What Is an Orthoptic Assessment — And Why Might You Need One?
At Nagle and Associates Optometrists & Orthoptics, we believe in caring for not just your eyes individually, but the way they work together. That’s where an Orthoptic Assessment comes in — a specialised series of tests designed to check how well your eyes function as a pair, a process known as binocular vision.
Why Is Binocular Vision Important?
Binocular vision is what keeps your eyes aligned and working in sync. When you focus on an object — whether it’s a book, a road sign, or a moving target — each eye sends a slightly different image to the brain. The brain fuses these images into one clear picture, giving you a single, three-dimensional view of the world and helping you judge distances accurately.
For this to happen, the six muscles in each eye need to move together in perfect coordination. Any weakness or problem in this system can lead to discomfort and vision difficulties.
What Can Affect Binocular Vision?
A variety of conditions can interfere with binocular vision. These may be:
Congenital (present from birth) muscle imbalances
Acquired issues, which can develop at any stage of life due to:
Eye injuries
Systemic diseases like diabetes or thyroid eye disease
Neurological conditions such as strokes or brain lesions
Certain genetic syndromes
Even an uncorrected need for glasses in children can result in a lazy eye (amblyopia) or a squint (strabismus), as the brain “switches off” one eye to avoid double vision.
Symptoms You Shouldn’t Ignore
Reduced binocular vision isn’t always obvious, but common symptoms include:
Blurred or double vision
Eyestrain or discomfort, especially when reading or focusing up close
Headaches
A noticeable change in head posture, where a person may tilt or turn their head to compensate
These signs are often subtle but can have a major effect on daily comfort and visual performance.
How Is Binocular Vision Tested?
During an Orthoptic Assessment, a series of tests are performed to check:
How well your eyes work together
The strength and coordination of your eye muscles
How effectively your brain fuses the images from both eyes
In certain cases, a Lees screen with Hess chart plotting may be used — a specialised tool for mapping eye movements. This is especially helpful for diagnosing and monitoring muscle problems, certain neurological diseases, and medico-legal cases.
Treatment Options for Binocular Vision Problems
There are several ways to manage and treat binocular vision problems, including:
Orthoptic exercises to strengthen and train the eye muscles
Updating spectacle or contact lens prescriptions to improve eye alignment and control
Adding prisms to glasses or contact lenses to assist with image alignmen
If exercises or prisms aren’t sufficient, referrals may be made to an Ophthalmologist or Neurologist for further investigation. In some cases, surgery or other treatments may be necessary.
Monitoring and Follow-Ups
If your condition requires monitoring, regular orthoptic assessments can track your progress over time. Hess chart plots are often used to measure and compare your eye movements between visits, helping to spot improvements or changes early.
Book an Appointment with Dr Mark Nagle
If you’ve been experiencing headaches, eye strain, double vision — or if your child shows signs of a squint — book an appointment with Dr Mark Nagle today. A comprehensive orthoptic assessment could make a real difference to your comfort, vision health, and quality of life.