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principles
1878, M. Mengin
. . . .
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Observation system
Main purpose:
To allows the observer to see the retinal reflex of the
patient.
Streak Retinoscope
Advantages of Streak Retinoscope
over Spot Retinoscope
Far point
• The far point of eye is defined as the point in space that is
conjugate with the fovea when accomodation is relaxed
Far point contd…
Optical Principle
• Retinoscope works on Focault's principle
• Retinoscopy is based on the fact that when light is
reflected from a mirror into the eye, the direction in which
the light will travel across the pupil will depend upon the
refractive state of the eye
Optical Principle
• The illumination stage
• The reflex stage
• The projection stage
Illumination Stage
Light is directed into the patient's eye to
illuminate the retina
Reflex Stage
An image of the
illuminated retina is
formed at the
patient's far-point
Exercises in Refractometry.
Thorofare, NJ: SLACK Incorporated; 1990
Projection Stage
The image at the far-point is located by
moving the illumination across the fundus
and noting the behaviour of the luminous
reflex seen by the observer in the patient's
pupil
Emmetropic eye
Hypermetropic eye
Myopia of less than 1D
Myopia of 1D
Myopia of more than 1D
Projection Stage
Working Distance
• The distance from the retinoscope to the patient’s eye
• D=1÷F
• The length of the average person’s arm is 66 cm.
The power of a lens that focuses parallel light rays
at 66 cm is +1.50 D
Should I use a “working lens” to
compensate for the working distance?
Advantages-
Instant identification of myope or hyperope.
Working lens might help relax accommodation.
No need for mental arithmetic to allow for working
distance
Disadvantages-
Too much blur does not necessarily relax
accommodation.
Working lens adds extra reflections to the view.
Formation of the Secondary Fundus
Source or "Fundus Reflex"
+3.00D
+ 2.00Ds / + 1.00 Dc X 90 0
With a sphere and cylinder
First neutralize one axis with an appropriate spherical
lens.
Neutralize the other axis with a cylindrical lens at the
appropriate orientation
The spherical cylindrical gross retinoscopy may be
read directly from the trial lens apparatus
Enhancement
This technique is to approximately estimate the amount
of refractive error with minimal use of trial lenses.
If the reflex inside pupil gets more thinner by changing
the sleeve width,it suggests a significant refractive error
Thinnest retinal reflex is called Enhanced band
Enhancement
A rough estimation of the refractive error is
possible,based on the sleeve position
End point of retinoscopy
Types of retinoscopy
• Static Retinoscopy: the patient is looking at a distant
object, with accommodation relaxed.
• Dynamic retinoscopy: the patient is looking at a
near object, with accommodation active.
• Near retinoscopy: the patient is looking at a near
object, with accomodation relaxed
Dynamic Retinoscopy Techniques
MEM Retinoscopy
Help to calculate patients lag or lead
of accomodation
Lettered targets are applied to the head of a
retinoscope
Fixation target is placed at harmon distance/50 cm
with patients corrected refractive error
the refractive power of the trial lens that brings
neutrality is the accommodative lag/lead
Nott’s method