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Objective refraction – Measurement of the refraction of the eye that is not based on the
patient's judgements, as when using an objective optometer or a retinoscope.
Retinoscope - An instrument for determining objectively the refractive state of the eye. It
consists of a light source, a condensing lens and a mirror. The mirror is either semi-
transparent or has a hole through which the retinoscopist can view the patient's eye along
the retinoscope's beam of light. A patch of light is formed on the patient's retina and by
moving that patch in a given direction and observing the direction in which it appears to
move after refraction by the patient's eye, the retinoscopist can determine whether the
patient's retina is focused in front of, at, or behind the retinoscope's sight hole. If the light
reflected from the patient's fundus (called the retinoscopic reflex or light reflex) and
observed in the patient's pupil through the retinoscope moves in the same direction as the
movement of the mirror (this is referred to as a with movement), the eye is hyperopic. If
the reflex moves in the opposite direction to that of the mirror (against movement), the
eye is myopic. Sometimes it is impossible to see a clear movement one way or the other
but only a bipartite reflex, showing opposite movements in the two sectors of the pupils
(this is called a split reflex or a scissors movement). The refractive error is determined
by placing lenses of various powers in front of the patient's eye until no movement is
seen, i.e. the whole pupil is either illuminated or dark and the image of the patient's retina
is then conjugate with the plane of the retinoscope's sight hole. When this phenomenon
occurs the neutral point has been reached. The neutral point is measured for each
principal meridian of the eye if it is astigmatic. To arrive at the patient's error of refraction
the dioptric power corresponding to the distance between patient and retinoscope (called
the working distance) is subtracted from the total lens power used to obtain
neutralization. The amount of dioptric power subtracted is called the allowance.
spot retinoscope A retinoscope that projects a circular beam of light upon the patient's
retina.
streak retinoscope A retinoscope that projects into the patient's eye an oblong streak,
which can be adjusted in width and rotated in various meridians. It is more efficient than
the spot retinoscope in determining astigmatism.
Parts of retinoscope
- fenestrated mirror
- vergence adjusting lens
- rotating line filament bulb
http://medical-dictionary.thefreedictionary.com/Snell%27s+law
http://medical-dictionary.thefreedictionary.com/retinoscope
Optometric Instrumentation by David B. Henson
Objective Examination
http://www.webmd.com/eye-health/ophthalmoscopy
http://www.eyetec.net/group2/M6S1.htm
http://www.stlukeseye.com/eyeq/Keratometry.asp
Ophthalmoscopy - is a test that allows a health professional to see inside the back of the
eye (called the fundus) and other structures using a magnifying instrument
(ophthalmoscope) and a light source. It is done as part of an eye examination and may be
done as part of a routine physical examination.
The fundus contains a lining of nerve cells (the retina), which detects images seen by the
clear, outer covering of the eye (cornea). The fundus also contains blood vessels and the
optic nerve. See a picture of the structures of the eye
Why It Is Done
Retinoscopy - is an objective measure of the refractive error, meaning the process and
results are not dependent upon patient responses. Retinoscopy is particularly valuable in
situations where communication difficulties inhibit the refractometric process, such as the
examination of an infant, a deaf person, a stroke victim, or someone who doesn't speak
your language.
Keratometry - measures the corneal curvature. It is performed for similar reasons
as topography, but rather than mapping the entire corneal surface, two curves are
measured – the steepest and the flattest. These measurements give the doctor
information about the cornea’s curvature, focusing power, and whether astigmatism
is present.
Some of the uses of keratometry include calculating the intraocular lens power for
cataract surgery, fitting contact lenses and monitoring the corneal curvature after
surgery.
Mhay Valencia June 18, 2009
Refraction Dr. Ferrer
Parts of retinoscope
- light source
- condensing lens
- mirror semi transparent and it has a hole
- fenestrated mirror
- vergence adjusting lens
- rotating line filament bulb
Optometric Instrumentation by David B. Henson
Objective examination
1. slit lamp
2. retinoscope
3. ophthalmoscope