye condition that present in patients who have had traumatic brain injury and stroke. She has a particular interest in children’s vision having completed her Masters in Orthoptics at University of Sydney in 2001 by research in this area. Read more by this author →

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