Orthoptics is a paramedical profession specializing in re-education, rehabilitation and exploration of visual function. What exactly are the missions of the orthoptist? What exams can he perform? We take stock.
What is an Orthoptist?
The orthoptist is specializing in the management of vision disorders, such as binocular vision disorders, strabismus, oculomotor paralysis, etc. He takes care of patients of all ages, including infants (from 9 months), young children, adolescents, adults, and the elderly.
What is the difference between an ophthalmologist and an orthoptist?
The orthoptist is not a doctor. He works on prescription from an ophthalmologist and may also be required to practice in collaboration with opticians, occupational therapists and psychomotor therapists. The certificate of orthoptist capacity is obtained after three years of university studies and hospital internships.
Why and when to consult?
The orthoptist can be consulted to relieve various symptoms:
- itchy or watery eyes,
- fatigue related to the frequent use of screens,
- difficulty adapting to glasses;
- headaches,
- dizziness,
- balance disorders,
- postural pain,
- nausea,
- diplopia (double vision),
- a strabismus,
- etc
In young patients, the orthoptist can also take care of amblyopia problems.
In the case of AMD or severe glaucomaorthoptic rehabilitation can allow the patient to make the best use of their remaining vision.
Orthoptic assessment: what examinations does the orthoptic specialist take?
As a paramedical professional, the orthoptist performs structural and functional vision screenings and examinations interpreted by the ophthalmologist. It can, for example, take photos of the fundus, measure ocular pressure or evaluate the visual field.
Orthoptists can also prescribe glasses and contact lenses
A decree published on April 26 at the Official newspaper (source 1) now allows orthoptists to renew, under certain conditions, prescriptions for corrective lenses and contact lenses.
« In certain regions, waiting times are very important and the kilometers traveled by patients for a consultation are exploding », underlines the National Autonomous Union of Orthoptists (SNAO), in a press release (source 2). This measure will allow « a real time saver within a visual sector that has been in tension for years, as well as substantial savings for thousands of patients and for Social Security accounts,” he continues.
- Regarding contact lenses: « The orthoptist can adapt, after carrying out a refraction examination and unless the doctor opposes it expressly mentioned on the prescription, the optical corrections of the initial medical prescriptions », specifies the decree. Prescriptions must be less than one year old for patients aged under 16, and less than three years old for patients aged 16 and over.
- As for corrective lenses, replacement by orthoptists is possible, under the same conditions. Only the deadlines differ slightly: the prescriptions must date back less than one year for patients aged under 16, less than five years for patients aged 16 to 42, and less than three years for patients over 42 years old.
Orthoptists will also be able to perform amblyopia screeningfor children aged 9 to 15 months and screening for refractive errorfor children aged 30 months to 5 years.
After this renewal, the orthoptist must report the corrective adaptation carried out on the prescription, indicate his surname, first name, quality, registration identifier carried out in accordance with article L. 4342-2, date and sign this modification. He then informs the prescriber, in other words the ophthalmologist, by tany means guaranteeing the confidentiality of the information transmitted.
Most orthoptists practice in private practice. But they can also work as an employee in a hospital, with an ophthalmologist, a rehabilitation center Where in a facility for people with disabilities.
Most of the time, patients are referred by an ophthalmologist or another medical specialist (paediatrician, neurologist, ENT, etc.), if he considers that an orthoptic check-up and/or rehabilitation are necessary.
How does an orthoptist consultation take place?
The consultation usually begins with an oral interview, a visual acuity test and one orthoptic assessment.
Depending on the orthoptic diagnosis, rehabilitation may be considered to improve the patient’s visual comfort through oculomotor and sensory work. It is most often aexercises practiced alongside the orthoptist. In some cases, to progress quickly, the patient may also have to perform certain exercises at home. However, these exercises are complementary and cannot replace the work done in consultation.
As in the case of a speech therapist follow-up, the patient therefore participates actively in the treatment : the success comes partly from a good collaboration with the orthoptist.
Price and reimbursement of an orthoptic session?
An orthoptic consultation lasts 20 minutes to 1 hour, once or several times a week. Each session is reimbursed by Health Insurance up to 60% in the coordinated care pathway. Rates vary depending on the region and the type of consultations required. We can, for example, count 22 euros for a measurement of visual acuity and 78 euros for an orthoptic assessment.
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