Orthoptist

**Job Purpose**: To assist in the delivery of the Orthoptic Service by providing a high standard of care, undertaking a range of professional duties and working in a variety of areas in both acute and community settings across Bedfordshire. To take sole responsibility to determine the clinical diagnosis and formulate relevant treatment plans in conjunction with Ophthalmologists/Specialist Optometrists and other health care professionals. To assess, diagnose, treat and manage adult and children patients referred to the Orthoptic service To be professionally responsible and accountable for the management of Orthoptic patients in Bedfordshire as an autonomous practitioner. To assess, diagnose, treat and manage (including discharge when clinically appropriate) the patients referred to the Community Eye Service.

These include Paediatric visual disorders (squint, amblyopia, and reduced visual responses), ocular motility disorders, other ophthalmic conditions and congenital developmental abnormalities. To evaluate visual behaviour in both children and adults, including patients with impaired comprehension and learning difficulties. To support/advise the Orthoptic Support Workers (OSW) providing the 4-5 year vision screening service. To secondary screen referrals from OSW, assessing and diagnosing problems with vision, eye co-ordination and binocular vision and to advise parents when children need further eye care.

To formulate individualised management and treatment plans using clinical reasoning and a wide range of treatment skills seeking advice when needed from senior staff, recognising the limits of their experience and competencies. To manage orthoptic cases with neurological and complex medical problems effectively, asking for addition support from more experienced staff when required. Also taking into account patients co-morbidities. To prioritise patients who need onward referral to the Ophthalmologist.

To formulate joint Ophthalmic/Orthoptic treatment plans for cases with the Consultant Ophthalmic Surgeon, and the Specialist Optometrist giving an informed professional opinion. To assess patients pre
- and post-operatively and discuss surgery options with the Consultant Ophthalmologist. To identify the opportune timing of surgery and discuss post-operative risks with the patients, carers and surgeon. The degree of surgery will be based on the Orthoptic measurements.

To offer advice and support in the clinic and over the telephone, and deal with queries from patients, carers and other health professionals. To contribute to the improvement of the service and refer to agreed policies and guidelines. To prioritise and organise own clinical caseload. To be responsible for booking patient appointments and related clinical administration in the Orthoptic clinic.

To contribute to Education, Health and Care Plan (EHCP) for patients when required. To maintain current and discharged clinical records at all clinical bases. To use electronic patient records (SystmOne) and Microsoft office in line with Trust policies. To maintain accurate contemporaneous patient records in line with the Records Keeping Policy including clinical reports and discharge letters.

To promote the need for early intervention and treatment of childhood eye problems. To work with the rest of the Orthoptic Team to ensure the safe and effective running of the clinics. To work independently in busy community children's clinics within broad professional guidelines and Orthoptic competencies, referring selected patients for ophthalmic opinion and to seek advice from senior staff where necessary. To take responsibility for advising patients, relatives and carers of the prognosis regarding their eye condition, including squint surgery and any possible complications.

Informing relevant clinicians and members of the multidisciplinary team where needed. To provide support for the more senior Orthoptists and assist in the monitoring, maintenance and development of professional quality standards When patients are wheelchair-bound and with young children it is necessary to adapt tests and work at awkward angles at times. To gain young childrens full attention and co-operation in order to gain accurate results it is necessary to be very mobile.