assessment of refractive errors
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Refractive error occurs when light is not correctly focused on the retina due to alterations in the shape of the eye, leading to blurred vision. There are several types of refractive error, including myopia, hyperopia, astigmatism, and presbyopia. Doctors use various tests to evaluate refractive error, such as visual acuity tests to check detail vision, retinoscopy to examine the retina's reflection and determine if someone is nearsighted or farsighted, and phoropters to measure refractive error by changing lenses while the patient provides feedback. Corneal topography provides a detailed 3D map of the cornea's shape to help plan for astigmatism surgery.
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-Retinoscopy
- In spherical ametropia
- In astigmatism
- Others: strabismus, amblyopia, pediatric pt.,
cycloplegic refraction
-Static and Dynamic Retinoscopy
-Problems seeing reflex during retinoscopy
-Errors in retinoscopy
Objective of retinoscopy and objective refraction
-To locate the far point of the eye conjugate to the retina
- Myopia or hyperopia
-Bring far point to the infinity by using appropriate lenses
- Determines amount of ametropia by retinoscopy and objective refraction
References:
-Clinical Procedures in Optometry by Eskridge, Amos and Bartlett ,
-Primary Care Optometry by Grosvenor T.,
-Borish’s Clinical Refraction by Benjamin W. J.,
-Theory And Practice Of Optics And Refraction by AK Khurana
-Retinoscopy-Student Manual by ICEE Refractive Error Training Package (2009)
-Clinical Optics and Refraction By Andrew Keirl, Caroline Christie
-Clinical Refraction Guide - A Kumar Bhootra
-Clinical Procedures in Primary Eye Care by David B. Elliott
-Internet
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Presentation Retina.pptx
Direct ophthalmoscopy involves examining the retina using an ophthalmoscope held close to the patient's eye, providing a magnified inverted image. Indirect ophthalmoscopy uses a condensing lens placed near the eye to form an erect magnified image, allowing a wider field of view but is more difficult to perform. The document describes the techniques, advantages, and disadvantages of direct and indirect ophthalmoscopy for examining the interior of the eye.
Presentation Retina.pptx
Direct ophthalmoscopy involves examining the retina using an ophthalmoscope held close to the patient's eye, providing a magnified inverted image. Indirect ophthalmoscopy uses a condensing lens placed near the eye to render it highly myopic, producing an upright magnified image seen by the examiner. Both methods allow assessment of the retina but indirect provides a wider field of view and is better for opaque media or uncooperative patients. The document describes the techniques, advantages, and applications of direct and indirect ophthalmoscopy.
Techniques of refraction is the process of calculation of glass power.
Refractive errors are most common cause of ocular morbidity. It affects all age groups, and ethnic profiles. There is no g nder discrimination. Most common symptoms are blur vission along with pain in eye ,headache and tiredness. Refraction is process of determination of eye and currect it with power glass power or contact lens power. It can subjective or objective.
Behind The Scenes
The document provides an overview of optometry and eye exams. It discusses the history of optometry, what a standard eye exam involves, including case history, refractive tests, binocular and accommodation tests, and ocular health evaluation. It then describes how some optometrists are modernizing exams with new technologies like optical coherence tomography, fundus photography, and automated testing to provide more detailed analysis of the eye.
Objective refraction
This document discusses objective refraction techniques, primarily retinoscopy. It begins by explaining the principles of retinoscopy, including far point concept and how different ametropias affect the far point. It then describes the components and optics of the retinoscope, how it works, and retinoscopy techniques. Key aspects covered include neutralization, prerequisites for retinoscopy, and problems that can occur. Autorefractometry is also briefly discussed. In under 3 sentences:
Retinoscopy is the primary objective refraction technique discussed, which uses a retinoscope to illuminate the retina and observe the movement of the red reflex to determine the refractive error, neutralizing with trial lenses. The document covers the optics
Objective Refraction and Subjective Refraction
This powerpoint slides include subjective refraction and objective refraction (their types along with the principle, purpose and procedure).
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Techniques of refraction is the process of calculation of glass power.
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assessment of refractive errors
- 2. Refractive error is defined as a problem in eye due to which light is not correctly focused on retina that results in blurred image. It mainly happens due to alterations in shape of eye. TYPES: • Myopia. • Hyperopia. • Astigmatism. • Presbyopia.
- 3. VISUAL ACUITY TEST: A visual acuity test is an exam that checks how will you see that details of a letter or symbol from a specific distance. Visual acuity refers to your ability to discern the shapes and details of things you see. It’s just one factor in your overall vision. PIN HOLE TEST: A pin hole occluder is an opaque disc with one or more small holes through it, used by opthalmologist, optometrist, orthoptisis to test visual acuity. The ocular is simple way to focus light, as in a pinhole camera, temporarily removing the effects of refractive errors such as myopia.
- 4. RETINOSCOPY: A retinoscope shines a special light into your eyes that reflects off your retina. Retinoscopy can show whether a person is myopic or hyperopic.
- 5. VISUAL ACUITY TEST: The initial hyperopia diagnosis is by visual acuity test asking the patient to read letters from an snells chart, which is keeping at specific distance RETINOSCOPY: It is useful to shine a light into a patient's eye for an eye optometrist to examine the reflection off the retina. The light is moving back and forth across the pupil. Retinoscope is particularly useful to assess small kids.
- 6. PHOROPTER: It is an instrument used during an eye examination to measure refractive error. The patient is requesting to sit behind the phoropter, and looks through it at an eye chart hanging at a specific distance. The examiner then changes lenses and other settings, by asking the patient for their feedback on which settings give the best vision, based on this the doctor assesses the corrective lens value for the error.
- 7. VISUAL ACUITY TEST: As part of the testing, people will ask to read letters on a distance chart. This test measures visual acuity, which is writing as a fraction such as 20/40. The top number is the standard distance at which testing is performing, twenty feet. The bottom number is the smallest letter- size that can read. A person with 20/40 visual acuity would have to get within 20 feet, for a letter that should see at 40 feet in order to see it clearly. Normal distance visual acuity is 20/20.
- 8. CORNEAL TOPOGRAPHY: This advanced technology provides the most detailed information about your cornea’s shape. The doctor will tell you to look at something specific. Meanwhile, the device collects thousands of tiny measurements. A computer then builds a color map of your cornea from the data. Your doctor will refer to it if he plans surgery for astigmatism.
- 9. DYNAMIC RETINOSCOPY: Objective technique of assessing accommodative function. Suitable from infancy. Non verbal response.
- 10. LAG-UNDER ACCOMMODATION: • Lag of approx 0.75D to 4D stimulus is normal. LEAD-OVER ACCOMMODATION: • Target held at distance X D from subject. • Retinoscope reflex observed while retinoscope is also at X D. • If this movement observed ret is moved away from until neutral achieved at distance A D. • Target remains at X • Target held at 25 cm / 4D from subject. • Retinoscope reflex observed while retinoscope is also at 4D • With movement is observed • Ret moved away from subject • Neutral achieved at 40cm / 2.50D • Target remains at 4D