When people talk about the strengths of Wilmer, they often mention how it is a “one-stop shop” for patients with vision challenges. Collaborative care teams ensure Wilmer’s ability to be the one place patients can go no matter their needs — from routine care to complex cases. Most Wilmer patients are familiar with ophthalmologists and optometrists, but if you become a patient in the Division of Pediatric Ophthalmology and Adult Strabismus, you could meet another type of specialist: an orthoptist.
Though not as commonly known as the other two professions, orthoptists partner with ophthalmologists to provide the diagnosis and nonsurgical treatment of irregularities of the eyes — especially those of the eye muscles — that prevent normal binocular vision.
When our binocular vision functions well, we can integrate the slightly different signals from each eye to judge distances and coordinate eye movements. When it does not function well, we can get double vision, headaches, eye strain, eye pain and blurred vision. Binocular vision can get disrupted for a number of reasons — strabismus, amblyopia, stroke or neurological issues. An orthoptist can perform a specific examination to gather key information needed to treat a patient with impaired binocular vision.
“The linchpin of the orthoptic exam is the sensory motor exam, which consists of measuring how well the eyes move together, whether they are being used at the same time, or whether one eye is being turned off or not,” says Alex Christoff, an assistant professor of ophthalmology and a certified orthoptist at Wilmer.
“Orthoptists play a crucial part in patient care and patient evaluation, especially in strabismus,” says Edward Kuwera, M.D., a pediatric ophthalmologist at Wilmer, who counts Christoff as one of his mentors. “A lot of patients we see have misalignments of their eyes and varying degrees of control, and the orthoptists are wonderful at teasing out what those nuances are.”
At Wilmer, orthoptists also serve an important educational role. “Alex Christoff was critical in building my skill set for properly evaluating patients who have strabismus,” explains Kuwera. “He played a pivotal role in teaching me proper techniques and methods for making sure that our measurements were accurate as well as reasonable for the problem at hand. The clinical skills that I developed through his teaching have served me well throughout all of my training and now into my career.”
Kuwera specifically cites orthoptists’ skill at examining children of all ages, which is invaluable for providing ophthalmologists key information to develop treatment plans for young patients. “We are taught how to measure visual acuity from birth to old age,” says Christoff. “Taking the vision on a verbal 10-year-old isn’t so hard. But how about a pre-verbal 2- or 3-year-old? How do we know what the vision is in an infant? That’s what we train to do in our schools.”
Orthoptists’ particular set of skills makes them integral members of care teams at Wilmer. And Wilmer, in turn, offers orthoptists an environment that fosters their success. “Here one can rise through the ranks of academia from almost any background, provided you do the work, stay humble and foster collaboration,” says Christoff.
While grateful for career development opportunities, Christoff returns to his patients when asked about his favorite part of being an orthoptist at Wilmer. “I like working one on one with people who need my help — and then seeing the smiles on their faces when I have listened and successfully addressed their chief concerns to their satisfaction,” he says.