Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Block 3 Clinical Skills > Retinoscopy > Flashcards

Retinoscopy Flashcards

1
Q

What is Objective Refraction?

A

Determining refractive status without input by the patient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 types of Objective Refraction?

A
  • Retinoscopy: Requires patient cooperation and judgement of clinician. Retinoscopy is a form of objective refraction.
  • Autorefraction Does not require evaluations of patient or clinician (does require patient cooperation and an operator)
  • Photorefraction Photo or video-graph of pupils interpreted by trained clinician or instrument
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Retinoscopy
Relies on the following:

The eye is a __________: focusable light can only enter or exit through the pupil.

A

closed optical system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Retinoscopy
Relies on the following:

The image detection during subjective refraction effectively occurs at ______ (junction of inner/outer segments of photoreceptors).

A

outer limiting membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Retinoscopy
Relies on the following:

Reflection of light from inside the eye produces a ______.

A

“fundus reflex”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the outer limiting membrane?

A

It is the junction of inner/outer segments of photoreceptors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Retinoscopy
Relies on the following:

The __________ is also at the outer limiting membrane. Thus, the effective surfaces for reflection and subjective refraction are ________.

A

effective ocular reflecting surface for visible light

coincident

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why do we do retinoscopy?

A
  • Serves as a starting point for the subjective refraction
  • Independent objective confirmation of subjective results
  • May be heavily relied on to determine spec Rx for patients unable or unwilling to give reliable subjective responses (examples?)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you set up for the retinoscopy test?

A

Retinoscopy Technique (set-up)
• Phoropter comfortably in front of patient
• Dark room
• Large fixation target at distance
• Examiner positioned arms length away, slightly temporal to eye being scoped:
• one hand manipulates scope
• other hand changes lenses within phoropter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q 
Retinoscopy Technique (procedure) 
1) Determine if spherical or astigmatic (is reflex same in all meridians?) What does that mean?
A
  • if same in all meridians (spherical)

* if different (astigmatic), determine the two principal meridians

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Retinoscopy Technique (procedure)
2) Neutralize using ____ lenses for “with” motion and ___ for “against” motion (goal is no motion)
• neutralize any meridian if spherical
• neutralize both principal meridians separately if astigmatic (leave “against” in second meridian scoped for minus cylinder).

A

plus lenses for “with” motion

minus for “against” motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q 
Retinoscopy Technique (procedure) 
3) Complete same procedure in both eyes

4) Add _____ power to compensate for working distance

A

minus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tell me about the retinoscopy technique (working distance)?

A

To compensate for working distance (WD): Add minus sphere = reciprocal of WD

Examples: for 50 cm WD, 1/.5 = 2 (add -2.00 D sphere to both eyes to compensate for WD)

For 67 cm WD, 1/.67 = 1.5 (add -1.50 D sphere to both eyes to compensate for WD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Summary of Retinoscopy Technique
1) Determine if ________

2) Neutralize using ____ lenses for “with” motion and ____ for “against” motion (goal is no motion)
3) Complete same procedure in both eyes
4) Add minus power to compensate for working distance

A
  1. spherical or astigmatic (is reflex same in all meridians?)
    • if same in all meridians (spherical)
    • if different (astigmatic), determine the two principal meridians
  2. plus
    minus
    • in any meridian if spherical
    • in both principal meridians separately if astigmatic (leave “against” in second meridian scoped for minus cylinder).
  3. minus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Optical Principles

The _____ of retinoscopy (neutrality) occurs when the far point matches with the aperture of the retinoscope.

A

Endpoint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Optical Principles

How is the endpoint obtained?

A

1) moving far point to retinoscope (w/ lenses) = static retinoscopy
2) moving retinoscope to far point = dynamic retinoscopy

17
Q

Optical Principles

What is static retinoscopy?

A

moving far point to retinoscope (w/ lenses) = static retinoscopy

18
Q

Optical Principles

What is dynamic retinoscopy?

A

moving retinoscope to far point = dynamic retinoscopy

19
Q

Optical Principles
The preferred working distance may vary by practitioner (≈ arms length). You must correct for specific working distance used (add reciprocal of working distance in meters to _____).

A

endpoint

20
Q 
Fundus Reflex (general principles)
(We use these as clues to do retinoscopy.)
• \_\_\_\_\_ is red-orange in color, because it is reflected from retina
A

Reflex

21
Q 
Fundus Reflex (general principles)
(We use these as clues to do retinoscopy.)
• Procedure to obtain endpoint similar to\_\_\_\_\_\_.
A

“hand neutralization.”

22
Q 
Fundus Reflex (general principles)
(We use these as clues to do retinoscopy.)
• Neutrality is a range of uncertainty between perceptible “with” and “against” motions \_\_\_\_\_\_\_.
A

(bracket midway).

23
Q 
Fundus Reflex (general principles)
(We use these as clues to do retinoscopy.)
• Six aspects of reflex indicate refractive status:
A

1) brightness
2) direction of motion
3) speed of motion
4) width
5) definition
6) alignment

24
Q 
Fundus Reflex (details)
• Gets \_\_\_\_\_\_ as you approach neutrality (\_\_\_\_\_ when not close or have media opacities, etc.)
A

brighter

dimmer

25
Q

Fundus Reflex (details)

• Motion ____ as you approach neutrality (endpoint = no motion). Remember, motion in same direction requires plus lenses to neutralize and motion in opposite direction requires minus lenses to neutralize.

A

decreases

26
Q

Fundus Reflex (details)

• Speed _____ as you approach neutrality (yes, that’s correct!)

A

increases

It. approaches infinity.

27
Q 
Fundus Reflex (details)
• Width \_\_\_\_\_\_ as you approach neutrality
A

narrows

28
Q 
Fundus Reflex (details)
• Definition \_\_\_\_\_ as you approach neutrality. It becomes more aligned with streak as you approach neutrality.
A

increases

It’s easier to see the edges and it is clearer.

29
Q

Fundus Reflex (abnormal)
• Sometimes the reflex looks funny or “confused.”
• Some portions of reflex may behave different than others
• An example is “scissors” motion (peripheral portions of reflex differ from central portion).

What do we do in these cases?

A

Pay attention to the reflex in the CENTER of the pupil.

Pay attention to the brackets.

30
Q

Control of Accommodation
• During ________, accommodation should be relaxed.

This is achieved by “fogging” both eyes prior to determining endpoint.

Question: Doesn’t that blur the target? What about second eye (once first eye neutralized)?

A

standard “static” retinoscopy

Answer:
Adding too much plus, the eye can’t accommodate.

31
Q

Control of Accommodation

Make sure patient fixates distant target, not retinoscope light. How can you tell?

A

Reflex and pupil changes

32
Q

What are potential problems that could interfere with retinoscopy?

A
  • Examiner too far to the side (excess obliquity of observation)
  • Reflections (from cornea and/or lenses)
  • Accommodation
33
Q

What are we hoping to get from doing retinoscopy?
Retinoscopy Results

Should be repeatable within _____ D in each principal meridian, and ____ axis of cylinder.

A

+/- 0.50

+/- 5°

34
Q

What are we hoping to get from doing retinoscopy?
Retinoscopy Results

Retinoscopy ≠ subjective refraction

Retinoscopy is objective. The findings require modification during subjective refraction.

Retinoscopy findings and subjective refraction are highly _____.

A

correlated

35
Q

What are we hoping to get from doing retinoscopy?
Retinoscopy Results
There is consistent _____ bias of retinoscopy in young patients.

A

hyperopic

Block 3 Clinical Skills (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions