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Retinoscopy Notes For Ophthalmologist

Retinoscopy is an objective method for measuring refractive error, essential for children and uncooperative patients. The technique involves observing the retinal reflex while sweeping light across the pupil to identify hyperopia, myopia, or neutrality. Key practices include ensuring proper working distance, using Jackson Cross Cylinder for astigmatism, and avoiding common errors like incorrect streak angle and patient fixation issues.

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Simran Sharma
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88 views2 pages

Retinoscopy Notes For Ophthalmologist

Retinoscopy is an objective method for measuring refractive error, essential for children and uncooperative patients. The technique involves observing the retinal reflex while sweeping light across the pupil to identify hyperopia, myopia, or neutrality. Key practices include ensuring proper working distance, using Jackson Cross Cylinder for astigmatism, and avoiding common errors like incorrect streak angle and patient fixation issues.

Uploaded by

Simran Sharma
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Important Concepts in Retinoscopy - Notes

1. Definition & Importance

Retinoscopy is an objective method to measure refractive error.

It is crucial for children, non-verbal patients, and uncooperative adults.

Widely used in busy OPDs, pediatrics, and rural outreach.

2. Basic Principle

Observe the retinal (red) reflex while sweeping light across the pupil.

Reflex behavior:

- With movement: Hyperopia or under-correction

- Against movement: Myopia

- No movement: Neutral point

3. Working Distance & Compensation

Typical working distance: 67 cm (equivalent to +1.50 D).

Subtract working distance from the final lens:

E.g., +3.50 D lens at neutrality = Rx of +2.00 D

4. Identifying Neutral Point

Neutral point = No visible reflex, reflex fills the pupil and disappears.

Confirm by moving closer/farther or bracketing with lenses.

5. Types of Reflex Movement

With movement: Hyperopia / Emmetropia

Against movement: Myopia

No movement: Neutral point

6. Astigmatism Detection

Rotate the retinoscope streak at different meridians.

Check for different neutrality points to determine axis and power of astigmatism.
Important Concepts in Retinoscopy - Notes

7. Jackson Cross Cylinder (JCC) Use

Used after retinoscopy to refine axis and power of astigmatism.

Mainly for subjective refraction following objective assessment.

8. Practical Technique Tips

- Ensure patient fixates at distance

- Dim room lighting

- Use steady, horizontal streak

- Stay on visual axis

- Adjust streak angle for astigmatic axis

9. Clinical Pearls

- Cycloplegic retinoscopy may be needed for children

- Always double-check neutrality in both meridians

- Use scissoring reflex to detect irregular astigmatism or keratoconus

10. Common Errors to Avoid

- Forgetting working distance subtraction

- Improper patient fixation

- Off-axis retinoscope position

- Incorrect streak angle in astigmatism

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