The orthoptic assessment involves a cover test to determine whether there is a latent or manifest squint present. A squint is where one eye deviates inwards or outwards. One can also have a vertical squint. She then assesses ocular movements making sure the eyes are working together and that there is no under action or over action of the muscles. The eyes work as a pair and if one muscle over acts the other will under act. Ocular movements in adults shows if there is a muscle palsy which can cause diplopia (double vision) and this can then be treated with prisms. Fran carries a full set of Fresnel stick on prisms which alleviate the diplopia whilst the palsy is resolving.
Her next test is to examine convergence. Both eyes should be able to converge towards the nose without deviating outwards. If convergence fails before 8/9 cms it can mean that the patient has convergence insuffiency. This is a condition that can cause frontal headaches from lactic acid building in the muscle causing a referred pain usually over the eyes called frontal headaches; these usually come on after close work and are very common in high powered business men, students and often with dyslexic patients. It can also cause difficulty with copying from board to book, missing lines or words when reading, blurred near vision and sometimes even diplopia (double vision). Fran specialises in treating patients with convergence problems and her referral come from schools, educational psychologists, GPs, optometrists and ophthalmologists. She also gives exercises for tracking using Rainbow Readers. She also sees a lot of patients with dyslexia or dyslexic type symptoms.
Fran also test the binocular function of the eyes with various fun tests using stereoscopic vision.
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