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Guest
Posted: Thu May 01, 2008 1:22 pm
Dear Doug,

In order to measure your refractive STATE objectively -- with
a retinoscope -- you will need.

1. The instrument.

2. Technical training on the instrument, and some
basic optical information (analysis) of the eye.

3. Assuming you have a friend who has your interest then
BOTH of you can make this measurement on each other.

4. The Snellen/Trial-lens is quite good -- and is preferred
for a final refraction. But the retinoscope will give
a similar reading.

5. You can do this, but you can ot "freeze" the eye with
a drug. If you think that is more "accurate" then you will
need some one to prescribe that drug for you.

As Mike as said, he thinks the retinoscope is quite accurate
with no drug -- and I would agree with him on that point.


Enjoy,



On May 1, 7:14 pm, douglas <Protoman2...@gmail.com> wrote:
Quote:
On May 1, 3:31 pm, otisbr...@embarqmail.com wrote:





Dear Doug,

Subject:  Best Visual Acuity -- METHOD

This is the standard that is preferred by most ODs.

Using a trial lens kit (or Phoropter), and a minus lens -- you do the
following.

Have the person read the Snellen.  OK, 20/70

Now you place a weak minus lens in your trial-lens frame, of -1
diopter.

20/30, OK

You then increase the power (asking 1 or 2 better) until you get the
sharpest
vision possible.

20/20.  OK with a -1.5 diopter lens.

Now let is see if we can do better.  Using a cyl lens, you rotate the
lens
from zero to 90 degrees, looking for that to sharpen the image.

So you get to 20/15 for that person.

You think write the prescription for the Spherical and Cyl and angle.

Enjoy,

On May 1, 3:18 pm, douglas <Protoman2...@gmail.com> wrote:

On May 1, 9:21 am, "Mike Tyner" <mty...@mindspring.com> wrote:

"douglas" <Protoman2...@gmail.com> wrote

OK, I know how to check the base refractive error, but how do you
check for astigmatism? I know the retinoscope has a protractor on it,

You don't see protractor markings on modern retinoscopes. The markings are
on the phoropter.

I'm pretty sure you use it just for that, but...how?

Once you get a good reflex, you rotate the streak and sweep it in different
directions across the pupil. Many times it's obvious that the streak
neutralizes in one meridian (say, sweeping side-to-side) yet it's way off
90 degrees away, when you sweep up-and-down. That's astigmatism, and the
trick is to determine the maximum and minimum meridians.

If you did both a static cycloplegic and a dynamic non-cycloplegic

Dynamic retinoscopy isn't useful for determining refractive error. Many
doctors never use dynamic and have forgotten how, because it's only valuable
for determining accommodative response and there are other ways to do that.
A few years ago the "Prio system" was pushed out, basically an LCD nearpoint
card with a hole it it, thru which you could do dynamic retinoscopy. It was
gimmicky ("computer vision") and seldom indicated any unique sort of
treatment, but you were obligated to prescripe Prio lenses from it. It
wasn't that much better than a plastic nearpoint card with the same hole.

Retinoscopy is a dying art. Most retinoscopy used to be done to gain a
starting point for subjective refraction, an estimate. Many doctors now use
autorefractors for that, and consequently never pick up a retinoscope. I
wouldn't either, except sometimes I get ahead of my staff and patients
haven't had the autorefraction done yet.

Cycloplegic retinoscopy may be used to help determine latent hyperopia but
dry (non-cyclo) ret is often a good indicator of LH, revealing results that
are a half- or full diopter more plus than the patient's chosen subjective.

Who makes good retinoscopes? Keeler?

Copeland and Welch-Allyn. Don't know the Keeler.

And what's the diff b/w a
retinoscope and an ophthalmoscope?

BIG diff. A ret just generates a streak of light. The streak can be focused
but it's designed to focus an image of the filament (the streak) to the
retina, such that you can see it moving in the pupil.

Ophthalmoscopes are illuminated too, but more important they have an
observation system that lets you see the details of what you're
illuminating. Direct and indirect o'scopes both produce an image of the
retina. In direct scopes, the image is upright and magnified. Indirect
scopes produce upside-down images that are wider-field (less detailed, not
as magnified.)

Can you use a indirect
ophthalmoscope for retinoscopy?

Not very well, I'm not sure it could be done because retinoscopes all focus
the streak in different planes. The ophthalmoscope generates only parallel
light for illumination.

And has any beginning optometry student accidently held the
retinoscope backwards, and temporarily blinded themselves?

Oh sure. Ophthalmoscopes are much brighter.  But with all hand-held scopes,
it's habit to turn it on, then shine it somewhere like your hand or the
wall, to make sure it's working. Putting it to your eye backwards is dumb
but even dumber is getting up in your patient's face then finding the scope
is dead.

-MT

But I'm sure you could use a direct ophthalmoscope for retinoscopy, if
you lacked a retnoscope, would the procedure be any different for
using an ophthalmoscope for static retinoscopy? Which provides better
bva, cyclo, or non-cyclo?- Hide quoted text -

- Show quoted text -- Hide quoted text -

- Show quoted text -

That's subjectively. And, according to House, patients lie. So, how do
we use retinoscopy to *objectively* determine our patient's refractive
error? I believe its as follows:

Dim the lights, instill cyclopentolate into the patient's eyes, and
have them look at at a target at optical infinity. You stand 67cm away
from the patient, and set the phoropter to -1.50D --please explain to
me exactly why this is done? To set the effective curvature to zero,
perhaps? And I know that -1.50D is the reciprical of 67cm--, and move
the retinoscope across the pupil. If you see with-motion, add plus
lenses; against-motion, add minus lenses. Stop when the pupil fills w/
light, and there's no motion. Rinse and repeat for all meridians.
Rinse and repeat for the other eye. Subtract -1.50D from the readings
to get the prescription.

How would you use the autorefractor to find an inital starting point
for the static retinoscopy?- Hide quoted text -

- Show quoted text -
douglas
Posted: Thu May 01, 2008 2:39 pm
Guest
On May 1, 4:52 pm, Dan Abel <da...@sonic.net> wrote:
Quote:
In article
94107388-eb1c-4341-a73b-ab2e01c04...@v26g2000prm.googlegroups.com>,

 douglas <Protoman2...@gmail.com> wrote:
On May 1, 9:21 am, "Mike Tyner" <mty...@mindspring.com> wrote:
Retinoscopy is a dying art. Most retinoscopy used to be done to gain a
starting point for subjective refraction, an estimate. Many doctors now
use
autorefractors for that, and consequently never pick up a retinoscope.
I
wouldn't either, except sometimes I get ahead of my staff and patients
haven't had the autorefraction done yet.
How would you use the autorefractor to find an inital starting point
for the static retinoscopy?

Perhaps I didn't understand your question, so I left a bit from Mike up
above.

My niece was hired to work in an OD office last summer, to do
autorefractions and field tests.  She was paid US$1.00 per hour.  She
thought that was pretty good, because it gave her something to do while
she hung out with her mother and aunt.  She is only nine years old.

--
Dan Abel
Petaluma, California USA
da...@sonic.net

So, a comparison of static retinoscopy and autorefraction is in order.
Is SR better then AR, worse, or equal? And why do you set the
phoropter to -1.50D if you're standing 67cm away? What's the purpose?

Oh, and in England, if you're a consultant ophthalmologist and
ophthalmic surgeon, and are named "Douglas K. Sartorius, DM, MCh,
FRCP, FRCS, FRCOphth", are you addressed as "Doctor", or "Mister"?

Thanks!
Guest
Posted: Thu May 01, 2008 3:45 pm
Dear Doug,

An ophthalmologist is a medical doctor first. With further
training he qualifies for his title. He and all medical doctors
are call "Doctors" -- if the subject is medical.

If a man has a Ph.D., he also can be called a "Doctor".

In the U.S.A., a optometrist is called a "Doctor", but in
other countries that is not legal, so he is called
a "Refractionist" -- to separate him from a medical doctor.
So their title is "Mister".

Enjoy,


On May 1, 8:39 pm, douglas <Protoman2...@gmail.com> wrote:
Quote:
On May 1, 4:52 pm, Dan Abel <da...@sonic.net> wrote:





In article
94107388-eb1c-4341-a73b-ab2e01c04...@v26g2000prm.googlegroups.com>,

 douglas <Protoman2...@gmail.com> wrote:
On May 1, 9:21 am, "Mike Tyner" <mty...@mindspring.com> wrote:
Retinoscopy is a dying art. Most retinoscopy used to be done to gain a
starting point for subjective refraction, an estimate. Many doctors now
use
autorefractors for that, and consequently never pick up a retinoscope.
I
wouldn't either, except sometimes I get ahead of my staff and patients
haven't had the autorefraction done yet.
How would you use the autorefractor to find an inital starting point
for the static retinoscopy?

Perhaps I didn't understand your question, so I left a bit from Mike up
above.

My niece was hired to work in an OD office last summer, to do
autorefractions and field tests.  She was paid US$1.00 per hour.  She
thought that was pretty good, because it gave her something to do while
she hung out with her mother and aunt.  She is only nine years old.

--
Dan Abel
Petaluma, California USA
da...@sonic.net

So, a comparison of static retinoscopy and autorefraction is in order.
Is SR better then AR, worse, or equal? And why do you set the
phoropter to -1.50D if you're standing 67cm away? What's the purpose?

Oh, and in England, if you're a consultant ophthalmologist and
ophthalmic surgeon, and are named "Douglas K. Sartorius, DM, MCh,
FRCP, FRCS, FRCOphth", are you addressed as "Doctor", or "Mister"?

Thanks!- Hide quoted text -

- Show quoted text -
douglas
Posted: Thu May 01, 2008 4:43 pm
Guest
On May 1, 6:45 pm, otisbr...@embarqmail.com wrote:
Quote:
Dear Doug,

An ophthalmologist is a medical doctor first.  With further
training he qualifies for his title.  He and all medical doctors
are call "Doctors" -- if the subject is medical.

If a man has a Ph.D., he also can be called a "Doctor".

In the U.S.A., a optometrist is called a "Doctor", but in
other countries that is not legal, so he is called
a "Refractionist" -- to separate him from a medical doctor.
So their title is "Mister".

Enjoy,

On May 1, 8:39 pm, douglas <Protoman2...@gmail.com> wrote:



On May 1, 4:52 pm, Dan Abel <da...@sonic.net> wrote:

In article
94107388-eb1c-4341-a73b-ab2e01c04...@v26g2000prm.googlegroups.com>,

 douglas <Protoman2...@gmail.com> wrote:
On May 1, 9:21 am, "Mike Tyner" <mty...@mindspring.com> wrote:
Retinoscopy is a dying art. Most retinoscopy used to be done to gain a
starting point for subjective refraction, an estimate. Many doctors now
use
autorefractors for that, and consequently never pick up a retinoscope.
I
wouldn't either, except sometimes I get ahead of my staff and patients
haven't had the autorefraction done yet.
How would you use the autorefractor to find an inital starting point
for the static retinoscopy?

Perhaps I didn't understand your question, so I left a bit from Mike up
above.

My niece was hired to work in an OD office last summer, to do
autorefractions and field tests.  She was paid US$1.00 per hour.  She
thought that was pretty good, because it gave her something to do while
she hung out with her mother and aunt.  She is only nine years old.

--
Dan Abel
Petaluma, California USA
da...@sonic.net

So, a comparison of static retinoscopy and autorefraction is in order.
Is SR better then AR, worse, or equal? And why do you set the
phoropter to -1.50D if you're standing 67cm away? What's the purpose?

Oh, and in England, if you're a consultant ophthalmologist and
ophthalmic surgeon, and are named "Douglas K. Sartorius, DM, MCh,
FRCP, FRCS, FRCOphth", are you addressed as "Doctor", or "Mister"?

Thanks!- Hide quoted text -

- Show quoted text -- Hide quoted text -

- Show quoted text -

OK, you obviously don't understand the British system at
all...ophthalmologists are surgeons, and most hold MRCS or above. If
you hold MRCS or above, you call yourself "Mr", due to some historical
anachronism of the RCS. But, if you also hold MRCP or above, you call
yourself "Dr". Same for MCh vs. DM. Would you consider an
ophthalmologist a surgeon, or a physician? Ophthos do a *lot* of
surgery. Ophthalmologists are kinda in between physicians and
surgeons. That's the key here.

Please do not proffer your advice on any of my threads ever again. You
clearly don't understand what you are talking about.

And what about my static retinoscopy vs. autorefractor question?
Zetsu
Posted: Thu May 01, 2008 4:51 pm
Guest
On 2 May, 02:45, otisbr...@embarqmail.com wrote:
Quote:
Dear Doug,

An ophthalmologist is a medical doctor first. With further
training he qualifies for his title. He and all medical doctors
are call "Doctors" -- if the subject is medical.

If a man has a Ph.D., he also can be called a "Doctor".

In the U.S.A., a optometrist is called a "Doctor", but in
other countries that is not legal, so he is called
a "Refractionist" -- to separate him from a medical doctor.
So their title is "Mister".

Enjoy,

On May 1, 8:39 pm, douglas <Protoman2...@gmail.com> wrote:

On May 1, 4:52 pm, Dan Abel <da...@sonic.net> wrote:

In article
94107388-eb1c-4341-a73b-ab2e01c04...@v26g2000prm.googlegroups.com>,

douglas <Protoman2...@gmail.com> wrote:
On May 1, 9:21 am, "Mike Tyner" <mty...@mindspring.com> wrote:
Retinoscopy is a dying art. Most retinoscopy used to be done to gain a
starting point for subjective refraction, an estimate. Many doctors now
use
autorefractors for that, and consequently never pick up a retinoscope.
I
wouldn't either, except sometimes I get ahead of my staff and patients
haven't had the autorefraction done yet.
How would you use the autorefractor to find an inital starting point
for the static retinoscopy?

Perhaps I didn't understand your question, so I left a bit from Mike up
above.

My niece was hired to work in an OD office last summer, to do
autorefractions and field tests. She was paid US$1.00 per hour. She
thought that was pretty good, because it gave her something to do while
she hung out with her mother and aunt. She is only nine years old.

--
Dan Abel
Petaluma, California USA
da...@sonic.net

So, a comparison of static retinoscopy and autorefraction is in order.
Is SR better then AR, worse, or equal? And why do you set the
phoropter to -1.50D if you're standing 67cm away? What's the purpose?

Oh, and in England, if you're a consultant ophthalmologist and
ophthalmic surgeon, and are named "Douglas K. Sartorius, DM, MCh,
FRCP, FRCS, FRCOphth", are you addressed as "Doctor", or "Mister"?

Thanks!- Hide quoted text -

- Show quoted text -

I noticed you watch 'House'. Me too! It's cool!
I watched it yesterday. The one with the guy who mimicks the persona
of anyone he comes into contact with. Creepy but cool.
Neil Brooks
Posted: Thu May 01, 2008 4:53 pm
Guest
On May 1, 7:43 pm, douglas <Protoman2...@gmail.com> wrote (re: Otis):

Quote:
Please do not proffer your advice on any of my threads ever again. You
clearly don't understand what you are talking about.

It actually took you a few posts longer to figure that out than it
does most people. I'll chalk it up to your being a cherry optimist
and having given Otis the benefit of the doubt Wink
Zetsu
Posted: Thu May 01, 2008 5:04 pm
Guest
On 2 May, 03:54, Nicolaas Hawkins <grumpy.m...@t.large> wrote:
Quote:
On Thu, 1 May 2008 18:45:42 -0700 (PDT), <otisbr...@embarqmail.com> wrote
in
news:19f24818-1d55-4c41-a7aa-af2f1cab094a@a23g2000hsc.googlegroups.com>:

On May 1, 8:39 pm, douglas <Protoman2...@gmail.com> wrote:
[...]
Oh, and in England, if you're a consultant ophthalmologist and
ophthalmic surgeon, and are named "Douglas K. Sartorius, DM, MCh,
FRCP, FRCS, FRCOphth", are you addressed as "Doctor", or "Mister"?
An ophthalmologist is a medical doctor first. With further
training he qualifies for his title. He and all medical doctors
are call "Doctors" -- if the subject is medical.

So much more than simply an ophthalmologist. Do the terms "consultant
ophthalmologist" and "ophthalmic surgeon" not convey anything to you? In
case you are unfamiliar, the letters after his name stand for:
DM = Doctor of Medicine;
MCh = Master of Surgery;
FRCP = Fellow of the Royal College of Physicians;
FRCS = Fellow of the Royal College of Surgeons;
FRCOphth = Fellow of the Royal College of Ophthalmologists.



If a man has a Ph.D., he also can be called a "Doctor".

In the U.S.A., a optometrist is called a "Doctor"

The gentleman was quite specific; "in England". "In the USA" is utterly
irrelevant, even if that is where you are.

but in other countries that is not legal, so he is called a
"Refractionist" -- to separate him from a medical doctor. So their
title is "Mister".

On the basis of his medical qualifications (DM and FRCP) he is entitled to
the honorific of 'Doctor'.

On the basis of his qualifications as a surgeon (MCh and FRCS) he is
entitled to the honorific of 'Mister', as are all surgeons in England and
many other places.

So, on the basis of the above, he would be entitled to use whichever
honorific he damned well chooses!

To answer his question of "are you addressed as "Doctor", or "Mister"?"
directly, I would venture that it would depend on who was doing the
addressing and the circumstances, adding that "Good morning, Doctor"
sounds a little less strange than "Good morning, Mister" - the latter
sounds as if you are addressing a stranger.

I agree! My dad is a "doctor" but not really a "doctor" how most
people would think. He has just got a Ph.D, but not any medical
qualifications! It just seems weird to me to even just imagine someone
addressing him as 'Doctor'!. But I agree that Doctor can sound a lot
more friendly whereas 'Mister' sounds slighly over-the-top formal and
pompous... or something to that effect?

Quote:
Oh ... and has it occurred to anyone that his question may have been a
rather subtle way of telling the group of his qualifications, suggesting
that he has rather more of a clue whereof he speaks than do many on this
group?

Well, everyone has their own time of being just a little ostentatious.
Just welcome him into the group, don't be so accusatory and harsh! We
all like to impress our friends by being super-clever now and then.
Don't you? Hmm.
douglas
Posted: Thu May 01, 2008 5:13 pm
Guest
On May 1, 7:54 pm, Nicolaas Hawkins <grumpy.m...@t.large> wrote:
Quote:
On Thu, 1 May 2008 18:45:42 -0700 (PDT), <otisbr...@embarqmail.com>  wrote
in
news:19f24818-1d55-4c41-a7aa-af2f1cab094a@a23g2000hsc.googlegroups.com>:

On May 1, 8:39 pm, douglas <Protoman2...@gmail.com> wrote:
[...]
Oh, and in England, if you're a consultant ophthalmologist and
ophthalmic surgeon, and are named "Douglas K. Sartorius, DM, MCh,
FRCP, FRCS, FRCOphth", are you addressed as "Doctor", or "Mister"?
An ophthalmologist is a medical doctor first.  With further
training he qualifies for his title.  He and all medical doctors
are call "Doctors" -- if the subject is medical.

So much more than simply an ophthalmologist.  Do the terms "consultant
ophthalmologist" and "ophthalmic surgeon" not convey anything to you?  In
case you are unfamiliar, the letters after his name stand for:
DM = Doctor of Medicine;
MCh = Master of Surgery;
FRCP = Fellow of the Royal College of Physicians;
FRCS = Fellow of the Royal College of Surgeons;
FRCOphth = Fellow of the Royal College of Ophthalmologists.



If a man has a Ph.D., he also can be called a "Doctor".

In the U.S.A., a optometrist is called a "Doctor"

The gentleman was quite specific; "in England".  "In the USA" is utterly
irrelevant, even if that is where you are.

but in other countries that is not legal, so he is called a
"Refractionist" -- to separate him from a medical doctor. So their
title is "Mister".

On the basis of his medical qualifications (DM and FRCP) he is entitled to
the honorific of 'Doctor'.

On the basis of his qualifications as a surgeon (MCh and FRCS) he is
entitled to the honorific of 'Mister', as are all surgeons in England and
many other places.

So, on the basis of the above, he would be entitled to use whichever
honorific he damned well chooses!

To answer his question of "are you addressed as "Doctor", or "Mister"?"
directly, I would venture that it would depend on who was doing the
addressing and the circumstances, adding that "Good morning, Doctor"
sounds a little less strange than "Good morning, Mister" - the latter
sounds as if you are addressing a stranger.

Oh ... and has it occurred to anyone that his question may have been a
rather subtle way of telling the group of his qualifications, suggesting
that he has rather more of a clue whereof he speaks than do many on this
group?

--
- Nic.

Well...thanks, but I most definitely am *not* entitled to use those
postnominals...I'm only 16.5 years old --and am an undergrad at
Cerritos College--, and I plan on being a medical doctor, either an
internal medicine subspecialist, or an ophthalmologist. If I do become
a medical ophthalmologist and/or ophthalmic surgeon, I'll most
definitely try for those degrees and qualifications. And, since the
fictional --merely shares my name-- consultant medical ophthalmologist
and ophthalmic surgeon has a "DM" instead an "MD", and an "MCh",
instead of a "ChM" that means he recieved his Bachelor of Medicine
and Surgery, Doctor of Medicine, and Master of Surgery from The
University of Oxford; erudite guy, he is. And, if I was who you were
thinking of for that split second, why, pray tell, would I be asking
*this* question, let alone on Usenet?

And I believe that Dr Sartorius is entitled to use the honorific of
"Doctor", since FRCP is an older qualification --RCPLond established
way before RCSEng--, thus it has higher precedence in the wonderfully
long table of British honors, degrees, and qualifications, so FRCP
outranks FRCS.

And what of my static retinoscopy vs. autorefractor question? Please
answer this.

Thanks!
Zetsu
Posted: Thu May 01, 2008 5:25 pm
Guest
On 2 May, 04:13, douglas <Protoman2...@gmail.com> wrote:
Quote:
On May 1, 7:54 pm, Nicolaas Hawkins <grumpy.m...@t.large> wrote:



On Thu, 1 May 2008 18:45:42 -0700 (PDT), <otisbr...@embarqmail.com> wrote
in
news:19f24818-1d55-4c41-a7aa-af2f1cab094a@a23g2000hsc.googlegroups.com>:

On May 1, 8:39 pm, douglas <Protoman2...@gmail.com> wrote:
[...]
Oh, and in England, if you're a consultant ophthalmologist and
ophthalmic surgeon, and are named "Douglas K. Sartorius, DM, MCh,
FRCP, FRCS, FRCOphth", are you addressed as "Doctor", or "Mister"?
An ophthalmologist is a medical doctor first. With further
training he qualifies for his title. He and all medical doctors
are call "Doctors" -- if the subject is medical.

So much more than simply an ophthalmologist. Do the terms "consultant
ophthalmologist" and "ophthalmic surgeon" not convey anything to you? In
case you are unfamiliar, the letters after his name stand for:
DM = Doctor of Medicine;
MCh = Master of Surgery;
FRCP = Fellow of the Royal College of Physicians;
FRCS = Fellow of the Royal College of Surgeons;
FRCOphth = Fellow of the Royal College of Ophthalmologists.

If a man has a Ph.D., he also can be called a "Doctor".

In the U.S.A., a optometrist is called a "Doctor"

The gentleman was quite specific; "in England". "In the USA" is utterly
irrelevant, even if that is where you are.

but in other countries that is not legal, so he is called a
"Refractionist" -- to separate him from a medical doctor. So their
title is "Mister".

On the basis of his medical qualifications (DM and FRCP) he is entitled to
the honorific of 'Doctor'.

On the basis of his qualifications as a surgeon (MCh and FRCS) he is
entitled to the honorific of 'Mister', as are all surgeons in England and
many other places.

So, on the basis of the above, he would be entitled to use whichever
honorific he damned well chooses!

To answer his question of "are you addressed as "Doctor", or "Mister"?"
directly, I would venture that it would depend on who was doing the
addressing and the circumstances, adding that "Good morning, Doctor"
sounds a little less strange than "Good morning, Mister" - the latter
sounds as if you are addressing a stranger.

Oh ... and has it occurred to anyone that his question may have been a
rather subtle way of telling the group of his qualifications, suggesting
that he has rather more of a clue whereof he speaks than do many on this
group?

--
- Nic.

Well...thanks, but I most definitely am *not* entitled to use those
postnominals...I'm only 16.5 years old --and am an undergrad at
Cerritos College--, and I plan on being a medical doctor, either an
internal medicine subspecialist, or an ophthalmologist. If I do become
a medical ophthalmologist and/or ophthalmic surgeon, I'll most
definitely try for those degrees and qualifications. And, since the
fictional --merely shares my name-- consultant medical ophthalmologist
and ophthalmic surgeon has a "DM" instead an "MD", and an "MCh",
instead of a "ChM" that means he recieved his Bachelor of Medicine
and Surgery, Doctor of Medicine, and Master of Surgery from The
University of Oxford; erudite guy, he is. And, if I was who you were
thinking of for that split second, why, pray tell, would I be asking
*this* question, let alone on Usenet?

And I believe that Dr Sartorius is entitled to use the honorific of
"Doctor", since FRCP is an older qualification --RCPLond established
way before RCSEng--, thus it has higher precedence in the wonderfully
long table of British honors, degrees, and qualifications, so FRCP
outranks FRCS.

And what of my static retinoscopy vs. autorefractor question? Please
answer this.

Thanks!

I think static retinoscopy would be better. Although I've never done
it. It sounds a lot more fun than just 'auto' whatever. I like doing
stuff manually, the long way around. Anyway, retinoscopy is way
cooler. You get to do cool stuff with lights and mirrors and lenses
and shadows and things. And you can do it on any of the lower animals.
Which is a big advantage, because you can't normally do that by any of
the other methods. I mean, imagine trying to get a dog to 'read the
damn snellen bitch!'. But you should do it at 6 ft because then it's
more accurate because you wouldn't make the subject nervous and that
spoils the measurement.
Zetsu
Posted: Thu May 01, 2008 5:36 pm
Guest
You're really smart for a 16 year old.
I mean, you talk about all these optics so intelligently. I hardly
have a clue about what you guys are talking about. Good luck with your
future you'll defininately succeed in optometry. But I hate optometry
because they give people glasses and destroy lives. So personally I
kind of dislike that profession.
Oh, I'm 16 too! Ophthalmology used to be my dream career as well! But
I gave it up because now I want to be an airline pilot. Me and Jason
Sperry (another guy who shares similar interests) are both 16. Welcome
to the '16 club' LOL. That makes three of us.
douglas
Posted: Thu May 01, 2008 5:49 pm
Guest
On May 1, 8:36 pm, Zetsu <absolutelyinvinci...@hotmail.com> wrote:
Quote:
You're really smart for a 16 year old.
I mean, you talk about all these optics so intelligently. I hardly
have a clue about what you guys are talking about. Good luck with your
future you'll defininately succeed in optometry. But I hate optometry
because they give people glasses and destroy lives. So personally I
kind of dislike that profession.
Oh, I'm 16 too! Ophthalmology used to be my dream career as well! But
I gave it up because now I want to be an airline pilot. Me and Jason
Sperry (another guy who shares similar interests) are both 16. Welcome
to the '16 club' LOL. That makes three of us.

Really? I talk about optics *intelligently*? How so? Give me an
example. To myself, I sound like some guy, who, in rl, walks around
bothering medical professionals w/ incessant questions --I do, but
said medical professionals don't mind...I'm great friends w/ my
pharmacist-friend at Sams Club and my internist-friend at church--. I
plan on asking my ophthalmologist and optometrist to let me shadow
them one half-day/week.

And, I want to be an *ophthalmologist*; refracting is so fun and cool,
but ocular malignancies and vitreoretinal disorders are where it's
at...literally! Have you seen the pay for ocular oncologists and
vitreo-retinal surgeons? $500K-$800K+!!!!

If you want to see me talk super-intelligently, see me talk about
hematology/oncology, immunology, or rheumatology.

Can I private email you, Zetsu?
Zetsu
Posted: Thu May 01, 2008 5:58 pm
Guest
Oh my God! I always wanted to shadow an optometrist/ophthalmologist!
It would be so awesome! But I don't think I'd be allowed! But it would
be great to put in my CV.

By the way, there's actually a yahoo group called 'why optometry
sucks' or something like that. They whine about getting low salaries
and whatnot. HAHA. And I'm not even joking, it really does exist. So
it looks like the pay can be bad and good. But 800K sounds quite good.
Over here in UK I think that would be about £400K! Mezmerizing!

Oh yes, private mail me away! (if you're a girl, then all I encourage
you all the more! If you're a boy, then that's OK but I'm a bit
disappointed.)
Dr Judy
Posted: Thu May 01, 2008 6:05 pm
Guest
On May 1, 7:14 pm, douglas <Protoman2...@gmail.com> wrote:
Quote:
On May 1, 3:31 pm, otisbr...@embarqmail.com wrote:





Dear Doug,

Subject:  Best Visual Acuity -- METHOD

This is the standard that is preferred by most ODs.

Using a trial lens kit (or Phoropter), and a minus lens -- you do the
following.

Have the person read the Snellen.  OK, 20/70

Now you place a weak minus lens in your trial-lens frame, of -1
diopter.

20/30, OK

You then increase the power (asking 1 or 2 better) until you get the
sharpest
vision possible.

20/20.  OK with a -1.5 diopter lens.

Now let is see if we can do better.  Using a cyl lens, you rotate the
lens
from zero to 90 degrees, looking for that to sharpen the image.

So you get to 20/15 for that person.

You think write the prescription for the Spherical and Cyl and angle.

Enjoy,

On May 1, 3:18 pm, douglas <Protoman2...@gmail.com> wrote:

On May 1, 9:21 am, "Mike Tyner" <mty...@mindspring.com> wrote:

"douglas" <Protoman2...@gmail.com> wrote

OK, I know how to check the base refractive error, but how do you
check for astigmatism? I know the retinoscope has a protractor on it,

You don't see protractor markings on modern retinoscopes. The markings are
on the phoropter.

I'm pretty sure you use it just for that, but...how?

Once you get a good reflex, you rotate the streak and sweep it in different
directions across the pupil. Many times it's obvious that the streak
neutralizes in one meridian (say, sweeping side-to-side) yet it's way off
90 degrees away, when you sweep up-and-down. That's astigmatism, and the
trick is to determine the maximum and minimum meridians.

If you did both a static cycloplegic and a dynamic non-cycloplegic

Dynamic retinoscopy isn't useful for determining refractive error. Many
doctors never use dynamic and have forgotten how, because it's only valuable
for determining accommodative response and there are other ways to do that.
A few years ago the "Prio system" was pushed out, basically an LCD nearpoint
card with a hole it it, thru which you could do dynamic retinoscopy. It was
gimmicky ("computer vision") and seldom indicated any unique sort of
treatment, but you were obligated to prescripe Prio lenses from it. It
wasn't that much better than a plastic nearpoint card with the same hole.

Retinoscopy is a dying art. Most retinoscopy used to be done to gain a
starting point for subjective refraction, an estimate. Many doctors now use
autorefractors for that, and consequently never pick up a retinoscope. I
wouldn't either, except sometimes I get ahead of my staff and patients
haven't had the autorefraction done yet.

Cycloplegic retinoscopy may be used to help determine latent hyperopia but
dry (non-cyclo) ret is often a good indicator of LH, revealing results that
are a half- or full diopter more plus than the patient's chosen subjective.

Who makes good retinoscopes? Keeler?

Copeland and Welch-Allyn. Don't know the Keeler.

And what's the diff b/w a
retinoscope and an ophthalmoscope?

BIG diff. A ret just generates a streak of light. The streak can be focused
but it's designed to focus an image of the filament (the streak) to the
retina, such that you can see it moving in the pupil.

Ophthalmoscopes are illuminated too, but more important they have an
observation system that lets you see the details of what you're
illuminating. Direct and indirect o'scopes both produce an image of the
retina. In direct scopes, the image is upright and magnified. Indirect
scopes produce upside-down images that are wider-field (less detailed, not
as magnified.)

Can you use a indirect
ophthalmoscope for retinoscopy?

Not very well, I'm not sure it could be done because retinoscopes all focus
the streak in different planes. The ophthalmoscope generates only parallel
light for illumination.

And has any beginning optometry student accidently held the
retinoscope backwards, and temporarily blinded themselves?

Oh sure. Ophthalmoscopes are much brighter.  But with all hand-held scopes,
it's habit to turn it on, then shine it somewhere like your hand or the
wall, to make sure it's working. Putting it to your eye backwards is dumb
but even dumber is getting up in your patient's face then finding the scope
is dead.

-MT

But I'm sure you could use a direct ophthalmoscope for retinoscopy, if
you lacked a retnoscope, would the procedure be any different for
using an ophthalmoscope for static retinoscopy? Which provides better
bva, cyclo, or non-cyclo?- Hide quoted text -

- Show quoted text -- Hide quoted text -

- Show quoted text -

That's subjectively. And, according to House, patients lie. So, how do
we use retinoscopy to *objectively* determine our patient's refractive
error? I believe its as follows:

Dim the lights, instill cyclopentolate into the patient's eyes, and
have them look at at a target at optical infinity. You stand 67cm away
from the patient, and set the phoropter to -1.50D --please explain to
me exactly why this is done?

You don't set it to -1.50 at the beginning. After you are finished
doing retinoscopy you add -1.50 to the result (if you are standing
67cm from the patient). This is because the patient is looking at the
chart 6 metres away and you are standing 67cm away. That creates a
+1.50 error in the measurement.


To set the effective curvature to zero,
Quote:
perhaps? And I know that -1.50D is the reciprical of 67cm--, and move
the retinoscope across the pupil. If you see with-motion, add plus
lenses; against-motion, add minus lenses. Stop when the pupil fills w/
light, and there's no motion. Rinse and repeat for all meridians.
Rinse and repeat for the other eye. Subtract -1.50D from the readings
to get the prescription.

How would you use the autorefractor to find an inital starting point
for the static retinoscopy?-

An autorefractor is a substitute for retinoscopy. Both provide a
starting point for subjective refraction.
To use an auto refractor you line up the patients pupils with the
cross hairs and push the button.

Judy


Hide quoted text -
Quote:

- Show quoted text -
Dr Judy
Posted: Thu May 01, 2008 6:12 pm
Guest
On May 1, 3:18 pm, douglas <Protoman2...@gmail.com> wrote:
Quote:
MT

But I'm sure you could use a direct ophthalmoscope for retinoscopy, if
you lacked a retnoscope, would the procedure be any different for
using an ophthalmoscope for static retinoscopy? Which provides better
bva, cyclo, or non-cyclo?

It's almost impossible to use a DO for ret; I've tried once or twice
while doing community screenings.

Best Visual Acuity is not related very well to cyclo or non cyclo. It
is a function of the eye, not the measurement system.

Judy
Dr Judy
Posted: Thu May 01, 2008 6:18 pm
Guest
On May 1, 8:39 pm, douglas <Protoman2...@gmail.com> wrote:
Quote:
O
So, a comparison of static retinoscopy and autorefraction is in order.
Is SR better then AR, worse, or equal?

With cyclopleged eyes, they give about the same result. Glasses
prescriptions will usually be based on subjective refraction, not SR
or AR.

Quote:
Oh, and in England, if you're a consultant ophthalmologist and
ophthalmic surgeon, and are named "Douglas K. Sartorius, DM, MCh,
FRCP, FRCS, FRCOphth", are you addressed as "Doctor", or "Mister"?

You'll have to ask someone locally. I seem to remember that Mr
carries more prestige in England, and that professors of medicine are
called Mr, while mere run of the mill MDs are called Dr.

Judy
 
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