Beruflich Dokumente
Kultur Dokumente
Presentor:Dr.Pushkar
Dhir
Moderator
:Dr. Jyoti
Puri
O
P
D
E
X
P
E
R
I
E
N
C
OBJECTIVE
REFRACTIO
N
SUBJECTIVE
JCC
RETINOSCO
PY
AUTO.R
EF
DUOCHROM
E
TEST
KERATOMET
RY
ASTIGMAT
IC
FAN
ABERROMET
RY
BINOCULAR
BALANCING
Introduced quantitative
refraction test.
Made possible to
measure
exact amount of
refractive
error using lenses.
Termed retinoscopie.
OPTICS OF RETINOSCOPY
ILLUMINATION
Pupillary shadow
observed by the
examinar by aligning
his/her eyes
D GOOD
OLD DAYZZ
DR.SHASHI
Advantages of
streak Undilated pupil
More accurate
Astigmatism
VIDEO
(on u tube)
TYPES OF RETINOSCOPES
Lister Reflecting
Retinoscope
Priestley Smith
Reflecting
Retinoscope
Self Illuminating
Retinoscope
Spot Retinoscope
Streak
retinoscope
Time to charge
ur laptop
~ 50
cms
WHAT TO ASSES?
Size,
Small
Speed
(Narrow)
& Brilliance
DEMONSTARTION
http://www.eyedocs.co.uk/ophthalmology-learning/articles
/optics-and-refraction/1508-retinoscopy-simulator
Neutralization of red
reflex :
in Streak
Retinoscope
a. Neutralization
- the band of red reflex moves
with or against the
movement of the band of light
from retinoscope
- in simple spherical errors, at
neutralization the band shaped
reflex disappears and pupil
appears completely illuminated.
Finding the
cylindrical axis
i) - break in alignment is observed
when the streak is not parallel
to one of the principal
meridia(horizontal and
vertical).
- the axis, can be determined
by rotating the streak until the
break disappears.
WET
RETIN
scPY
2%
1%
<5 yrs
1%
0.5%,1
%
MYDRIATIC
>CYCLOPLE
GIC
5-8 yrs
8-20 yrs
1DROP X
10 MIN X6
TIMES
1 DROP X
15 MIN X
6 TIMEES
1DROP
X15MIN X3
TIMES
-do-
60-90MINS
80-90
MINS
20-40 MINS
-do-
AFTER 90
MIN OF 1ST
DROP
AFTER 90
MIN OF
1ST DROP
AFTER 40
MINS
-do-
1020DAYS
48-72 HRS
6-18 HRS
4-6 HRS
-do-
PMT-
AFTR 3
WKS
AFTER 3
DAYS
AFTER 3
DAYS
8
HOURS/NEX
T DAY
-do-
CORRE
1D
0.5 D
0.75 D
XXX
XXX
DOSEPEAK
EFFECT
RETINO
TIMEEFFECT
DURTN
TDS X
3DAYS
2/3
DAYS
4TH DAY
-do-
NEED DR
LIKH KAR
BHEJ DETA
HUN
x
e
fl
Re hi
a
n
i
H
h
k
i
d
a
h
a
r
Beta
Kitne
Der
Lagegi!!!
PROBLEMS IN
RETINOSCOPY
PROBLEMS
CHANGING
RETINOSCOPIC
FINDINGS
SCISSOR
SHADOWS
POSITIVE
CAUSE
SOULTION
1.SMALL PUPIL
2.HAZY MEDIA
3.APHAKIA/HIGH
MYOPIA
1.TRY MYDRIATICS
+CYCLOPLEGICS
COMBINATION
2.REDUCE WORKING
DISTANCE + BRIGHT
SOURCE OF LIGHT
3.TRY LENSES OF HIGH
POWER+/- 7D, IF STILL NOT
,GO HIGHER.
ACCOMODATION USED
BY PATIENTS
Shack-Hartmann (SH)
aberrometer measures wavefront
objectivel
Subjective
Refraction
Power of spherical and cylindrical
refraction refined based on patient
response
General rule: Maximum Plus for
Maximum Visual Acuity.
Duochrome test:
Based on chromatic aberration; red is
focused more hyperopically than
green; yellow is focused on retina
Letters on both red and green
background should appear equally
clear
SUBJECTIVE REFRACTION
1. Subjective verification of refraction
. By Trial & Error technqiue
. Astigmatic Dial technique
2. Subjective refinement of refraction
. JCC
. Astigmatic Fan test
To determine end-point of
magnitude, place JCC with
axis parallel to the axis of the
cylindrical prescription.
REFERENCES
http://www.slideshare.net/meikocat/Refraction
http://www.eyedocs.co.uk/ophthalmology-learning/articles/o
ptics-and-refraction/1508-retinoscopy-simulator
http://retinoscopy.blogspot.in/
http://books.google.co.in/books?
id=6I6JeDWonhQC&pg=PA2&lpg=PA2&dq=RETINOSCOPY+
WITH+PLANE+MIRROR&source=bl&ots=owV9UpZtAO&sig
=ku6SiYptvYp_qlEbBi-g2YW7izM&hl=en&sa=X&ei=mypU8K5MdeUuASBi4HIDw&ved=0CEkQ6AEwCg#v=onep
age&q=RETINOSCOPY%20WITH%20PLANE
%20MIRROR&f=false
http://www.college-optometrists.org/en/college/museyeum/o
nline_exhibitions/optical_instruments/retinoscopes.cfm
GOD