Orthoptics

Orthoptics

Orthoptic Clinics

• Visual Processing Difficulties

  About This Clinic:

  The Visual Processing Difficulties (VPD) Clinic is a clinic run by Orthoptists to help children with eye problems specifically related to or contributing to a reading or learning difficulty. Once you see something the information is taken into your brain, your brain then needs to make sense of that visual information. 

  What To Expect On The Day:

  • The Orthoptist will take a history and ask questions about your symptoms. 
  • You will have your vision tested for close up and further away to make sure you can see well when you are reading or looking at something in the distance. 
  • Your eye muscles will be checked and how you use them as a pair 
  • Your ability to move your eyes all the way close to your nose will be assessed 
  • The Orthoptist will perform various tests, particularly at how you read and recognize words, numbers and shapes on a page 
  • You may be asked to read text with various overlays
  • The Orthoptist will provide advice, support, and guidance on how to manage your visual processing difficulties. This will discussed verbally at the time of the appointment and a written report will be sent to the referrer and you. You may wish to share the report with teachers, school and other professionals. 

  Referral Information:

  Your GP, Optometrist, school SENCO team and other health care professionals i.e. Audiology, Paediatricians and Occupational Therapist can refer into the VPD service.

• Adult low vision

  What is low vision?

  Low vision is a vision problem that makes it hard to do everyday activities. It cannot be fixed with glasses, contact lenses, or other standard treatments like medicine or surgery. 

  What is a Low Vision Aid clinic?                   

  A Low Vision Aid clinic is where patients with visual impairment (vision which cannot be improved with glasses or contact lenses) can be assessed to maximise the use of their remaining vision.

  You do not need to be registered as visually impaired to access this service.

  Causes of low vision in adults

  Low vision is more common in older adults because many of the diseases that can cause it are more common in older adults. Aging doesn’t cause low vision on its own. 

  Many different eye conditions can cause low vision, but the most common causes are: 

  • Age-related macular degeneration (AMD).
  • Cataracts.
  • Diabetic retinopathy (a condition that can cause vision loss in people with diabetes).
  • Glaucoma.
  • Eye and brain injuries and certain genetic disorders can also cause low vision.  

  Adult Low Vision Aid clinic

  Having low vison as an adult can impact your ability to

  • Read.
  • Drive.
  • Recognise faces.
  • Watch television.
  • Work.

  A Low Vision Aid assessment involves working with your existing vision and assessing your visual ability to perform daily living tasks such as:

  • Reading.
  • Cooking.
  • Going shopping.
  • Organising medicines.
  • Hobbies.
  • Problems with glare

   

  What will happen at my Low Vision Aid appointment?

  We will assess your vision for near and distance and show you various types of magnifiers which may help.

  There are different types of magnifiers such as:

  • Illuminated or non-illuminated.
  • Handheld or stand magnifiers.
  • Hands free magnifiers.
  • Telescopes.

  We can also advise you about:

  • Being registered as sight impaired.
  • Glare.
  • Lighting.
  • Technology such as tablets, phones, computers, and audio books.
  • Recommend useful apps designed for people with visual impairments.
  • Non-optical aids.
  • Digital magnifiers.

  Eye Clinic Liaison Officer (ECLO)

  Following your Low Vision Aid assessment, you will be offered to meet with our hospital ECLO. The ECLO will offer advice and information on:

  • Counselling.
  • Access to employment and education.
  • Benefits checks.
  • Symbol cane or white cane training.
  • Charles Bonnet Syndrome.
  • Various services and local support groups for the visually impaired

  How can I get a referral to the Low Vision Aid service?

  You may request a referral from:

  • GP.
  • Optician.
  • Ophthalmologist (eye doctor).
  • Eye clinic liaison officer (ECLO).

  You can also self-refer yourself to the low vision aid clinic.

  Do I need to bring anything with me?

  Please bring:

  • Your own glasses.
  • Any existing magnifiers.
  • Any examples of tasks that you would like magnification to assist with.
• Paediatric Low Vision

  Causes of low vision in Children

  Low vision in children can be caused by different things like:

  • High refractive errors – needing very strong eyeglasses.

  • Injury to the eyes.

  • Childhood cataracts – cloudiness in the lens of the eye.

  • Childhood glaucoma – extra pressure in the eye.

  • Nystagmus – shaky eye movements.

  • Albinism – a condition where the body does not make colour or pigment for the hair, skin, and eyes.

  • Damage to part of the brain that helps you see (cerebral/cortical visual impairment or CVI).

  • Problems with the retina or optic nerves.

  Paediatric Low Vision Aid clinic

  Paediatric low vision service can see children and young people at least yearly, and assessments are particularly important at times of transition – for example, to secondary school, further study, or work.

  This clinic will allow you to have a greater understanding of how your child uses their eyesight and to ensure they have the equipment and skills to make best use of it.

  Having low vison as a child can impact their ability to:

  • Recognise people’s faces, even people they know.
  • See objects at a distance, like on a whiteboard or blackboard.
  • Read.
  • See objects that could be dangerous, like walls or stairs. 
  • See the difference between colours.
  • See things that don’t stand out well.
  • See in different lighting conditions.

  The assessment should help you and your child have a clear idea of what vision they have and how to use it. This might include information about:

  • What spectacles are needed for particular tasks?
  • How well your child sees in poor light conditions.
  • If your child has a loss of vision affecting detail.
  • If your child has peripheral vision loss (peripheral vision allows us to be conscious of objects either side, above and below our gaze. We do not see them in full detail, but it helps us to judge space, distance and objects or people approaching us).

  A comprehensive low vision assessment will also look at the emotional wellbeing of your child as well as the skills your child needs to use devices and find different ways of doing everyday tasks.

  What will happen at my child’s Low Vision Aid appointment?

  We will assess their vision for near and distance and identify any equipment that may help your child. It is important to equip your child with the skills to use these devices.

  We show you various types of magnifiers and equipment which may help such as:

  • Illuminated or non-illuminated.
  • Handheld or stand magnifiers.
  • Hands free magnifiers.
  • Telescopes.
  • Reading stands.
  • Line guides.
  • Filter glasses for glare

  We provide instructions and ongoing training in using equipment so that they are making the best use of their sight. This includes learning how to scan across a page, using a magnifier or telescope.

  We can also advise you about:

  • Being registered as sight impaired.
  • Education health care plan (EHCP).
  • Qualified teacher for visually impaired (QTVI).
  • Glare.
  • Lighting.
  • How your child sees contrast.
  • Technology such as tablets, phones, computers, and audio books.
  • Recommend useful apps designed for people with visual impairments.
  • Non-optical aids.
  • Digital magnifiers.
  • Eye Clinic Liaison Officer (ECLO) - Paediatrics.

  Following your Low Vision Aid assessment, you will be offered to meet with our hospital ECLO.

  The ECLO will offer advice and information on:

  • Counselling.
  • Education health care plan (EHCP).
  • Qualified teacher for visually impaired (QTVI).
  • Access to education.
  • Mobility training - Symbol cane/white cane training.
  • Benefits checks.
  • Informing of support received from local council.
  • Informing of support received from various paediatric services and local support groups for the visually impaired.

  How can I get a referral to the Low Vision Aid service?

  You may request a referral from:

  • GP.
  • Optician.
  • Ophthalmologist (eye doctor).
  • Eye clinic liaison officer (ECLO).

  You can also self-refer yourself to the low vision aid clinic.

  Do I need to bring anything with me?

  Please bring:

  • Most recent glasses prescribed.
• Special Educational needs

  About This Service

  Children with Special educational needs (SEN) are 28 times more likely to have a sight problem compared to other children. Vision problems can affect learning and behaviour in children. It is therefore important children with SEN undergo a vision testing assessment with an Orthoptist.

  Lancashire teaching hospital Orthoptic department leads a SEN school eye service for children. Children who attend SEN schools (Age 4-19) in the Preston and Chorley area are offered a vision assessment with an Orthoptist.

  Testing vision in the familiar environment of school is beneficial as it reduces the discomfort a SEN child can feel when they attend unfamiliar environments. It also reduces travel time as well as the amount of school time lost.

  Currently the following schools are covered by the Orthoptic SEN team. We are constantly working on getting into further SEN schools in the area:

  Astley Park
  Mayfield
  Acorns
  Coppice
  Applebee
  Hillside
  Pear Tree

  The SEN eye service is an opt out service. Parents/ Guardians can opt out of the service if they would not like their child to have a vision test. A consent letter will be provided to Parents/Guardians (via school) prior to the orthoptic assessment in school.

  What to expect on the day:

  Orthoptists work within the hospital eye care team; when they visit your child’s school, they will undertake various tests to determine the level of vision in each eye and using both eyes together, they will assess the straightness of the eyes, eye movements, 3D vision along with other vision function tests.

   What to expect after the Orthoptic Assessment:

  A summary letter of the visit will be written by the Orthoptist. These letters will be sent home with the child for parents/guardians.

  The outcome of these tests will be shared with you along with advice if requiring seeing an Optometrist (Optician) or Ophthalmologist (Eye Doctor), in addition the results may be shared with your child’s class teacher and linked visual impairment teacher to ensure the best use of vision, placement within class and other resources available for children with vision problems.

  If your child needs to see an Optometrist, they will perform a glasses test and general health check of the back of the eye, this may be performed by a visiting Optometrist within school, by you visiting a high street Optometrist or if necessary, by one of our hospital based children’s Optometrists at Royal Preston Hospital or the Lancashire Eye Centre in Chorley.

  If your child needs to see an Ophthalmologist an appointment will be made for you at Royal Preston Hospital or the Lancashire Eye Centre in Chorley.

  What to expect on the day:

  Orthoptists work within the hospital eye care team; when they visit your child’s school, they will undertake various tests to determine the level of vision in each eye and using both eyes together, they will assess the straightness of the eyes, eye movements, 3D vision along with other vision function tests.

   What to expect after the Orthoptic Assessment:

  A summary letter of the visit will be written by the Orthoptist. These letters will be sent home with the child for parents/guardians.

  The outcome of these tests will be shared with you along with advice if requiring seeing an Optometrist (Optician) or Ophthalmologist (Eye Doctor), in addition the results may be shared with your child’s class teacher and linked visual impairment teacher to ensure the best use of vision, placement within class and other resources available for children with vision problems.

  If your child needs to see an Optometrist, they will perform a glasses test and general health check of the back of the eye, this may be performed by a visiting Optometrist within school, by you visiting a high street Optometrist or if necessary, by one of our hospital based children’s Optometrists at Royal Preston Hospital or the Lancashire Eye Centre in Chorley.

  If your child needs to see an Ophthalmologist an appointment will be made for you at Royal Preston Hospital or the Lancashire Eye Centre in Chorley.

   

  Common Questions and Answers

  Q: How will my child’s visions be tested if they are non-verbal?

  Orthoptists can use a variety of vision assessments that do not require a child to be verbal. We have picture and letter-based tests which can be performed using a matching card.  Also, preferential looking based vision assessments can be used to assess a child’s vision. Orthoptist also observe your child’s visual behaviour.

  Q: How will I know how my child did in their vision test?

  A summary letter of the visit will be written by the Orthoptist. These letters will be sent home with the child for parents/guardians.

  Q: How often will my child be reviewed in school?

  All children are routinely reviewed by the Orthoptist in school every 1-2 years until their final year. However, some children are more frequently reviewed if they wear glasses and/or have problems with their vision.

  Q: Do they still need to be seen if they are under the hospital eye department?

  If your child currently attends the orthoptic department, if suitable, we may be able to see them for their assessments in school rather than the hospital.

• Clinical Education

  About this service:

  Lancashire teaching hospital is a hospital that welcomes students. Our Orthoptic department is committed to providing high quality clinical education and informative, enjoyable placement experiences. We provide block (4 week long) placements for Orthoptic students, from years 1, 2 and 3 and do so throughout the year. We have good links to the Universities providing the Orthoptic degree course.

  HoloLens Clinic:

  Lancashire teaching hospital was the first Orthoptic department to deliver virtual teaching sessions using a video headset called a HoloLens. This was part of an award winning project and is ongoing with excellent feedback received from students, University tutors, and patients alike. The process allows students to watch patient assessments with a 'clinicians view' live in real time via a secure, high-quality, video link between the Orthoptic clinic and their university lecture rooms. It also supports interaction between the students and clinicians so they can ask questions about what they are seeing in live time. 

  Career events:

  We are passionate about promoting the career of Orthoptics. We support this by attending career events to show-case what Orthoptists do and the training required. If you would like more information about a career in Orthoptics please visit https://www.orthoptics.org.uk/become-an-orthoptist/