20/20: Where are Orthoptists Going?

The year 2020 has been greatly anticipated by the entire ophthalmic community. This year's Scobee lecture will be a photographic look at our past with the orthoptists and pediatric ophthalmologists we have learned from, taught, and worked with. A sobering snapshot of our present will reveal a world with extreme medical access inequality. This creates a need for an inexpensive screening device for amblyogenic anisometropia. A technique for such a fast and inexpensive screening device will be shown using first retinoscopy; and then compare the effectiveness of the direct Heine streak ophthalmoscope, a common ophthalmic instrument, will be shown to be effective in screening for ≥1 diopter of spherical anisometropia. The challenges of the present hint at an optimistic future for orthoptists, expanding their role as physician extenders to help ease the medical access inequalities in the world. Finally, I introduce the patron saint of the blind and those with vision impairment.

Monocular elevation deficiency ("double elevator" palsy): a cautionary note.

Monocular elevation deficiency (or "double elevator" palsy) is a descriptive term denoting a congenital deficiency of monocular elevation that is equal in abduction and adduction. We describe a child with monocular elevation deficiency who displayed tethering and buckling of the central lower eyelid in downgaze. We caution that this manifestation of inferior rectus contracture can simulate impaired infraduction in the involved eye.