Orthoptics

This may be due to amblyopia (lazy eye) and/or the need for glasses.

Orthoptists also assess abnormal eye movements, which may be caused by nerve palsy, injury to the eye or diseases affecting the muscles in the eye. Patients with eye movement problems often complain of seeing diplopia (double vision).

Orthoptists may treat patients with prisms, eye exercises or patches.

A more detailed description of the role of the orthoptist can be found on the British and Irish Orthoptic Society (BIOS) website.

Orthoptists must be registered with the Health and Care Professions Council (HCPC) to practise.

We provide a specialist orthoptic role, working independently, and as part of the variety of services provided the Oxfordshire Orthoptic Department accepts direct referrals from GPs, health visitors and optometrists.

Appointments

All orthoptic clinics are by appointment only. An orthoptic appointment takes approximately 20-30 minutes. If you need to see the optometrist and/or ophthalmologist as well, the whole process may take up to three hours.

Dilating eye drops are frequently used for assessment by the optometrist and/or ophthalmologist, and take 30 minutes to take effect. Time will then be needed for the eye examination itself and a discussion of the results of the test.

It may be possible for the orthoptist to see you at one of our community clinics nearer to your home if a follow-up appointment is needed. Please ask at the end of your visit to see if this is possible.

How often you need an appointment will depend on your age, type of eye problem and treatment. The orthoptist will tell you how regularly you need to attend and for how long.

Services

Paediatric Rapid Access Clinic (PRAC)

This clinic is primarily for children referred by the GP, Health Visitor, local optometrist or School Vision Screening service (provided by Oxford Health) who need a combined orthoptic and optometry refraction (glasses test).

The children seen in this clinic are aged between two and a half and eight years of age.

Children attending this clinic will require eye drops for the refraction. The eye drops take around 30 minutes to dilate the pupils, with the total appointment time being around two hours.

Health Visitor Referral Clinic

This clinic is for children referred via their health visitor or GP because of a suspected squint or vision problem. We aim to offer an appointment within eight weeks of referral.

Special schools

A specialist orthoptist visits seven special schools around the county. This may be once a term or on an annual basis, depending on the school. The orthoptist can provide the initial assessment and follow-up care at school for those children who require it.

Community Paediatrics

The orthoptist assesses children with complex needs working as part of a multidisciplinary team. The children with needs, such as speech and language disorders and suspected autistic spectrum disorder, have a variety of assessments over the course of the week, including an eye examination with the orthoptist and optometrist in the Community Paediatrics Department at the Oxford Children's Hospital.

Oxford Centre for Enablement (OCE)

Rehabilitation Centre for patients post stroke / head injury)

We provide orthoptic assessment within part of the multidisciplinary team for patients admitted to the OCE for rehabilitation following a stroke or brain injury.

Neurology / Neuro-ophthalmology

The orthoptist works with the ophthalmologist and neurologists on the neuro-ophthalmology ward round. The orthoptist assesses day case and inpatients on the Neurosciences Ward who have visual disturbances e.g. double vision.

Stroke Service

We receive referrals from the multidisciplinary team for patients who have specific vision problems following a stroke, such as double vision, blurred vision and peripheral vision loss.

We can assess inpatients on the Hyper Acute Stroke Unit at the John Radcliffe Hospital, Oxfordshire Stroke Rehabilitation Unit at Abingdon Community Hospital, or at Oxford Centre for Enablement. They can offer diagnoses and advice to help manage immediate visual symptoms.

We can also see patients in the Orthoptic Stroke Outpatient Clinic for ongoing follow-up after they have been discharged. This can include monitoring visual fields, double vision management and advice and support around visual impairment registration and returning to driving. In some cases, appointments may be carried out at a local optician, followed up with a telephone consultation from our team where appropriate.

We work closely with occupational therapists and physiotherapists to provide personalised care to each patient.

GPs can refer patients directly to the Orthoptic Department if the patient is experiencing a vision problem post stroke.

Visual Impairment Support Service

This is a clinic for the parents of children with a newly diagnosed visual impairment. The visual impairment clinic provides support for families with a child who has recently been diagnosed with visual impairment. The orthoptist can liaise with any other hospital or community services to ensure families are supported and have access to the services they need.

Craniofacial Clinic

The orthoptist works as part of the multidisciplinary team for patients attending the Oxford Craniofacial Unit, which is one of the four supra regional centres in the UK for craniofacial disorders. A significant number of craniofacial patients have eye movement disorders and visual problems.

Teaching and research

We teach various professional groups, including undergraduate orthoptic students, pre-registration optometrists, medical students, junior doctors and trainee GPs. The department is an accredited centre for undergraduate students on clinical placement from the University of Liverpool and the University of Sheffield and Glasgow Caledonian. The department is also involved in research.

Private patients

Private patients can be seen in the Orthoptic Department following referral from a Consultant Ophthalmologist.

Paediatric Neuro-oncology

An orthoptist is part of the multidisciplinary team and provides appropriate management of this patient group, co-ordinates appropriate follow-up and provides input at the weekly team meetings about visual problems, implications and progress.

NF2 Service

An orthoptist is part of the multidisciplinary team to ensure integration of ophthalmology care with the rest of the patient's needs. The Oxford NF2 Service is one of four supra regional services in the UK for assessment and management of patients with neurofibromatosis type 2.

Maxillofacial service

All patients with orbital fractures and possible ocular motility disorder as a result, have an Orthoptic assessment to document eye alignment, ocular movements and measurements where appropriate. A report is sent back to the maxillofacial team, any diplopia managed, and follow-up arranged as necessary.

In addition to the above clinics, we provide orthoptic support to the twice weekly Paediatric Ophthalmology Clinic, once monthly Ocular Motility Clinic and once a week Neuro-ophthalmology Clinic.

Orthoptists also perform the preoperative and postoperative assessment of children and adults having squint surgery.

Community clinics

General orthoptic clinics are held at:

• Abingdon Community Hospital Outpatients
  Most Wednesdays 9.00am - 4.30pm and one Thursday per month
  Tel: 01865 904346
  
• Banbury: Horton General Hospital Outpatients
  Mondays, Tuesdays, Wednesdays and Fridays.
  Tel: 01295 229358
• Bicester Community Hospital
  Wednesdays 9.00am - 4.30pm
  Tel: 01865 903880
• Didcot Community Hospital
  Tuesday and one Thursday per month 9.00am - 4.30pm
  Tel: 01235 205860 (hospital main reception) or contact the Oxford Orthoptic Department on 01865 234567
• Wantage Community Hospital
  Thursdays week 1, week 2, (week 3 alternative months) 8.00am - 4.30pm
  Tel: 01865 904030
  
• Witney Community Hospital Outpatients
  Fridays 9.00am - 4.30pm
  Tel: 01865 904222

If there is no answer when you call, please phone the Orthoptic Department at the John Radcliffe Hospital.

Tel: 01865 234567 Monday to Friday 8.30am - 4.30pm and listen to the options for the Orthoptic Department.

At all of the above there is a combined Orthoptic and Optometry refraction (glasses test) clinic once a month or every other month.

Contact us

Orthoptic Department Secretaries

Email: orthoptic.secretaries@ouh.nhs.uk

Orthoptic Department
Oxford Eye Hospital
Level LG1, West Wing
John Radcliffe Hospital
Headley Way
Oxford OX3 9DU

Tel: 01865 234567

Monday to Friday 8.30am - 5.00pm
Select Option 1; when asked again select Option 5 for Orthoptics

Head Orthoptist

Jacqui Greenhalgh

Email: jacqui.greenhalgh@ouh.nhs.uk

How to find the John Radcliffe Hospital

Web resources

• British and Irish Orthoptic Society (BIOS)
• Health and Care Professions Council (HCPC)