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An eye for orthoptics


Singapore National Eye Centre Senior Orthoptist Tan Yi Ling presenting her work in the clinic.

When people ask me what keeps me going at work, I tell them it is when I see my patients getting better after each session. This may sound like a textbook answer, but it is the truth.

A day in my job is never dull. I get to meet people from all walks of life, including children, adults and the elderly. In the clinic, I conduct consultations and assess how my patients' eyes work as a pair. Most of the time, I work with ophthalmologists, optometrists and nurses in the clinic. When the case calls for it, we may even tap on the expertise of physiotherapists and occupational therapists. See how multidisciplinary the team can get? Together, we play a critical role in the diagnosis and management of our patients' eye conditions.

As an orthoptist, I have been confused with either an optometrist, optician or even an ophthalmologist! It definitely does not help that all these professions deal with the eye and begin with an 'O'. These professions are different in many ways – areas of specialisation, qualifications, experience and more. To make it easier for my patients to understand, I tell them that I am an 'eye physiotherapist', specialising in the assessment, diagnosis and non-surgical management of eye disorders. These range from strabismus (squint), amblyopia (lazy eye) to diplopia (double vision).

Yi Ling assessing a young patient for strabismus (squint).

While I am based at the Singapore National Eye Centre (SNEC), I spend some sessions at KK Women's and Children's Hospital (KKH). That's where I meet most of my young patients for their eye issues.

It can get tricky to conduct assessments for the younger ones. During our sessions, they understandably feel anxious and nervous as they are unsure of what's happening. Even as adults, we feel that way sometimes! Whenever I see the frightened looks on the children's faces or hear their cries as soon as they enter the consultation room, I know I must first break the ice. With children, you have to sayang (show warmth or affection) them first… play games, banter, or do something creative to gain their trust and let them see the assessment as a game! What I've learnt over the years is that every child is different, so be prepared to have a few tricks up your sleeve.

When it comes to older patients, I spend time listening to their concerns, as well as that of their caregivers, to understand things from their perspectives. This makes it easier to educate them on their conditions and treatment plans. I feel encouraged when they regain their independence and no longer need to use prescribed aids.

These days, I run the Early Intervention Clinic at both SNEC and KKH, where we educate caregivers on strategies to help their little ones. This is done through monthly catch-up sessions to discuss if the patient has made any improvement, review treatment plans or simply to hear their concerns.

One of my first few Early Intervention patients left a deep impression on me. He had multiple developmental disorders, and was just a few months old when his parents brought him to the clinic due to his poor visual response. Although his parents were still learning to care for him, they were proactive and involved in the assessment and strategies I had provided for visual stimulation. They would return to the clinic with feedback, and even videos of the baby's progress at home. Over the years, the patient's follow-up reviews became not just assessments with the patient, but education and support for the family as well. Sometimes, we may treat patients individually, but I am reminded frequently that family support is equally important.

Patients are truly what keep me going. Be it verbally or through written cards, they offer me words of thanks to show their appreciation. The little ones also have their own way of showing gratitude – by giving me big hugs.

Throughout my journey as an orthoptist, I have realised that most of us tend to take our vision for granted. It's only when it gets compromised, that we realise how important our sight is.

My name is Tan Yi Ling, and I am a Senior Orthoptist at SNEC. If you're someone patient, empathetic and energetic, how about setting your sights on becoming an orthoptist?