Orthoptist

Orthoptists are the specialists in binocular vision, eye movement, and visual development. You assess patients for strabismus (squint), amblyopia (lazy eye), diplopia (double vision), and abnormalities of eye movement caused by neurological conditions, thyroid eye disease, or head injury. You carry out and interpret a comprehensive battery of orthoptic tests — cover tests, motility assessments, prism measurements, visual acuity testing — and plan and deliver treatment programmes. For children, you prescribe and monitor patching (occlusion therapy) and oversee refractive correction for amblyopia. You work closely with ophthalmologists, performing pre-clinic investigations and participating in joint clinics. Neurological orthoptics — assessing eye movement disorders resulting from stroke, multiple sclerosis, and brain tumour — is a growing subspecialty. Most orthoptists work in NHS ophthalmology departments, though community and independent sector opportunities exist.

Orthoptics is a small profession — roughly 1,400 HCPC-registered orthoptists in the UK — with a long-recognised shortage that NHS Eye Care Workforce Planning has repeatedly flagged. Demand is driven by rising rates of childhood amblyopia screening, an ageing population with increasing neurological and diabetic eye disease, and growing ophthalmology outpatient activity. The clinical assessment skills of an orthoptist are highly specialised, hands-on, and developed over years; they cannot be replaced by automated screening alone. The protected HCPC title limits supply and sustains the profession's negotiating position within NHS structures.

A morning paediatric orthoptic clinic involves cycloplegic refractive checks, binocular vision assessment, and prescribing patching regimes for three children with amblyopia, followed by a combined clinic with the ophthalmologist for new strabismus referrals. An afternoon neuro-orthoptic session assesses a patient with new-onset diplopia following a minor stroke, documenting findings for the neurology team and planning follow-up.