The little girl's mother noticed that the child's left eye was beginning to turn inward. Her pediatrician referred them to a pediatric ophthalmologist, a physician who specializes in pediatric eye care.

At the ophthalmologist's office, the girl was first seen by an orthoptist, who carried out a series of diagnostic tests and measurements to assess visual function, the need for glasses, and how well the child's eyes worked together.

The orthoptist recorded the results in the medical record and conferred with the ophthalmologist. Together they formulated a treatment plan, which included a prescription for glasses and use of an eye patch on the stronger eye. Then over the next few months, the orthoptist monitored the child's progress.

What Do They Do?

Orthoptics literally means "straight eyes." Orthoptists specialize in eye muscle disorders. They evaluate depth perception, eye alignment, eye movements and eye coordination.

Most are employed in the offices of pediatric ophthalmologists, says Bill McMichael, a certified orthoptist at Park Nicollet Clinic (www.parknicollet.com). But he notes that some work with neurophthalmologists, evaluating adults with vision problems caused by conditions such as multiple sclerosis, Parkinson's disease and stroke.

A Day In The Life

During a typical day, McMichael sees between 15 and 20 patients - about 80 percent of whom are children. Some referred by pediatricians and local schools after routine vision screening. Others have conditions like Down syndrome, cerebral palsy, prematurity or even congenital cataracts.

"I like the challenge and the variety," McMichael says. "Every patient is a mystery. Our job is to ask the questions, do the tests and find the answers that will allow us to help the patient function and see better."

Education And Outlook

Before beginning a specialized program in orthoptics, students must earn a baccalaureate degree. A science or health-related degree is helpful, but not required.

The 24-month post- baccalaureate internship includes both course work and hands-on clinical experiences under the supervision of a certified orthoptist. Graduates must pass a national certifying exam.

According to the American Association of Certified Orthoptists (www.orthoptics.org), opportunities for professionals in this field will remain plentiful in the years ahead.

Nancy Giguere is a freelance writer from St. Paul who has written about healthcare since 1995.