Accuracy and Efficiency of Orthoptists in Comprehensive Pediatric Eye Examinations

• Published in: American orthoptic journal 2016-01, Vol.66 (1), p.98-106
• Main Authors: Scheetz, Jane, Koklanis, Konstandina, Long, Maureen, Morris, Meg E.
• Format: Article
• Language: English
• Subjects: Amblyopia - diagnosis; Child; Child, Preschool; Clinical Competence - standards; comprehensive eye examination; delivery of health care; Delivery of Health Care - standards; Female; Humans; Infant; Male; Ophthalmologists - standards; Orthoptics - standards; orthoptist; pediatrics; Refractive Errors - diagnosis; Reproducibility of Results; Retrospective Studies; Strabismus - diagnosis; triage; Vision Screening - standards
• ISSN: 0065-955X; 1553-4448
• DOI: 10.3368/aoj.66.1.98

To investigate the level of agreement between orthoptists and medical practitioners in the comprehensive eye examination of children seen in an orthoptist-led triage clinic. Patient records over a 6-month period were retrospectively reviewed. Those with a presenting complaint related to vision or ocular motility were triaged into the orthoptist-led clinic and included in the study. Patients who did not meet the triage protocol and those who were not assessed by a medical practitioner at a subsequent appointment were excluded from analysis. The clinical findings from the orthoptist and medical practitioner were collected and compared. In total, sixty-three patients were reviewed during the 6-month period and met the inclusion criteria. After the initial comprehensive eye examination with an orthoptist, thirty-two were discharged from hospital and thirty-one were asked to return for a review appointment with a medical practitioner. Agreement between the orthoptists and medical practitioners for the diagnosis of strabismus and/or amblyopia was 84.6% (κ = 0.649, P < 0.001). There was strong agreement between orthoptists and medical practitioners for refractive error of the right eye [τ (19) = 0.352, P = 0.729] and left eye [τ (19) = 1.785, P = 0.090]. Fundus examination comparisons between the orthoptists and medical practitioners showed very high agreement (95.7%). Orthoptists have the skills necessary to provide comprehensive care of children referred for ocular motility and/or vision related disorders. There was close agreement between orthoptists and medical practitioners when performing comprehensive eye examinations.