Alis Sejourne
I am a Specialist Orthoptist at King's College Hospital and I want to promote my brilliant Allied Health Profession. Please get involved and ask questions along the way!
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Alis Sejourne replied to Ather Hussain
Mild amblyopia is when vision is only mildly reduced, usually between 0.200-0.575 LogMAR. Dense amblyopia is when vision is significantly reduced, usually worse than 0.600 LogMAR. For mild amblyopia, PEDIG studies reccommend 2 hours of patching, and for dense amblyopia, it is reccommended 6 hours of patching. 2 hours is just as good as 6 hours for mild...
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Alis Sejourne replied to Heather J
@AtherHussain Physiological diplopia is that what you are focusing on is single, but everything else in the background and foreground is double. Pathological diplopia is double vision for the image you are focusing on.
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Alis Sejourne replied to Ather Hussain
Hi Ather, thank you for your interest! You should be suitable for the MSc Orthoptic pre-registration course at UCL. You can contact them ioo.admissions@ucl.ac.uk. See for more information: https://www.ucl.ac.uk/prospective-students/graduate/taught-degrees/orthoptics-pre-registration-msc#introduction
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Alis Sejourne made a comment
I am an Orthoptist and interested in takling health inequalities through public health stratagies.
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Alis Sejourne replied to Gabriela Dimitrova
Hi Gabriela, that is great to hear, good luck with applying to study Orthoptics next year!
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Alis Sejourne replied to Amani Alom
That's great to hear Amani, good luck with your application :)
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Alis Sejourne replied to Margaret Taylor
Thank you Margaret for your insight, these are great resources which I will look into! We mainly use acetazolimide, alongside healthy weight conversations, as a management approach for patients with IIH. It is interesting to read all its other uses.
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Alis Sejourne replied to Margaret Taylor
Hi Margaret, that's great to hear you are able to share information with your colleagues and gain knowledge from this course. As the aging population grows, so will the waiting lists!
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Alis Sejourne replied to Navinee Gilliat
@MargaretTaylor Thank you for this feedback! The answers can now be downloaded above.
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Alis Sejourne replied to Kulthum Chariwala
Hi Kulthum, thank you so much for this lovely message, I am really glad you benefited from this course. I wish you luck with your future :)
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Alis Sejourne replied to Gabriella Giovinchi
This is great to hear Gabriella! Good luck with your studies :)
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Alis Sejourne replied to sarita pachabhaiya
Thank you for your comment Sarita and further reading recommendation. The cover-uncover test is used to show manifest deviations, which is where the eyes are misaligned. An alternating cover test is used to dissociate eyes which were initially straight. This breaks down the ability for the eyes to work together and will show a latent/phoria deviation. Most...
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Alis Sejourne replied to Margaret Taylor
Good observation Margaret! The inward movement means the eyes are originally sat outwards and move inwards to fix. Therefore, this shows an exo deviation.
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There are certainly numerous causes. Strokes very commonly cause visual field defects. Pease 'see also' for how the location of a lesion can cause specific visual field defects.
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Alis Sejourne replied to Ryian Kaila
I'm glad to hear you found this course useful, definitely make sure to include it on your personal statement as Universities will be impressed with your interest! Good luck with your application Ryian :)
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You're exactly right Sarita! The right lateral rectus and right inferior oblique are on the same side of the body, so they are ipsilateral muscles. They also share the same role which is abduction, which makes them synergists. Therefore, they'll be ipsilateral synergists :)
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You're right Sarita, that's a great point. Unfortunately, School Vision Screening is a postcode lottery for children in the UK. The British and Irish Orthoptic Society School Screening Clinical Advisory Group are working hard to make it mandatory and a right for every child!
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Well said Kulthum, you are exactly right!
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Alis Sejourne replied to Anam Shaikh
Thank you so much for this positive feedback Anam!
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@KulthumChariwala I am glad you are interested - it is a very rewarding career!
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Orthoptics is a specialist subject in demand in the UK, so eligible students receive £6,000 each year of study, which they never have to pay back via the NHS learning support fund. I hope this makes the degrees more accessible!
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That's great to hear Kulthum!
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Alis Sejourne replied to Kulthum Chariwala
Hi Kulthum, welcome to the course :)
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That's incredible! I'm glad you enjoyed the experience.
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Alis Sejourne replied to Dr Tony Ohanyere
@AliceMpinyuri The UCL Master's programme is a course that requires face-to-face learning. However, there are some other online master's programmes which will be covered in Week 3: Post-graduate qualifications.
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Alis Sejourne replied to Anam Shaikh
Great points Anam!
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Alis Sejourne replied to Weza Mendes
Congratulations on completing the course Weza. It is so great to hear that you are looking to gain work experience in Orthoptics - that's the next step! Good luck with your journey.
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Alis Sejourne replied to Dr Tony Ohanyere
Hi Dr Tony Ohanyere, thank you for your interest! You can study orthoptics at University College London as a Masters degree for 2 years, and you will be able to practise as an Orthoptist after this. Please see Week 1: Routes into Orthoptics for more information.
Alternatively, there are more speciality-specific Masters courses and modules available, which are... -
Alis Sejourne replied to Tomoyo Kobayashi
Hi Tomoyo, welcome :) It's very interesting to me that Orthoptics is slightly different in every country. Hopefully, this course will inspire you to take something new to your department, and we can learn from you too!
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Alis Sejourne replied to Weza Mendes
That's great to hear Weza! I hope you continue to enjoy over the next couple weeks.
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Alis Sejourne replied to Reanne Stennett
That's great to hear Reanne!
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Alis Sejourne made a comment
Great video, thank you all!
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Alis Sejourne made a comment
Thank you for this week!
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Alis Sejourne replied to manuel de santos
Hi Manuel, I'm sorry to hear you are experiencing double vision, it must be very bothersome! I hope this course gives you some answers. Let us know if you have any questions.
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Alis Sejourne replied to Afifa Akbari
Hi Afifa, thank you for your lovely message, I'm glad you benefited from the course! Good luck with your academic journey.
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Alis Sejourne made a comment
This was very useful, thank you
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Alis Sejourne made a comment
Thank you!
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Alis Sejourne made a comment
Thank you!
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Alis Sejourne replied to Afifa Akbari
That's great to hear Afifa!
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Hi Afifa, thank you for your great engagement!
Children are still developing their vision and have neural plasticity until around the age of 7 years old. Therefore, they will suppress the squinting eye and ignore the double vision. This is great for the child as they no longer will see double. However, they may unfortunately develop amblyopia (reduced visual... -
Alis Sejourne replied to Brenna McCormick
Welcome Brenna! Have a look at The American Association of Certified Orthoptists (AACO) website, which is the professional association for Orthoptists in the USA: https://www.orthoptics.org/
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Hi Siddig, I'm glad to hear you found this useful! Please 'see also' a PDF of this presentation to download.
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See Week 3 for some of the different post-graduate options with distant learning in Orthoptics.
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Alis Sejourne replied to Vikki McDermott
Every clinician is different, but I personally take notes. It is important to remember all that the patient is telling you.
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Alis Sejourne replied to Narendra Kumar
Exactly Narendra, with the right training, optometrists and orthoptists can help fill this gap!
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Alis Sejourne replied to Narendra Kumar
Thank you Narendra for your interest and engagement! Good luck with your career journey.
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Alis Sejourne replied to Caroline B
Thank you Caroline! We appreciate your engagement. Please spread the word to introduce Orthoptics to many :)
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Alis Sejourne replied to Narendra Kumar
Hi Narendra, it is interesting how the same career can be different in different countries! Hopefully we can one day get to a point where the profession is standardised globally.
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Alis Sejourne replied to Humaira Amin
Good luck with your studies Humaira!
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Alis Sejourne replied to Narendra Kumar
Click on the 'Interactive Eye Movements' link in the 'See also' section for an interactive eye movement game. You will need keyboard arrows to move the eyes around and see how each nerve palsy presents.
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Alis Sejourne replied to Caroline B
Hi Caroline, if you are having an issue with accessing the video, it can be downloaded by clicking on the standard or HD button next to 'video download', underneath the video. I hope this helps.
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Alis Sejourne replied to Caroline B
Hi Caroline, if you are having an issue with accessing the video, it can be downloaded by clicking on the standard or HD button next to 'video download', underneath the video. I hope this helps.
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Exactly right Narendra!
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'See also' a video which explains Muscle Sequelae in further detail.
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Alis Sejourne replied to Linda Osman
Hi Linda, there is more information on post graduate study in UK in Week 3. Good luck with preparing for your PhD!
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Alis Sejourne replied to Narendra Kumar
1. Down - Visual cortex
6 Across - Macula -
Alis Sejourne replied to Narendra Kumar
Thank you Narendra!
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Hi Caroline, if you are not able to view the video, have a read of the video transcript.
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Alis Sejourne replied to Tania Mathew
Fantastic! We are grateful for your engagement Tania.
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Alis Sejourne replied to Murekwa Joseph
Background noise was removed for this video :)
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Hi Tania, currently in the UK, there are specific Advanced Clinical Practice Master Courses which will allow you to become an Advanced Clinical Practitioner.
Typically, entry requirements include a minimum 2:1 undergraduate honours degree in an eye care-related degree, as well as suitable experience in the field of specialty.
If you are unsure if you...
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Alis Sejourne replied to Sana Khan
That's great news Sana!
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Hi Carla, it would be great to hear from you towards the end of the course to see what you find are the biggest differences between our countries!
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My pleasure Haleema, we are glad to create interest!
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Beautifully written Hermenegilda, I completely agree!
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Thank you for your kind words Emna, we are glad you are learning!
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Alis Sejourne replied to Sana Khan
This is great news Sana. Do let us know if you have any unanswered questions!
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This is great to hear Haleema, keep up the great work!
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Alis Sejourne replied to Sana Khan
Great work Sana!
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Alis Sejourne replied to Margaret Taylor
We get lots of patients with retinal tears and detachment within our ocular emergencies clinic. King's is a major trauma centre in London, so we also get a lot of patients with traumatic injury to the orbit. Our large medical retina team manage macular degeneration patients with injections. We will learn more about this in Week 3 - King's Extended Roles....
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Alis Sejourne replied to Abdallah Kunja
We will be covering Low Vision in more detail when discussing King's Extended Roles in Week 3.
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It is a bit disorientating! Use the arrows, or click and drag the screen to navigate your way round the orthoptic department.
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Alis Sejourne replied to Navinee Gilliat
Print out, draw out, or test your knowledge in your head. Use this exercise to see how much you remember!
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Alis Sejourne replied to Edel Quinn Atamba
That's great to hear Edel, good luck with your studies!
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Alis Sejourne replied to Noeline Nambalirwa
Thank you for the kind words Noeline, we are glad you are interested!
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Alis Sejourne replied to Afifa Akbari
Fantastic key learning Afifa!
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Muscle sequelae is a topic many Orthoptic students struggle with. The more patients you see, the more you understand it! Think of it as when one muscle is weak, the others compensate for it, abiding by Herring's and Sherringdon's Law.
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'See also' a recommended video on HESS chart interpretation for further understanding. The best way to understand a HESS chart is to try it yourself! Ask to give it a go when shadowing an Orthoptist on work experience, or clinical skills in University studies.
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Alis Sejourne replied to Grace Thompson
Hi Grace, thank you for the feedback. I'm glad you enjoyed learning!
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There is also primary position, which is looking straight ahead!
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Alis Sejourne replied to Murekwa Joseph
The fovea is the area of the retina which produces the best possible vision as it has the highest density of cone photoreceptors (which gives coloured, detailed vision).
Normal Retinal Correspondence is when the fovea is used for central vision in both eyes. The eyes are straight and looking in the same direction to see the same image with excellent...
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Alis Sejourne replied to Murekwa Joseph
Manifest (tropic) deviations are typically unilateral, so only one eye turns at a time. This may be the right eye, left eye, or alternating eyes (where the patient doesn't mind which eye they fix with).
A latent (phoric) deviation is when the eyes are straight and can work together with binocular vision, yet they have a hidden tendency to move in or out...
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Hi Faryaal, you can definitely specialise to become a specialist paediatric orthoptist.
There are even opportunities for Orthoptists to undergo MMedSci Ophthalmology studies and become Advanced Clinical Practitioners in Paediatrics. Have a look at the following post-graduate course to see if it appeals to...
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Alis Sejourne replied to Murekwa Joseph
The Goldmann Visual Field plots the patients visual field exactly as they see it. It is used to identify enlarged blind spots and visual field defects. 'See also' what is a typical field looks like. This way, you can identify when something is abnormal. 'See also' the different types of visual field defects which may be detected using a Goldmann Visual Field...
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Alis Sejourne replied to Noeline Nambalirwa
The Goldmann Visual Field plots the patients visual field exactly as they see it.
- The patient is instructed to place their chin on the chin rest, keep still, and look straight ahead at the black spot.
- They must click on their buzzer as soon as they notice a light coming from the side of their vision, without moving their eyes off the black...
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Great points learnt so far Abdallah!
Orthoptists are now graduating with medical exemptions, so they are able to prescribe certain medicines to help with their management. This saves the time of ophthalmologists, and increases efficiency in the department.
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Great key points Afifa!
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Alis Sejourne replied to Murekwa Joseph
Noeline is exactly right!
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Alis Sejourne replied to Robert Gill
Students in the UK are eligible for funding throughout their studies with the Government's Learning Support Fund. Currently, students receive £6,000 each year of study which they do not have to pay back.
For more information, check out https://www.nhsbsa.nhs.uk/nhs-learning-support-fund-lsf
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Alis Sejourne replied to Robert Gill
That's great to hear Robert! Good luck with your training :)
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Visit the International Orthoptic Association for more information on Orthoptics in your country: https://www.internationalorthoptics.org/
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Alis Sejourne replied to Murekwa Joseph
@EdelQuinnAtamba a cover test is to observe movement of the eyes when covered. This will show us any misalignments/strabismus. We will go over this in more depth when we learn about conditions orthoptists investigate: Strabismus later on in the course.
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Alis Sejourne replied to Afifa Akbari
Great tips Afifa!
My tips:1. Create a good timetable.
- Make sure this is detailed with specific, manageable tasks.
- Find out what time frame you are the most productive before you lose concentration. This may be half an hour, one hour or even two for you!
- In between these study sessions, make sure to take 15 minute breaks, and half an hour...
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The pencil push up test is another simple convergence exercise Orthoptists can use to improve amplitude and accommodation and a good alternative to the dot card. It involves watching the tip of a pen and moving it forward towards your nose slowly. When you get to a point where you notice double vision which you can't get rid of, you should bring the pen back...
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Enela, I would recommend watching this YouTube video on HESS Chart interpretations: https://youtu.be/NDvxWruzWI8
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Alis Sejourne replied to Murekwa Joseph
On doing cover-uncover test, you focus on the fixing eye, which is the eye looking at the target, not the one under the occluder. If the deviation is manifest (exotropia or esotropia), you will see the fixing eye move.
On alternate cover test, you watch both eyes for movement of both eyes either moving in to fix (exophoria) or out to fix (esophoria).
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Alis Sejourne replied to Murekwa Joseph
Great point Murekwa! Most visual development problems can be prevented if identified and managed in early childhood whilst the brain is still developing. This is why school vision screening with 4-5 year olds children is so important.
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Alis Sejourne replied to Murekwa Joseph
A prism fusion range measures motor fusion. As prisms bend light, this shifts the image towards to apex (pointy side) of the prism. The eyes are therefore being forced to not work together, resulting in double vision. As the brain does not like double vision, they pull in together, using their motor fusion to overcome the prism and return to binocular single...
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Alis Sejourne replied to Murekwa Joseph
Different tests have different testing distances.
The hand held LogMAR Sonkson Chart books are held at 3m. However, this can be brought forward in those with reduced visual acuity and converted using a table. -
This course is at an introductory level only. Visit the 'Routes into Orthoptics' section to find out more about how to qualify and start working as an orthoptist.
