How does one perform static retinoscopy using a direct retinoscope? Do
dilate the eyes w/ atropine, darken the lights, take the retinoscope,
stand 20' away, and try to neutralize the cat's-eye reflex w/ the
phoropter?

Which is better, direct or indirect, sreak or spot?

Thanks!

You'll, of course, have to forgive Otis.

He's ... well ... he's stupid.

On Apr 29, 8:01 pm, Neil Brooks <neil0...@yahoo.com> wrote:

You'll, of course, have to forgive Otis.

He's ... well ... he's stupid.

And, the correct answer I'm looking for is...?

How does one perform static retinoscopy using a direct retinoscope?

Do
dilate the eyes w/ atropine, darken the lights, take the retinoscope,
stand 20' away, and try to neutralize the cat's-eye reflex w/ the
phoropter?

Which is better, direct or indirect, sreak or spot?

Dear Friend,

A Phoropter is used to measure the refractive status of the eye.

It is basically and "enhanced" trial-lens kit.

If you are nearsighed, say 20/70, then then a minus lens (in the
Phoropter) is
used to clear the Snellen. Typically, about -1.25 diopters is used to
clear the 20/20 line. If you are being prescribed for "Best Visual
Acuity",
then you will get a much stronger minus lens for your prescription.

That is one means to determine your refractive STATE.

A retinascope and induced paralysis creates a profoundly
different measurement. (By some people this is a so-called
"objective" measurement.)

Enjoy,

On Apr 29, 6:52 pm, douglas <Protoman2...@gmail.com> wrote:

How does one perform static retinoscopy using a direct retinoscope? Do
dilate the eyes w/ atropine, darken the lights, take the retinoscope,
stand 20' away, and try to neutralize the cat's-eye reflex w/ the
phoropter?

Which is better, direct or indirect, sreak or spot?

Thanks!

How does one perform static retinoscopy using a direct retinoscope? Do
dilate the eyes w/ atropine, darken the lights, take the retinoscope,
stand 20' away, and try to neutralize the cat's-eye reflex w/ the
phoropter?

Which is better, direct or indirect, sreak or spot?

On Apr 29, 9:29 pm, otisbr...@embarqmail.com wrote:
Dear Friend,

That is one means to determine your refractive STATE.

Here goes Otis with his misinformation again!

On Apr 29, 6:52 pm, douglas <Protoman2...@gmail.com> wrote:

How does one perform static retinoscopy using a direct retinoscope? Do
dilate the eyes w/ atropine, darken the lights, take the retinoscope,
stand 20' away, and try to neutralize the cat's-eye reflex w/ the
phoropter?

It would be impossible to do at 20',  the reflex would be far too dim
and you would be unable to reach either the phoropter or trial lenses
in a trial case.

Can be done with or without cycloplegia.  Usually done at 50cm or
67cm, depending on the length of the examiner's arms.  Either loose
lenses in trial frame, lens bar or lenses in phoropter can be used.
An allowance is made for the working distance.



Which is better, direct or indirect, sreak or spot?

There is no indirect retinoscope, streak is preferred as it is much
easier to detect astigmatism with it.

Judy

On Apr 30, 6:10 am, Dr Judy <mpac...@rogers.com> wrote:





On Apr 29, 6:52 pm, douglas <Protoman2...@gmail.com> wrote:

How does one perform static retinoscopy using a direct retinoscope? Do
dilate the eyes w/ atropine, darken the lights, take the retinoscope,
stand 20' away, and try to neutralize the cat's-eye reflex w/ the
phoropter?

It would be impossible to do at 20',  the reflex would be far too dim
and you would be unable to reach either the phoropter or trial lenses
in a trial case.

Can be done with or without cycloplegia.  Usually done at 50cm or
67cm, depending on the length of the examiner's arms.  Either loose
lenses in trial frame, lens bar or lenses in phoropter can be used.
An allowance is made for the working distance.

Which is better, direct or indirect, sreak or spot?

There is no indirect retinoscope, streak is preferred as it is much
easier to detect astigmatism with it.

Judy

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

If you did both a static cycloplegic and a dynamic non-cycloplegic
retinoscopy on your patient, which reading would you use, or would you
somehow combine the readings? Coul you give me an example?

Who makes good retinoscopes? Keeler? And what's the diff b/w a
retinoscope and an ophthalmoscope? Can you use a indirect
ophthalmoscope for retinoscopy?

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

Thanks!- Hide quoted text -

- Show quoted text -

"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

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,

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

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

Who makes good retinoscopes? Keeler?

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

Can you use a indirect
ophthalmoscope for retinoscopy?

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

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 -

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 -