As an autonomous practitioner to be legally, professionally and solely responsible for the comprehensive investigative, diagnostic and therapeutic orthoptic procedures requiring accuracy, acute observations and dexterity whilst working within established protocols and the BIOS competency standards and professional practice guidelines. To ensure that each patient receives the highest standard of care, taking into account the interpretation of a broad range of specialised clinical options, working as an autonomous practitioner To assess and diagnose Orthoptic patients presenting to the department. To determine the diagnosis, prognosis and management of Orthoptic cases where clinical signs and symptoms are highly complex, may be sensitive and emotive, and do not always fall into particular categories and/or where information is limited or unavailable and there may be significant barriers to acceptance and understanding. To provide condition related information to patients, relatives and other medical staff. This may be of a sensitive nature and will need to be phrased so there is full understanding of the condition. To be able to communicate effectively with a diverse range of patients, including adults and children, English and non-English speaking patients/parents. Use appropriate skills, such as empathy and reassurance, to achieve effective communication in difficult circumstances for example stroke patients, those with physical disability, learning disability, children with significant sight defects and patients with newly diagnosed visual impairment. To understand the implication of some treatments for children at both home and school and negotiate with the parents and child (where applicable) the most effective plan of care to ensure the wellbeing of the child is paramount. To formulate each individual patient management and treatment plans, using clinical reasoning and a wide range of treatment skills, developed specifically for their ocular condition. To assess pre-op and post-ops and discuss with the Consultant Ophthalmologist and identify post-operative risks. Significant hand-eye co-ordination, manual dexterity and speed will be required, especially in infants, to ensure accurate results of eye surgery. Surgery is based on the Orthoptic measurements. To attend MDT meetings with consultant ophthalmologist to discuss patients listed for surgery to provide advice in the decision and timing for surgery. This requires an up-to-date knowledge of evidence based practice. To administer eye drops into childrens eyes to allow for a full refraction and fundus check to take place. To assess patients with complex ocular movement disorders in patients with sudden onset of symptoms attending the urgent referral clinic. To liaise with the doctor / consultant on call to recommend further investigations on the basis of the clinical findings. To competently assess visual fields using the Humphrey visual field analyser. To work as part of a multidisciplinary team with consultants, optometrists, GPs, health visitors, MDTs and other health professionals to advise on diagnosis and recommend management/ treatment options. To develop and maintain these professional links. To signpost patients to the appropriate support services in line with their visual and quality of life needs, including but not exclusively Teachers of Visually Impaired and Sensory Rehabilitation Officers. To observe and maintain professional standards at all times using advanced theoretical and practical specialist knowledge, accumulated over a significant period. To formulate each individual patient management and treatment plans, using clinical reasoning and a wide range of treatment skills, developed specifically for their ocular condition. This will be for both core orthoptic patients and those with special educational needs. To assess patients with complex ocular movement disorders in patients with sudden onset of symptoms attending the urgent referral clinic. To liaise with the doctor / consultant on call to recommend further investigations on the basis of the clinical findings To have specialist skills in areas such as special educational needs, intravitreal injections, stroke and visual processing and to be deemed competent in line with both professional and local competency standards. This will include working to specific national guidelines, local training competency assessment, PGDs, SOPs and competency frameworks which will be signed off by the lead Orthoptist and/or Consultant for the area of specialism. To contribute to future service development in Orthoptics and in your area of specialist skill and core orthoptics. To be aware of external agencies who may contribute to the multidisciplinary treatments of patients within the special educational needs. Liaise with members of MDT to provide Orthoptic information for children to various professionals. To organise and undertake vision assessments of children with Special Needs, within the Special Schools Carry out vision assessments for children with significant physical and learning disabilities. This requires highly developed skills to overcome significant barriers to communication and understanding, with high levels of patience and empathy. Advanced clinical skills are needed to interpret finding and determine if any further investigation or follow-up within the hospital setting is required. Communicate outcomes to parents/carers and make onward referral as appropriate. To liaise with safeguarding team and/or other agencies when dealing with patient safeguarding concerns ensuring all correct safeguarding procedures are followed and documented. To have excellent and highly developed communication skills with all staff, patients, and parents/ carers of patients. To utilise a range of verbal and non-verbal mechanisms in the assessment and communication of treatment plans to patients and parents / carers. To be aware of barriers to communication and be able to overcome them effectively. To explain the details of (confidential) medical conditions which may be highly complex and sensitive, to gain acceptance for treatment, and motivate or persuade patients/ parents to comply with treatment regimes. This requires a holistic and tactful approach where patients or parents have no knowledge of the ocular defects associated with a particular medical condition, and / or have difficulty accepting the diagnosis. To communicate the initial actual or potential diagnosis which may be of a distressing nature requiring sensitive, careful explanation of highly complex information, either to the parent or carer of a child, or to an adult patient Use appropriate skills, such as empathy and reassurance, to achieve effective communication in difficult circumstances.