Seeing is Believing

A clear, unimpaired vision is a gift that many of us take for granted. Meet a young Orthoptist who has made it her life’s mission to share this gift with the masses, young and old alike.

By Winifred Tan

Our eyes may be small compared to the other body organs, but their structure is incredibly complex and their function, priceless.

In the same way, orthoptists play a small but no less significant role in the healthcare industry. Working as part of a multidisciplinary allied health team comprising occupational therapists, physiotherapists and nursing staff, orthoptists are responsible for helping to restore the precious gift of sight to their patients.

We speak with Karen Zhang, a 28-year-old Orthoptist at the Singapore National Eye Centre (SNEC), a member of SingHealth Group, to find out more about her work and what keeps the light in her eyes shining since taking up the SNEC Orthoptics Scholarship eight years ago.

What sparked your interest in Orthoptics?
Karen: To be honest, I was initially unaware of what Orthoptics meant. When I first heard the term, I did research and found out that it was all about visual dysfunctions and eye abnormities, including but not limited to amblyopia (lazy eye), strabismus (squints), and diplopia (double vision). Given my inherent interest in science and the healthcare profession, I thought this was a field I could see myself in for the long run.

Is that why you applied for the Scholarship?
Karen: Yes, interest in the field of study was definitely one of the factors that influenced my decision to take up the SNEC Orthoptics Scholarship and specialise in Orthoptics. I believe in contributing to the wellbeing of others.

That’s a big leap of faith, considering Orthoptics is something new to you.
Karen: Not completely new, thankfully. When I accepted the scholarship, the Board sent me on a 2-day attachment to SNEC to gain some exposure, because they are aware that Orthoptics is a field not many people are familiar with. It was this attachment that sealed the deal – I had the opportunity to observe the Chief Orthoptist then, Mr. Linley Seenyen, and felt inspired by the way he interacted with and managed his child patients. They would come in to the clinic crying and screaming, but somehow leave afterwards in the best of spirits.

Is that a skill you’re emulating now as an Orthoptist yourself?
Karen: The majority of my patients are young children, so working with them definitely requires some degree of patience and child behaviour management skills. Though challenging, I must say that my work is actually quite fun; every clinic session feels like a play session!

Children are often scared and will be in tears by the time they enter the paediatric clinic, so my immediate task would be to calm them down, show them different toys and cartoon videos to alleviate their apprehensions, and slowly gain their trust. Once they’ve settled down sufficiently, I will coax them into following simple instructions and proceed with the eye examination.

Eye examination? What does it entail?
Karen: In a nutshell, an orthoptist’s work involves carrying out a number of clinical tests to assess the patient’s visual functions and diagnose the problem, after which we will work with fellow colleagues to formulate a suitable treatment plan. For instance, if a child patient is diagnosed with a lazy eye, we will recommend patching and counsel the parents accordingly. Similarly, if a patient complains of a squint, we will determine whether it is a genuine squint, measure the squint angle with specialised equipment, and thereafter refer the patient for surgery or recommend the use of less invasive orthoptic treatment such as eye exercises.

One example of an eye exercise would be pencil push-ups, which we often prescribe for patients with a divergent squint, or a similar variation using a Stereogram Card with cats printed on it.

[Ed’s note: She pantomimes moving a pencil inward slowly, towards the tip of her nose.]

We also make use of optical aids such as prisms – the same triangular prisms we used to see in Physics class – to deviate light in the correct orientation such that it helps a patient with binocular vision fuse the image together.

Your work sounds fascinating! Was it difficult adjusting to the steep learning curve?
Karen: Based on my own experiences, I have to say both SingHealth and SNEC did a great job preparing their scholars to meet the rigours of a career in healthcare. Every scholar is sent on an attachment to their department of choice so that they better understand the actual job scope they’re committing to. Thereafter, attachment programmes are organised on an annual basis for scholars to come back during their vacation breaks and translate their newly-learnt knowledge into practice.

During my third year of study, SNEC even sponsored me for a 2-month clinical attachment in the UK, at the Moorfields Eye Hospital and the Great Ormond Street Hospital for Children. I picked up many useful skills there; skills which have come in useful even till today.

What other unique opportunities can scholars look forward to?
Karen: SingHealth is the biggest healthcare group in Singapore. With two hospitals, five national speciality centres and nine polyclinics, research and clinical collaboration efforts amongst all our health professionals are well-coordinated. As part of continuing professional development, SingHealth also provides financial support and offers time off work for us to attend conferences to keep up to date with current practices.

Any tips to share with aspiring scholars?
Karen: Contrary to popular belief, pursuing a career in Orthoptics does not limit you to a narrow field of work. There are many sub-specialities to consider, such as low vision; we’re even starting a stroke management clinic soon.

Furthermore, when students think of the local medical industry, the careers that typically surface in their minds would be doctors, nurses, dentists, maybe even pharmacists or physiotherapists. The truth is, there are actually a lot of other allied health professions that are not as commonly known but are just as important – Orthoptics is one; so is Podiatry, Dietetics, and even Speech Therapy.

Unfortunately many of these programmes are not offered in Singapore, so aspiring scholars will have to pursue their studies overseas. They should therefore be proactive, do research on the particular profession they intend to specialise in, and request for industrial attachments to prepare them mentally for their future career.

Any final words about a career in Orthoptics?
Karen: A happy and fulfilling learning process. The sense of gratification you receive from helping your patients and relieving their symptoms will keep you going strong in your career.

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