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Volume 43, 1993, p. 125129

AIDS: The St. Paul's Experience Part II: The Orthoptist's Role (Abstract)
S. D. MacDonald, O.C.(C.), S. J. McDonald, O.C.(C.)


In 1970 Jennifer Conn and Susan Ellis co-authored a paper entitled "A New Look at the Role of the Orthoptist" which was published as an editorial in the American Orthoptic Journal in 1971. The premise of this paper was that orthoptics was becoming a less treatment-oriented profession and orthoptists had time to perform other duties. In fact, unless the orthoptist obtained additional skills, employment was going to be more difficult.


Today, many orthoptists accept the idea of combining orthoptics with visual fields, refraction, ophthalmic photography, fluorescein angiography, contact lens management, potentiometry, and tonometry. In fact, some or all of these additional skills are often mandatory for gainful employment.


The authors of this paper felt it was appropriate to mention this piece of history while introducing a new area in which orthoptists at our center are involved: The eye care of AIDS patients.


Through education and experience we have grown to feel comfortable dealing with these patients. The biology of the human immunodeficiency virus (HIV) dictates that conditions for its transmission must be specifically met. Unless mucous membranes or non-intact skin is exposed to HIV infected whole blood, or an accidental needle-stick injury results in a microinjection of HIV infected whole blood, it is almost impossible for healthcare workers to become infected. Prospective studies indicate that the risk of HIV infection to health-care workers is less than 1%.


We feel that working with AIDS patients is an enriching and rewarding experience. However, as orthoptists we are used to dealing with healthy patients. We are now having to cope with the fact that our patients will die. It is not easy. To date 114 of the 345 patients in our study have died.