Can someone tell me how to do retinoscopy? Any optometrists out there - help!?

Question

I'm so bad that half the time it is hard to tell whether the reflex is with or against...can anybody help explain the whole technique/process?

Answer 1

The realy right way is to:

Have the patient fixate a distant letter or object with both eyes.

Place a lens in front of one eye.

Position the retinoscope at 26 inches ( 2/3 meter ) or so.

Using the scope, try a horizontal sweep.

If the reflection from the retina or choroid moves with the scope add plus power until the motion is neutral.

Now use a vertical motion and look for more with motion.

If you find with motion add plus until it is neutral.

Now add minus cylinder to neutralize.

Go to the other eye and add plus to neutralize the horizontal meridian.

Repeat for the vertical meridian.

Now go back to the first eye and check it the same way again.  (If the second eye takes plus, then you know that the first eye was accommodating when you scoped it so you have to go back and neutralize it again.)

Then back to the other eye and recheck.

They remove the working distance lenses.  Subtract 1.50 D of plus from each eye.

My uncle's optometry teacher said concerning the observation of reflexes that, "It's like watching a streetcar go by by while looking out a window.  You only have to watch it once to know which way it is going."

Actually there's a little more to it than I have outlined.

Retinoscopy usually gives 20/20 if the patient can see 20/20.

Answer 2

I'll try to help..... Bear in mind, it's really hard to convey something like this in writing.  I assume you know about the concave/plano settings on the scope.  I am also assuming you work in  minus cylinder.  I would use concave mode and sufficiently fog the patient until "with" motion (the beam of light moves in the same direction as you are tilting the scope) is seen in all meridians.  Find the meridian with the most movement (and thinnest beam reflex) and then turn the beam 90 degrees away.  Correct this meridean by adding minus sphere until the motion becomes neutral.  Align the axis arrows with this meridian. Then turn 90 degrees away and if there is still "with" movement add minus cylinder until that meridian is neutral.  Go back and check that the original meridian is still neutral.  All meridians should be equal in this case if you've done it correctly.  Hope this helps....and I hope I didn't cross my wires in my thought process!  You do it for so long, you just do it naturally without thinking.  I had stop and actually think my way through it.  Thanks for the mental exercise....

Also...see this site, it may help:  http://www.eyetec.net/group2/M6S1.htm

Answer 3

If you can't tell with from against you've got problems.  Talk to your instructors.