The document provides a comprehensive overview of retinoscopy and retinoscopes, detailing their function as tools for measuring refractive errors in the eye. It discusses various types of retinoscopes, the principles of operation, and different retinoscopy techniques, including static and dynamic methods. Additionally, it addresses the use of cycloplegic drugs to enhance the examination process in both children and adults.

1. RETINOSCOPE & RETINOSCOPY
BY – MUSHAHID RAZA

2. RETINOSCOPE – AN OVERVIEW
RETINOSCOPE AS A TOOL –
▪ Retinoscope is an objective refraction instrument used to
determine the refractive error ( myopia , hyperopia,
astigmatism ) , as well as observe the irregularities.
▪An accurate objective measurement of the refractive State
an eye can be made using an instrument called
retinoscope .

3. TYPES OF RETINOSCOPE
REFLECTING MIRROR RETINOSCOPE
▪Plane Mirror Retinoscope
▪ Priestly- Smith’s Mirror ( plane & concave)
SELF ILLUMINATED RETINOSCOPE
▪ Spot Retinoscope
▪ Streak Retinoscope

4. RETINOSCOPE
Plane & priestly retinoscope Spot & streak retinoscope

5. PART OF RETINOSCOPE :-
▪ Head piece
light bulb
Peep hole
Mirror
▪ Neck piece
▪Sleeve – for rotating either down or up
▪Handle

6. REFLECTING MIRROR RETINOSCOPE
▪A perforated Mirror by which the beam is reflected in to
the pt. eye & through a central hole the emergent rays enter
the observer’s eye .
▪ Movement of illuminated retinal areas are produced by
tilting a mirror , either a plane or concave .

7. REFLECTING MIRROR RETINOSCOPE
▪ADVANTAGE
▪ Cheaper than self illuminated
▪ DISADVANTAGE
▪ Require a separate light source
▪ To check the axis & amount of cylinder is difficult
▪ Glare from the source light annoying to the pt.

8. SELF ILLUMINATED RETINOSCOPE
▪ The light source & the mirror
are incorporated in one .
▪ streak retinoscope – light source
is a linear ( uncoiled) filament.

9. STREAK RETINOSCOPE
Two Operating System :-
▪ Projecting system
To illuminate the retina
▪ observation system
To allows the observer to see the retinal reflex to pt.

10. RETINOSCOPY

11. RETINOSCOPY- AN OVERVIEW
▪Retinoscopy is an objective method of measuring the
optical power of the eye
▪ Retinoscope is an objective refraction instrument used to
determine the refractive error . that’s all procedure is
called Retinoscopy .
▪ Also known as shadow test , skiascopy , pupilloscopy ,
koreoscopy .

12. HISTORY
▪Sir William Bowman in 1859 , reported the movement
of light and shadow effect.
▪ Use since 1873 reflecting mirror spot retinoscope
externally illuminated.
▪ modern streak design that bought significant change in
1927 by jack c Copeland.

13. PRINCIPLE
Retinoscope works on focault’s principle.
Light that comes to focus behind the Retinoscope acts as
a Fulcrum for the Retinoscopy reflex so that beam and
reflex move in the same direction.
The basic principles of Retinoscopy :-
It is an objective method of finding out the error of
refraction by utilizing the technique of neutralization.

14. OPTICS
▪ Illumination stage
▪ Reflex stage
▪ Projection stage

15. Illumination stage:-
light is directed into
the patient’s eye to
illuminate the retina .

16. Reflex stage:-
An image of illuminated retina
is formed at the Pateint’s Far-point .

17. Projection stage:-
The image at the far point is located by moving the
illumination across the fundus and noting the behaviour of the
luminous reflex seen by the observer in the patient’s pupil.

18. Emmetropic eye

19. Hypermetropic eye :-

20. Myopic of less than 1 D

21. Myopic of 1 D

22. Myopic more than 1D

23. PREREQUISITES FOR RETINOSCOPE
▪A dark room
▪A trial set
▪A trial frame
▪Phoropter / Refractor
▪Distance vision chart
▪Near vision chart
▪Retinoscope

24. WORKING DISTANCE
▪ The Distance between patient’s eye and the
Retinoscope, while perform the Retinoscopy is
called working distance.
▪The length of average person’s arm is – 66cm
▪Normally 66cm ( +1.50 D ) or 50 cm ( +2.00 D )

25. TECHNIQUE
The main retinoscopy techniques are :-
▪ Static Retinoscopy
▪ Dynamic Retinoscopy
▪ Wet Retinoscopy
▪ Dry Retinoscopy

26. Static retinoscopy
Accommodation fully relaxed
Working distance lens added or subtracted to objective finding.
Fixates letter at 6 m .
Dynamic Retinoscopy
Accommodation is Active
No influence of WD
Accommodative lag can be determined.
Fixate at the bulb of retinoscope

27. Wet Retinoscopy
Done with cycloplegic drugs
Done in children & adult
Dry Retinoscopy
Done without cycloplegic drugs
Done in elderly patients.

28. PROCEDURE
▪ The examiner is sit from the distance of patients is either
1m, 66 cm as per comfort to examiner.
▪Light is thrown onto the patient’s eye via help of
retinoscope.
▪Tell to patients for see far point for relax accomodation.
▪However cycloplegic has been used the patients can look
directly in the eye & refraction assessed.
▪ Moov light horizontal & vertical and watch red reflex..

29. CHARACTERISTICS OF RED REFLEX
▪ Speed & brilliance
Low degree error show rapidly movement of red reflex
High degree error show slowly movements of red reflex.
▪ Width of retinoscope
Narrow – A high degree ametropia.
Wide – In case of low degree ametropia

30. NEUTRALIZATION
▪ When we have got red reflex with movement use convex (+D)
lens for neutralization.
▪ When we have got red reflex against movement use concave (-
D) lens for neutralization.
▪ We got no movement without using any lens on that condition
pt. eye is myopic equal to working distance.
▪ We have neutral the movement of both meridian ( horizontal &
vertical) .

32. USE OF CYCLOPLEGICS IN RETINOSCOPY
▪ Atropine
1. It is use in children less than 5 years.
2. Effect lasts for 10-20 days
3. Use 1% in the form of ointment
4. It is use TDS in for three days before performing
Retinoscopy
5. Reduce -1.00D into gross Retinoscopy.

33. ▪Homatropine
1. It’s use 2 % in the form of drop.
2. One drop is installing in every 10-15 min for 3 times.
3. Retinoscopy perform after 1-2 h.
4. Reduce-0.50D into gross retinoscopy .
5. Its use in that pt.having age 5-25 years.

34. ▪Cyclopentolate
1. It’s short acting cycloplegic.
2. Effect lasts for 6-12 h.
3. Use 1% in the form of drop
4. Retinoscopy perform after 60-90 min of installing the
drugs.
5. Reduce -0.75D into gross retinoscopy.