4.1 Orthoptic research spanning assessment, diagnosis and treatment leading to improved patient care – Professor Helen Davis

Orthoptic research spanning assessment, diagnosis and treatment leading to improved patient care
Professor Helen Davis –
Professor of Orthoptics
Academic Unit of Ophthalmology & Orthoptics Department of Oncology & Metabolism
The Medical School
The University of Sheffield
Dr Anna Horwood Infant Vision Laboratory University of Reading
Dr Fiona Rowe VISION research unit University of Liverpool
At least 10% of the population will seek professional advice for squint, double or blurred vision, or eye strain at some time in their lives. For vision to develop normally, very tiny babies have to learn to co-ordinate accommodation (eye focusing to make near images clear) and convergence (pointing the eyes accurately towards objects as they move in depth) in the very first weeks of life: at the same time, or before, many other aspects of vision are also developing. Many common visual problems which crop up later in life happen because these systems do not develop normally in early childhood. Dr Anna Horwood leads the Infant Vision Laboratory at the University of Reading. The lab’s research has ranged widely across many aspects of normal and abnormal visual development from birth to maturity in full-term and premature infants, as well as studying children with many common types of strabismus.
This research has produced results which have challenged long-held assumptions, providing a better understanding of how these systems work and how, and why, problems develop. This research helps eye care professionals target, plan and explain treatment options for their patients. By providing alternative and better explanations of how visual co-ordination works, improvements and efficiencies are being adopted in patient care.
Stroke is the most common cause of UK adult disability with about 100,000 new cases of stroke per annum. Post stroke visual impairment is just one disability that affects stroke survivors. Research from the VISION research unit at the University of Liverpool led by Dr Fiona Rowe aims to improve the orthoptic and vision care of stroke survivors with visual impairment occurring following their stroke. Their research has provided evidence on the prevalence and incidence of post-stroke visual impairment, the types of visual conditions experienced by stroke survivors, how best to screen and assess these visual conditions and what rehabilitation options can be considered for these visual conditions.
Post stroke visual impairment is broadly divided into four categories of impaired central vision, eye movement abnormalities, visual field loss and visual perceptual abnormalities. These may occur in isolation but more frequently occur in combination. Screening for visual impairment is essential and this research has led to the National UK recommendations for the integration of specialist orthoptist screening on acute stroke units. The UK population is aging and so improving care provision for stroke survivors is important and will continue to be a future need.
Investigation of binocular function and the ability to appreciate 3D vision is a pivotal investigation of patients with strabismus. Whilst there was evidence that the quality of distance 3D vision could influence the timing of surgery in some forms of strabismus there was a lack of ability to clinically test this particularly in the UK. Professor Helen Davis in collaboration with Professor John Frisby designed a test which has been validated for clinical practice and now used worldwide. There is a need to continue all aspects of Orthoptic research to provide better and more accurate assessment with a view to better targeted treatment regimes.