Orthoptics is the diagnosis, management and treatment of strabismus (squint), eye movement disorders and visual development anomalies.

Conditions seen in the orthoptic clinics include:

Amblyopia (lazy eye): Amblyopia is reduced vision in one or both eyes despite no structural abnormality of the eye. Amblyopia occurs in childhood and may be caused by a squint, high refractive error in each eye, unequal refractive errors and by conditions that deprive the eyes of visual input such as cataracts and droopy eyelids (ptosis). Treatment includes eye patches (occlusion) and eye drops (atropine penalisation).

Adult and paediatric squints:  Squints are a misalignment of the eyes. Treatment may include glasses, botulinum toxin and surgery.

Eye movement disordersEye movement disorders may be caused by injury, disease, neurological or congenital disorder which affects the eye muscles or nerves supplying these muscles.

Binocular diplopia (double vision): Binocular diplopia (double vision) may occur in the presence of eye movement disorders or squint. Treatment may include eye exercises, glasses and prisms, botulinum toxin or eye muscle surgery.

Binocular vision defectsBinocular vision defects are an inability to use both eyes together.


We offer a range of services, including:

Adult and paediatric orthoptic appointments: These appointments will be at Epsom and St Helier hospitals. Including inpatient assessments on the stroke wards.

Paediatric refraction clinics:  These appointments will be at Epsom and St Helier hospitals.

School vision screening: These screenings take place in reception classes in the London Borough of Merton. 

Specific learning difficulties/visual stress assessments: Specific learning difficulties assessments, including visual symptoms which may be associated with dyslexia, take place at St Helier hospital. Some people, such as dyslexics, experience difficulties learning to read. The orthoptist will assess binocular vision (ability to use both eyes together), accommodation (ability of the eyes to focus) and tracking (ability to follow a line of writing) and discuss any visual discomfort and distortions associated with reading. Treatment may include exercises and/or coloured overlays.

Visual field clinics: Visual field clinics are held at St Helier and Epsom hospitals. If you are only attending for a visual fields test you will not require drops. If you have a copy of your current glasses prescription please bring this to your appointment.

Low Vision Aid (LVA) clinics: These appointments will be at Epsom and St Helier hospitals.

What to expect on your first visit

Children's orthoptic appointments

Your child will normally be seen by both the orthoptist and the ophthalmologist (eye doctor) or optician on their first visit.

The orthoptist will take a case history prior to examining your child's eyes and assessing their vision. The appointment with the orthoptist takes about 20 minutes.

Your child may then require eye drops to dilate (enlarge) their pupils. This aids the ophthalmologist/optician to check the health of the eyes and assess any need for glasses (refraction).

The eye drops (cyclopentolate) usually take about 30 minutes to work. Your child's near vision will become blurry for several hours and they will become sensitive to sunlight. It is therefore advisable to bring sunglasses/sunhat.

The effects of the drops wear off within 24 hours. Please note parental consent is required for eye drops.

Your child will then be examined by the ophthalmologist/optician who will provide you with a diagnosis and treatment/management plan, if required.

Please allow up to two hours for your child's first appointment. The second appointment (orthoptist only) is usually quicker and will take only 20 - 30 minutes.

Adult orthoptic appointments

You will be seen by an orthoptist and ophthalmologist. Please note these appointments may be on different days.

You may require drops to dilate your pupils prior to seeing the ophthalmologist. These drops may blur your vision for several hours so please do not drive to your appointment.

If you are only seeing the orthoptist or are only attending for a visual fields test you will not require drops.

Please allow 40 minutes for an orthoptic appointment.

If you have a copy of your current glasses prescription, please bring this to your appointment.

General information

We have lovely colourful children’s waiting rooms on both Epsom and St Helier sites with baby change facilities.

Our hospitals are teaching hospitals therefore you may be seen by a student. Please inform the receptionist if you do not wish to be seen by a student working under supervision.

You will be seen in order of appointment time, not arrival time. Whilst we endeavour to see patients on time, please note that some cases are more complex and may require additional time with the orthoptist or doctor causing clinics to run behind. From time to time we may also be required to see extra patients from the emergency eye clinic. 

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NHS image placement

Healthy Workplace Achievement Award 2016 NHS Choices