Orthoptist - Ophthalmology - Full time - Dearborn

GENERAL SUMMARY: 
Under direct supervision, the Certified Orthoptist (CO or Canadian cert – (O)CO) assists the ophthalmologist (typically pediatric or neuro-ophthalmologist) in the clinic setting.  Orthoptists are bound by a Code of Ethics as specified by the American Orthoptic Council.  Among other things, this code requires that orthoptic services be rendered only under the overall supervision of an ophthalmologist.  This code also forbids orthoptists from being employed or supervised by optometrists.   
Orthoptists treat non-surgical disorders of ocular motility and binocular vision including but not limited to amblyopia, convergence insufficiency, accommodative esotropia and diplopia.  Patients can be seen in conjunction with an ophthalmologist in their clinic or can be referred for sensorimotor evaluation/non-surgical treatment from within the ophthalmology practice.   

PRINCIPLE DUTIES AND RESPONSIBILITIES: 

• Medical History Taking: Obtain and accurately record patient’s medical and ocular history including chief complaint, medications, allergies, and review of systems in accordance with compliance guidelines. Select and complete appropriate forms and protocol as required by the supervising ophthalmologist and/or sub-specialist. Use approved medical abbreviations.   
• Visual acuity testing: Perform visual acuity testing in pre-verbal, illiterate, literate and non-English speaking patients, at both near and far, with and without correction.
• Conduct pinhole acuity test, glare test, and potential acuity test (e.g. BAT, PAM) Measure vision without charts (CF, HM, LP, F & F, CSM, etc.).  
• Lensometry: Apply basic optics necessary to measure the power of corrective lenses using automated or manual lensometers. Verify spectacle lens power, bifocal addition power, mark optical centers, and detect prism, if present. Measure base curves. Verify prescribed and unwanted prism as ground-in or induced.  
• Assessment of eye muscle function using duction and version testing.   
• Assessment of binocular vision including sensory and motor fusion, stereopsis and binocular correspondence using subjective and objective techniques including but not limited to Worth 4 dot, Titmus, Lang, Bagolini lenses, after image test, red-filter test, prism vergence, double Maddox rod and amblyoscope. Measure and document eye deviations in appropriate fields of gaze.    
• Under the direct or indirect supervision of an ophthalmologist, the orthoptist designs and/or monitors a program of non-surgical treatment of strabismus, amblyopia and disorders of binocular vision including: Pre/post-operative sensorimotor evaluations, management of diplopia including but not limited to the fitting of ophthalmic prisms or filters, designing of exercises to improve binocular function, modification of 
• Visual Fields: Perform confrontation visual field testing. Identify visual field defects typical of various ophthalmic and neurologic conditions.  
• Tonometry: Demonstrate proper aseptic technique and measure intraocular pressure with non-contact, digital and/or Goldmann applanation tonometers. Calibrate TonoPen and Goldmann applanation tonometers.  
• Other specialized tests: Perform color vision testing with color plates, Ishara and HRR. Measure pupil size and detect abnormalities in pupil reaction. Estimate anterior chamber depth by slit lamp evaluation.    
• Refractometry: Enter spectacle data into Phoropter. Refine spectacle correction or automated findings using a Phoropter. Measure a refractive error by retinoscopy. 
• Refine objective refraction using a Phoropter and/or trial lenses and trial frame. 
• Calculate reading add at 40 centimeters (16 inches). Measure vertex distance.  
• Surgical Assisting: Set up and assist in pediatric minor surgery, such as probing of the nasal lacrimal duct. Prepare instrument tray for minor surgical procedures and help hold infant (papoose) for above procedure. Maintain surgical instruments in accordance with OSHA standards. Properly gown and glove self and assist others in gowning and gloving. Select proper instruments using physician’s preference for common ocular surgical procedures. Identify the sterile field and instruments and maintain aseptic technique. Clean and prepare microsurgical instruments for sterilization. 
• Other patient services: Must have the ability to interact well with infants and small children.  Must be able to communicate effectively with anxious parents.  Coordinate patient flow and appointments. Return patient phone calls. Complete vision forms. Instill drops and ointment into patient’s eye as directed for completion of diagnostic evaluation of patient by ophthalmologist. Recognize the symptoms of allergic reactions to medications. Follow department protocol on prescription refill processing.
• Measure and record vital signs (blood pressure, pulse, and respirations).  
• Education and training of residents during clinical rotations.  Supervise motility evaluations with resident patients when available.     
• Provide patient education on tests – why done, when results are expected. Participate in telephone triage. May perform minor repairs of spectacles.  
  Instrument maintenance: Care for, maintain, and perform minor servicing of exam room equipment. Maintain records, equipment manuals, and repair logs. Restock supplies as rooms are opened; protect and properly store instruments as rooms are closed. Replace light bulbs and fuses as needed. Troubleshoot electrical instrument failure 
• Performs other related duties as required.