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14
As to current development or general trend of importance
within our profession, I should add that more and more
Psychiatric Social Workers are being used in the training
schemes of social workers, e.g. Younghusband courses, the
generic case work course, etc.
ORTHOPTICS
Contributed by Miss M.C. Wheeler, D.B.O.
Orthoptics is the treatment of squint with and without the
use of surgery.
All patients have a routine refraction, and glasses are
prescribed if necessary by the ophthalmic surgeon. Some
difficulties are experienced when the patient is 'set against'
wearing glasses or if he is very young. However, perseverence
and co-operation at home can overcome this. Alternatively the
patient with the high refractive error is usually delighted
with his glasses and his personality will change accordingly.
Patients are then referred to the orthoptic department.
Occlusion (or patching) is the most well known part of
the treatment when the-occlusion is put onto the good eye to
enable the amblyopic eye (low vision due to disuse) to get
better. This can cause great difficulties and upsets to the
patient, especially if he is very young, or the anplyopia is
very bad. However, with a firm hand and co operation at home
ensuring that the occlusion is always worn, the vision will
improve and both patient and parent will be delighted.
Orthoptic exercises form the other part of the treatment
and these are normally very popular, as it merely entails
looking at 'coloured pictures and thus keeping the patient's
attention while the various exercises are executed.
Surgery is required on some cases of squint and is
advised and carried out by the ophthalmic surgeon. The much
discussed psychological trauma' of young patients in hospital
can come into effect here. Usually however, the short stay
of a week, although sometimes difficult at the time, is soon
forgotten and there are no ill effects whatsoever. The
pleasure and satisfaction gained by both patient and parent
when the squint is cured, and the self confidence gained by
the patient himself far outweighs any risk of trauma.
The basis of success of orthoptic treatment is to get
the patient young, when with the co operation at home a
complete cure can be effected. The older patient may not be
able to obtain a functional cure, but a 'cosmetic' cure can
always be brought about (by surgery) to prevent any psychological
or inferiority complexes.