This document discusses various aspects of clinical refraction including objective refraction using retinoscopy, subjective refraction, finding the cylinder axis using techniques like break, width, intensity and skew, refining the sphere power using endpoint tests, and achieving binocular balance through fogging, prism dissociation, and cycloplegia.

1. Parallel Beam Convergence Divergence

4. Fovea
Light rays

20. CLINICAL REFRACTION
• 1 OBJECTIVE REFRACTION ( RETINOSCOPY )
• 2 SUBJECTIVE REFRACTION

21. RETINOSCOPY
• POSITIONING AND ALIGNMENT
• FIXATION AND FOGGING
• RETINAL REFLEX
• CORRECTING LENS
• NEUTRALITY

23. Speed brilliance width

24. FINDING CYLINDER AXIS
1. BREAK
2. WIDTH
3. INTENSITY
4. SKEW

28. • Cross cylinders

29. REFINING OF SPHERE
• Endpoint strongest plus and weakest minus
• Duochrome test
• RAM-GAP ( red add minus green add plus)

30. BINOCULAR BALANCE
1. FOGGING
2. PRISM DISSOCIATION
3. CYCLOPLEGIA