Simone and Andrea, under the guidance of Jorie Jackson, CO and the rest of Dr. Miller’s staff, observed many facets of Dr. Miller’s practice. They spent much of their time in the orthoptic clinic, where they experienced how American orthoptists see, diagnose, and treat their patients. Vision testing was especially different in the United States than in Switzerland. Simone and Andrea noted that children in the U.S. seemed to know the alphabet much earlier than Swiss children, and subjective vision testing was done at much younger ages than children than they were used to at home. They also noted that for non- and pre-verbal children, a 10-12 diopter vertical prism was used to check ocular preference, while at home they use Cardiff cards or forced preferential looking tests. This was of particular interest to Jorie, who reported that it would be helpful to have Cardiff cards in clinic as another resource to test visual acuity in young children! They observed that stereopsis was measured differently in the U.S. than Switzerland; while Simone and Andrea primarily use the Lang or TNO stereo tests for their exams, at HEA the orthoptists mainly use the Titmus stereo test (but will use Randot if more detailed stereopsis results are needed). Another difference Simone and Andrea saw was how retinal correspondence is tested. They typically use Bagolini lenses, while at HEA orthoptists use a Synoptophore. Although there were many noted differences between Swiss and American orthoptists, there were also some similarities. The flow of an orthoptic exam, the range of the ages of patients (from infant to adult), the time allotted for each patient’s exam, and the hours worked in clinic were all alike.
Along with participating in clinic, Simone and Andrea also observed Dr. Miller perform strabismus surgery. They watched several surgeries, and observed Dr. Miller operate on all six extraocular muscles in some form throughout the day.
Although the majority of time for Simone and Andrea was with Dr. Miller and his staff during clinic, there was plenty of time to explore the Houston area! They attended the world’s largest rodeo where they sampled many Texas delicacies (including the famous barbeque). They also visited NASA at the Johnson Space Center.
While there were many differences seen between Swiss and American orthoptists one thing is obvious: both work tirelessly to treat patients who are affected by binocular vision disorders.
Simone and Andrea had a wonderful experience in Houston, and wish to thank Dr. Miller, Jorie, and the rest of his staff for welcoming them into their lives for two weeks.
https://www.internationalorthoptics.org/fileadmin/user_upload/Houston_Visitors_from_Switzerland.pdf
