retinoscope
This is a hand-held tool the eye doctor uses to estimate refractive error such as nearsightedness, farsightedness, and astigmatism. This tool is challenging to learn and not as accurate as a true phoropter refraction. However, this is often the only method of determining a glasses prescription in a young child or non-verbal patient who can’t give feedback while reading an eye chart. The retinoscope can also be used to determine a baseline prescription before refining the glasses prescription using the phoropter.
Hi! Doc Tim.
Your video on loose lens retinoscopy has been a great help to me. I do retinoscopy with sleeve down position (I use Keeler retinoscope).
Please let me know when and why sleeve up position is used.
Regards
Optom Anant
Hello, Anant.
In my experience, using the retinoscope in the sleeve up position (concave mirror for all scopes other than Copeland) is helpful in three different scenarios:
1. High myopes where the initial retinoscopic reflex appears to look like “dull neutrality”. Because it’s generally accepted that with motion is easier to appreciate, scoping with the sleeve up converts the motion to with – you then just neutralize in the opposite direction (i.e. adding minus lenses for with motion).
2. Moving the sleeve up can help enhance the reflex to determine the axis of cylindrical error. The when rotating the sleeve, the reflex within the pupil will be the narrowest and brightest when on-axis.
3. For confirming neutrality. Regardless of sleeve position (down = plane mirror effect, up = concave mirror effect) neutrality is neutrality. If you think you’ve reached neutrality, move the sleeve up. If you have effectively neutralized that meridian, the reflex will not change.