16/07/2015

Although autorefractors are easily accessible, retinoscopy

Streak Retinoscopy remains an important skill and

tool for the ophthalmologist to objectively determine the
spherocylindrical refractive error
A retinoscope can also help the examiner detect optical
aberrations, irregularities, and opacities, even through small
pupils.

Useful for
Fixation and Fogging
Infants
Children Retinoscopy should be performed with the patient's
and adults unable to cooperate accommodation relaxed. The patient should fixate at a
distance on a nonaccommodative target.
For example, the target may be a dim light at the end of the
room or a large Snellen letter (20/ 200 or 20/ 400 size) .
Children typically require pharmacologic cycloplegia.

The Retinal Reflex

emmetropic, the light rays emerging from the patient's pupil
are parallel to one another
if the eye is myopic, the rays are convergent (Fig 3-4); and
if the eye is hyperopic, the rays are divergent.

1
 16/07/2015

Characteristics of the reflex Working distance and finding

The moving retinoscopic reflex has 3 neutralization
main characteristics common working distance is 67 cm, many phoropters have a
1.50 D (1.00/0.67 m)
1. Speed.The reflex seen in the pupil moves slowest when the far point is distant
from Pupil fills the examiner (peephole of the retinoscope). As the far point is moved
toward the peephole, the speed of the reflex increases. In other words, large refractive
errors have a slow-moving reflex, whereas small errors have a fast reflex. Finding Neutrality
In against movement, the far point is between the examiner
2. Brilliance.The reflex is dull when the far point is distant from the examiner; and the patient minus lenses put in front of patient
it becomes brighter as neutrality is approached. Against reflexes are usually
dimmer than with reflexes. with movement, a plus lens is placed in front of the
patient's eye
3. Width. When the far point is distant from the examiner, the streak is narrow. As
the far point is moved closer to the examiner, the streak broadens and, at neutral-
ity, fills the entire pupil. This situation applies only to with motion reflexes.

Finding the cylinder axis

Retinoscopy of Regular Astigmatism
light is refracted differently by the 2 principal astigmatic
meridians
Moving the retinoscope from side to side (with the streak
oriented at 90) measures the optical power in the 180
meridian with 90 axis.
1. Break. A break is observed when the streak is not oriented
parallel to 1 of the principal meridians. The reflex streak in the pupil is
not aligned with the streak projected on the iris and surface of the eye,
and the line appears broken (Fig 3-10).
2. Width. The width of the reflex in the pupil varies as it is rotated
around the correct axis.The reflex appears narrowest when the
streak, or intercept, aligns with the axis (Fig 3-11).
3. Intensity.The intensity of the line is brighter when the streak is
on the correct axis.
4. Skew. Skew (oblique motion of the streak reflex) may be used to
refine the axis in small cylinders..The reflex and streak move
in the same direction when the streak is aligned with 1 of the
principal meridians.

Finding the cylinder power

With 2 spheres. Neutralize 1 axis with a spherical lens; then
neutralize the axis 90 away.

With a sphere and cylinder. Neutralize 1 axis with a spherical

lens. To enable the Use of with reflexes, neutralize the less
plus axis first. Then, with this spherical lens in place,
neutralize the axis 90 away by adding a plus cylindrical lens
spherocylindrical gross retinoscopy is read directly from
the trial lens apparatus

2
 16/07/2015

Working distance 67cm

Contoh soal

Working distance 67 cm

S-2.50C-2.00x0

Working distance 67 cm
Working distance 67 cm

3
 16/07/2015

S-2.50C-2.00x90 S+0.50C-5.00x90

4
 16/07/2015

Although autorefractors are easily accessible, retinoscopy

Streak Retinoscopy remains an important skill and

tool for the ophthalmologist to objectively determine the
spherocylindrical refractive error
A retinoscope can also help the examiner detect optical
aberrations, irregularities, and opacities, even through small
pupils.

Useful for
Fixation and Fogging
Infants
Children Retinoscopy should be performed with the patient's
and adults unable to cooperate accommodation relaxed. The patient should fixate at a
distance on a nonaccommodative target.
For example, the target may be a dim light at the end of the
room or a large Snellen letter (20/ 200 or 20/ 400 size) .
Children typically require pharmacologic cycloplegia.

The Retinal Reflex

emmetropic, the light rays emerging from the patient's pupil
are parallel to one another
if the eye is myopic, the rays are convergent (Fig 3-4); and
if the eye is hyperopic, the rays are divergent.

1
 16/07/2015

Characteristics of the reflex Working distance and finding

The moving retinoscopic reflex has 3 neutralization
main characteristics common working distance is 67 cm, many phoropters have a
1.50 D (1.00/0.67 m)
1. Speed.The reflex seen in the pupil moves slowest when the far point is distant
from Pupil fills the examiner (peephole of the retinoscope). As the far point is moved
toward the peephole, the speed of the reflex increases. In other words, large refractive
errors have a slow-moving reflex, whereas small errors have a fast reflex. Finding Neutrality
In against movement, the far point is between the examiner
2. Brilliance.The reflex is dull when the far point is distant from the examiner; and the patient minus lenses put in front of patient
it becomes brighter as neutrality is approached. Against reflexes are usually
dimmer than with reflexes. with movement, a plus lens is placed in front of the
patient's eye
3. Width. When the far point is distant from the examiner, the streak is narrow. As
the far point is moved closer to the examiner, the streak broadens and, at neutral-
ity, fills the entire pupil. This situation applies only to with motion reflexes.

Finding the cylinder axis

Retinoscopy of Regular Astigmatism
light is refracted differently by the 2 principal astigmatic
meridians
Moving the retinoscope from side to side (with the streak
oriented at 90) measures the optical power in the 180
meridian with 90 axis.
1. Break. A break is observed when the streak is not oriented
parallel to 1 of the principal meridians. The reflex streak in the pupil is
not aligned with the streak projected on the iris and surface of the eye,
and the line appears broken (Fig 3-10).
2. Width. The width of the reflex in the pupil varies as it is rotated
around the correct axis.The reflex appears narrowest when the
streak, or intercept, aligns with the axis (Fig 3-11).
3. Intensity.The intensity of the line is brighter when the streak is
on the correct axis.
4. Skew. Skew (oblique motion of the streak reflex) may be used to
refine the axis in small cylinders..The reflex and streak move
in the same direction when the streak is aligned with 1 of the
principal meridians.

Finding the cylinder power

With 2 spheres. Neutralize 1 axis with a spherical lens; then
neutralize the axis 90 away.

With a sphere and cylinder. Neutralize 1 axis with a spherical

lens. To enable the Use of with reflexes, neutralize the less
plus axis first. Then, with this spherical lens in place,
neutralize the axis 90 away by adding a plus cylindrical lens
spherocylindrical gross retinoscopy is read directly from
the trial lens apparatus

2
 16/07/2015

Working distance 67cm

Contoh soal

Working distance 67 cm

S-2.50C-2.00x0

Working distance 67 cm
Working distance 67 cm

3
 16/07/2015

S-2.50C-2.00x90 S+0.50C-5.00x90

4
 16/07/2015

Although autorefractors are easily accessible, retinoscopy

Streak Retinoscopy remains an important skill and

tool for the ophthalmologist to objectively determine the
spherocylindrical refractive error
A retinoscope can also help the examiner detect optical
aberrations, irregularities, and opacities, even through small
pupils.

Useful for
Fixation and Fogging
Infants
Children Retinoscopy should be performed with the patient's
and adults unable to cooperate accommodation relaxed. The patient should fixate at a
distance on a nonaccommodative target.
For example, the target may be a dim light at the end of the
room or a large Snellen letter (20/ 200 or 20/ 400 size) .
Children typically require pharmacologic cycloplegia.

The Retinal Reflex

emmetropic, the light rays emerging from the patient's pupil
are parallel to one another
if the eye is myopic, the rays are convergent (Fig 3-4); and
if the eye is hyperopic, the rays are divergent.

1
 16/07/2015

Characteristics of the reflex Working distance and finding

The moving retinoscopic reflex has 3 neutralization
main characteristics common working distance is 67 cm, many phoropters have a
1.50 D (1.00/0.67 m)
1. Speed.The reflex seen in the pupil moves slowest when the far point is distant
from Pupil fills the examiner (peephole of the retinoscope). As the far point is moved
toward the peephole, the speed of the reflex increases. In other words, large refractive
errors have a slow-moving reflex, whereas small errors have a fast reflex. Finding Neutrality
In against movement, the far point is between the examiner
2. Brilliance.The reflex is dull when the far point is distant from the examiner; and the patient minus lenses put in front of patient
it becomes brighter as neutrality is approached. Against reflexes are usually
dimmer than with reflexes. with movement, a plus lens is placed in front of the
patient's eye
3. Width. When the far point is distant from the examiner, the streak is narrow. As
the far point is moved closer to the examiner, the streak broadens and, at neutral-
ity, fills the entire pupil. This situation applies only to with motion reflexes.

Finding the cylinder axis

Retinoscopy of Regular Astigmatism
light is refracted differently by the 2 principal astigmatic
meridians
Moving the retinoscope from side to side (with the streak
oriented at 90) measures the optical power in the 180
meridian with 90 axis.
1. Break. A break is observed when the streak is not oriented
parallel to 1 of the principal meridians. The reflex streak in the pupil is
not aligned with the streak projected on the iris and surface of the eye,
and the line appears broken (Fig 3-10).
2. Width. The width of the reflex in the pupil varies as it is rotated
around the correct axis.The reflex appears narrowest when the
streak, or intercept, aligns with the axis (Fig 3-11).
3. Intensity.The intensity of the line is brighter when the streak is
on the correct axis.
4. Skew. Skew (oblique motion of the streak reflex) may be used to
refine the axis in small cylinders..The reflex and streak move
in the same direction when the streak is aligned with 1 of the
principal meridians.

Finding the cylinder power

With 2 spheres. Neutralize 1 axis with a spherical lens; then
neutralize the axis 90 away.

With a sphere and cylinder. Neutralize 1 axis with a spherical

lens. To enable the Use of with reflexes, neutralize the less
plus axis first. Then, with this spherical lens in place,
neutralize the axis 90 away by adding a plus cylindrical lens
spherocylindrical gross retinoscopy is read directly from
the trial lens apparatus

2
 16/07/2015

Working distance 67cm

Contoh soal

Working distance 67 cm

S-2.50C-2.00x0

Working distance 67 cm
Working distance 67 cm

3
 16/07/2015

S-2.50C-2.00x90 S+0.50C-5.00x90