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At least 19 recordsLinked to original sources
PubMed1985

Comparison of refraction obtained by "near retinoscopy" and retinoscopy under cycloplegia.

This study compared refractive error obtained by the "near retinoscopy" method as described by Mohindra and static retinoscopy under cycloplegic conditions. Twenty-two patients between the age of 3.6 and 10.0 years were objectively refracted. The examiner performed a near retinoscopy on each patient. Immediately after this procedure, 2 drops of 1% Cyclogyl (cyclopentolate) were administered to each eye, 5 min apart. Cycloplegic retinoscopy was performed 35 to 40 min after the 2nd drop was administered. In order to reduce examiner bias, the specific powers of the neutralizing lenses were unknown to the examiner throughout the entire procedure. On average, retinoscopy under cycloplegic conditions revealed +0.50 to +0.75 D more plus than near retinoscopy. Although the Student's t-test indicated the values were significantly different on an absolute basis, a Pearson's r of +0.85 was found when all meridians were compared. In addition, if a "cut" factor is introduced to adjust for normal accommodative tonus eliminated under cycloplegic conditions, the two procedures produce essentially the same results.

Child↗
PubMed1992

Comparison between near retinoscopy and cycloplegic retinoscopy in the refraction of infants and children.

We investigated the validity of replacing cycloplegic retinoscopy with a noncycloplegic, "near" retinoscopy technique. We refracted a group of 31 infants (less than 2 years) and 43 children (greater than 2 years) with both techniques, grading our level of confidence in the result. Near retinoscopy gave on average a less hypermetropic result than cycloplegic retinoscopy by 0.39 D. The difference was significant in infants and for low levels of examiner confidence. However, a repeatability study showed that much of the variability in the infant group could be attributed to the poor repeatability of either retinoscopy technique. Agreement between the two techniques is improved by changing the suggested adjustment factor from 1.25 to 1.00 D for children and to 0.75 D for infants.

Adolescent↗
PubMed1997

The artifact of retinoscopy revisited: comparison of refractive error measured by retinoscopy and visual evoked potential in the rat.

PURPOSE: The validity of retinoscopy in small eyes has not been clearly established due to uncertainty regarding the source of the ocular reflections assessed during this procedure. A widely cited model which proposes that their origin is the inner limiting membrane of the retina was evaluated in the rat by comparing refractive errors measured by retinoscopy to those measured by visual evoked potentials (VEPs). METHODS: Ten rats were refracted both by cycloplegic streak retinoscopy and by VEP while viewing 0.05 to 0.15 cpd square-wave gratings-reversed at 1.875 Hz. Spherical aberration of the rat eye was assessed as a potentially confounding variable in VEP refraction by sequential retinoscopic refractions across the rat's natural pupil through a 1.5-mm pinhole. RESULTS: All animals were moderately to highly hyperopic by both methods (range = +4.5 to +18.5 D). Spherical aberration was minimal (median = 3.5 D of overcorrected aberration). The median difference between retinoscopic refractions and those by VEP was not significant (+1.94 D more hyperopia by retinoscopy; p = 0.062, Wilcoxon signed rank) but was significantly less than the +9.64 D difference predicted by an inner limiting membrane model (upper 95% limit = +3.76 D). CONCLUSION: This suggests that the origin of the retinoscopic reflex is located in the outer retina rather than at the inner limiting membrane. Correction factors for retinoscopy in small eyes may be smaller than previously assumed.

Animals↗
PubMed1979

Near retinoscopy and cycloplegic retinoscopy in early primary grade schoolchildren.

Retinoscopy under cycloplegia with various agents can yield varied results. Additionally, cycloplegics and produce adverse local as well as central nervous system disturbances. A noncycloplegic near retinoscopy technique as promulgated by Mohindra is compared with cycloplegic retinoscopy on schoolchildren in early grades. Results obtained by a study utilizing the two techniques show that they yield similar objective measurements of refraction.

Child↗
PubMed1999

Comparison between MEM and Nott dynamic retinoscopy.

PURPOSE: The aim of this study was to compare MEM dynamic retinoscopy with the Nott method, to discover whether there were different results in the accommodative response and whether a relation exists between the two techniques. METHODS: We performed MEM and Nott dynamic retinoscopy in 50 visually normal university students. Both methods were performed first on the basis of static retinoscopy and second with the result of the subjective refractive exam (binocular balancing). RESULTS: A statistically significant difference existed between the methods. Nott retinoscopy assessed on basis of the subjective refractive exam was the method that obtained the lowest amounts of accommodative lag (+0.42 D), whereas MEM method performed through the static retinoscopy result showed the highest accommodative lag (+0.94 D). Furthermore, correlation analysis showed that a linear relation existed between both methods, so that the Nott value was about one-half the value of the MEM retinoscopy. CONCLUSIONS: MEM dynamic retinoscopy showed greater lag than Nott retinoscopy.

Accommodation, Ocular↗
PubMed1998

Accuracy of the Nidek ARK-900 objective refractor in comparison with retinoscopy in children ages 3 to 18 years.

PURPOSE: To compare the increased speed and accuracy of the Nidek ARK-900 objective refractor with standard retinoscopy. METHODS: In a prospective study, 100 children aged 3 to 18 years were refracted after cycloplegia. Visual acuity measurements were determined in randomized fashion with the Nidek objective refractor, by retinoscopy, and by subjective refraction. One eye from each patient was included in the study. RESULTS: Ninety-six percent of the children read the 20/30 line perfectly with the result from the objective refractor compared to 88% with retinoscopy. The mean +/- SD visual acuity value obtained with the objective refractor was 20/24 +/- 4.75 and with retinoscopy was 20/27 +/- 6.8, a significant difference (paired t value = 4.81, P < .001). CONCLUSION: The Nidek ARK-900, representing the third generation of objective refractors, is comparable or superior to retinoscopy in accuracy in children, can be easily run by an ophthalmic technician, and therefore eliminates the physician's examination time required for retinoscopy.

Adolescent↗
PubMed1999

Per-operative retinoscopy as a predictor of final post-operative refraction.

PURPOSE: To assess the accuracy of streak retinoscopy performed at the end of cataract surgery as a predictor of final post-operative error. METHOD: Retinoscopy was performed on 68 patients as they lay on the operating table after routine cataract extraction and intraocular lens implantation. In each case the predicted post-operative refraction by biometry and the retinoscopy at the end of the operation were compared with the 6 week post-operative subjective refraction. RESULTS: The retinoscopy had a mean difference of 0.6 D (standard deviation of 0.5 D). The post-operative refraction predicted by biometric measurements had a mean difference of 1.6 D (standard deviation 0.6 D). When corrected for systematic error, 8% of patients were found to have an error of greater than 2 D as predicted by pre-operative biometry. Prediction by retinoscopy made no error greater than 2 D. The accuracy in the retinoscopic prediction of post-operative refraction was significantly better than the biometry using the F-test (p = 0.001). CONCLUSION: Retinoscopy at the end of cataract surgery may be a valuable tool to alert the surgeon to an unexpected refractive error. This would enable immediate intraocular lens exchange, if required.

Biometry↗
PubMed2001

Retinoscopy in infants using a near noncycloplegic technique, cycloplegia with tropicamide 1%, and cycloplegia with cyclopentolate 1%.

PURPOSE: This study compares retinoscopy in infants using a near noncycloplegic technique, cycloplegia with tropicamide 1%, and cycloplegia with cyclopentolate 1%. The study sample included 29 healthy, nonstrabismic infants 4 to 7 months of age (mean 5.71 months). METHODS: Each study subject was examined at two separate visits an average of 2 weeks apart (mean [+/-SD] 14 +/- 9 days). The examiner completed a case history, iris color grading, confrontation tests, and noncycloplegic near retinoscopy in a dark room and then instilled a drop of topical anesthetic in each eye followed by 2 drops of cycloplegic agent separated by 5 min. Retinoscopy was performed 25 to 30 min after the first drops were instilled. The bottles were masked, and the drop administered at the first visit was randomly assigned. RESULTS: On a scale of 0 to 4.9, the median iris grade was 4.0, which corresponds to a brown or darkly pigmented iris. All reported retinoscopy results are for the horizontal meridian of the right eye. The mean refractive error using noncycloplegic near retinoscopy was +0.94 D (+/-1.19 D). The mean refractive error was +1.81 D (+/-1.19 D) with tropicamide and +1.88 D (+/-1.45 D) with cyclopentolate. There was no statistically or clinically significant difference between the two cycloplegic measurements using different diagnostic agents (t = -0.46, p = 0.65). The mean difference between noncycloplegic and cycloplegic retinoscopy was 0.89 D (+/-0.66 D) with tropicamide (t = -6.57, p < 0.0001) and 1.04 D (+/-0.94 D) with cyclopentolate (t = -5.38, p < 0.0001; all two-sided paired t-tests). There were no serious adverse reactions with either agent, although one infant temporarily developed redder than normal cheeks after instillation of cyclopentolate. CONCLUSION: Our results suggest that tropicamide is as effective as cyclopentolate for the measurement of refractive error in most healthy, nonstrabismic infants.

Ciliary Body↗
PubMed2001

[Retinoscopy. A multi-media teaching program on CD].

INTRODUCTION: Retinoscopy is a classical method to determine the refraction of the eye by observing the dynamics of reflexes and varying the experimental parameters until a specific reflex (neutralisation point) is observed. Until now photographs and geometrical drawings of the different ray tracings have been commonly used to visualise the pathways. We intend to use new media such as video and CD to offer the students a better understanding of retinoscopy. METHODS: With the aid of appropriate experimental devices, retinoscopal reflexes of artificial and human eyes are recorded on video. The video sequences are converted in computer files and together with computer animations of the geometrical ray tracings, text files and audio sequences, they are stored in a suitable CBT-programme. RESULTS: The systematically prepared computer compatible contents offer a modern individually controllable method to perform the instruction programme by multimedia. The CBT-program and the specific files are stored on CDs or can be distributed on the internet. A collection of retinoscopy records of patients, some with extraordinary reflex phenomena is also available. DISCUSSION: Video and animation procedures are more suitable for matching the dynamic phenomena on retinoscopy than photographs or drawings as they offer a more direct basis for understanding of the sometimes difficult processes of retinoscopy. The collection of recorded reflexes also offers the direct visualised experience of particular patient findings such as the appearance in context of implanted spherical and aspherical intraocular lenses or the irregularities of the optic system of eyes with keratokonus.

Computer-Assisted Instruction↗
PubMed2002

MEM and Nott dynamic retinoscopy in patients with disorders of vergence and accommodation.

The accommodative response in 34 patients with accommodative and binocular disorders was assessed with two different techniques of dynamic retinoscopy used in clinical practice: monocular estimate method (MEM) and Nott retinoscopy. The data obtained by both techniques were compared, evaluating the correlation and agreement between them. Results showed that there were statistically significant differences between the techniques with MEM values being more plus than Nott ones. There was a high correlation between the two techniques (0.90) and the regression analysis indicated that a linear relationship existed between MEM and Nott dynamic retinoscopy, so that accommodative lag value for Nott dynamic retinoscopy would be calculated by dividing the MEM result by 2. However, although both retinoscopies were related, there was a lack of agreement between them (+/-0.53 D) indicating that the two methods are not interchangeable for clinical purposes.

Accommodation, Ocular↗
PubMed1976

Reflections on retinoscopy.

It has often been stated that static retinoscopy findings are not affected by the examiner's refractive correction. To what extent this statement remains true is the subject of this statement remains true is the subject of this paper. The basic principle of retinoscopy is the Foucault test. In this test, a knife edge placed on the principal axis of an optical system (S) intercepts a bundle of rays coming out of (S). Depending on the position of the knife edge, various distributions of light and shadow can be observed on the anterior surface of (S). In retinoscopy it is either the entrance pupil of the examiner or the peephole of the instrument that plays the role of the knife edge. Therefore, any change in conditions that bring about a change in the "knife-edge-pupil" position will result in errors in static retinoscopy. Nevertheless, calculations show that these errors do not become significant under usual clinical conditions of static retinoscopy.

Evaluation Studies as Topic↗
PubMed2002

[In paediatric ophthalmology there is no preferred timing for retinoscopy].

BACKGROUND: In paediatric ophthalmology retinoscopy may be performed immediately after an orthoptic examination or during an additional ambulatory visit. So far, no studies have been performed to investigate which of both procedures is preferred by the persons accompanying or examining the children. PATIENTS AND METHODS: 32 consecutive children under the age of 16 were randomly assigned to have retinoscopy immediately after the orthoptic examination or during an additional visit. Children coming from far away or needing a cycloplegia with atropine were excluded from this study. The accompanying persons and the examiners (orthopedist/physician) were interviewed using a validated, written questionnaire. Associations between answers were determined via a cluster analysis. RESULTS: 84 % (28/32) of all accompanying persons returned the questionnaire. The timing of retinoscopy was not associated with other variables. The question "Would you recommend our Department?" was strongly associated with how the accompanying persons judged the medical and orthoptic examination and also with the waiting times. CONCLUSIONS: There is no difference for the accompanying persons and the examiners if retinoscopy is performed immediately after an orthoptic examination or during an additional visit. As reported in the literature about patient satisfaction in an ambulatory setting, we found that the satisfaction of the accompanying persons correlated with the interaction between health professionals and the persons accompanying the children, as well as with the waiting times.

Adolescent↗
PubMed2001

Comparison of measured astigmatic retinoscopies from different lid specula.

PURPOSE: We wanted to study the effects of different lid specula on retinoscopy readings in the pediatric population. METHODS: We prospectively enrolled 29 patients from the Eye Clinic at The Children's Hospital of Denver who were being examined under anesthesia and met the inclusion criteria for the study. Any patient with ocular pathology that could affect the pliability of the sclera of both eyes was excluded. Patients with preexisting lid abnormalities or adnexal masses were also excluded. Cycloplegic retinoscopies were performed under anesthesia with the Barraquer wire and the Lancaster solid-blade specula. The amounts and the axes of the astigmatism were tabulated and statistically analyzed with the paired t test. RESULTS: A statistically significant difference occurred in the retinoscopies obtained from the 2 lid specula. The Barraquer lid speculum seemed to induce the least amount of astigmatism (P =.0001). CONCLUSIONS: There was a statistically significant difference in the amount of astigmatism found with each lid speculum. The choice of lid speculum in performing retinoscopies on the pediatric population can influence the final refraction and may have implications for visual outcome.

Adolescent↗
PubMed1989

A comparison study of dynamic retinoscopy techniques.

The dynamic retinoscopy technique that has undergone the most quantitative study is the Monocular estimate method (MEM). For reasons of examiner preference, patient cooperation, or equipment availability it may be useful for the practitioner to have alternative methods available to assess accommodative status. The purpose of this study was to compare data obtained by two experienced examiners using Bell, Cross, and Nott retinoscopies, MEM and Binocular cross cylinder (BCC) to evaluate accommodative lags of 10 young adult subjects. Statistical analysis revealed no significant differences between the results of the two examiners (p less than 0.2672). Results obtained by the MEM, Cross, and Nott techniques were not significantly different, but those obtained by Bell and BCC were significantly different from the other three techniques. The results of this study suggest that an examiner may use MEM, Cross retinoscopy, or Nott retinoscopy interchangeably to evaluate accommodative lag of the young adult subject.

Accommodation, Ocular↗
PubMed1994

Comparison of the techniques of videorefraction and static retinoscopy in the measurement of refractive error in infants.

Photorefraction has been suggested as a suitable method of screening for refractive error in infants. The relative performance of cycloplegic and non-cycloplegic videorefraction and cycloplegic retinoscopy was investigated on 150 infants. Under cycloplegic conditions the correlation between findings for spherical error (Rxy = 0.70) was compatible with a previous study. However, where cycloplegia was not used for videorefraction, there was poor agreement between the two techniques in the case of astigmatic error, and all types of ametropia. Interobserver repeatability was very high both for cycloplegic retinoscopy (Rxy = 0.96 spherical error, and Rxy = 0.75 astigmatic error) and for videorefraction measurements (Rxy = 0.95 horizontal meridian of photograph and Rxy = 0.85 vertical meridian). Intraobserver repeatability was also good, both for cycloplegic retinoscopy (Rxy = 0.91 spherical error and 0.82 astigmatic error) and for videorefraction with regard to spherical errors (Rxy = 0.84). Throughout the experiments videorefraction measurements of astigmatic errors proved less consistent when compared with cycloplegic retinoscopy, and to its internal reliability.

Astigmatism↗
PubMedDate not supplied

Near retinoscopy in accommodative esotropia.

We tested whether near retinoscopy, a noncycloplegic retinoscopic technique, was applicable to the optic correction of patients with accommodative esodeviations. We performed a study in 17 patients with accommodative esotropia to compare the refractive values obtained by near retinoscopy and by cycloplegia, as measured by two examiners. The interobserver variability was the same for the two techniques for the refractive values of the horizontal and vertical meridia and spherical equivalent. For the astigmatism, there was greater variability for near retinoscopy. The correlation between the two methods was good, but the variability of the differences was high. We recommend that near retinoscopy should be employed only as a noninvasive method for screening refractive errors in children.

Accommodation, Ocular↗
PubMedDate not supplied

Retinoscopy after excimer laser photorefractive treatments.

Photorefractive keratectomy (PRK) is capable of changing the refractive power of the human cornea. Retinoscopy is an objective method of measuring the refractive power of the eye. The authors performed PRK in 28 myopic eyes with the Aesculap Meditec MEL 60 ArF excimer laser. During a prospective study, the subjective and objective refractive power of the eyes were assessed and compared 6 months after PRK. The average preoperative refractive error was: -5.11 +/- 2.51 D and -5.08 +/- 2.20 D on the right side (n = 16) and on the left side (n = 12), respectively. In order to obtain the best corrected visual acuity 6 months after PRK, the right and left eyes needed an average of -0.09 +/- 0.26 D and -0.33 +/- 0.64 D postoperative correction, respectively. The postoperative refractive change could be verified with the retinoscopy at +/-0.5 D accuracy. The authors describe a double refractive corneal ring after PRK, which may disturb retinoscopy. The post-PRK refractive change can be verified by retinoscopy. Postoperative funduscopy, fundus photography and possible future retinal procedures were not disturbed by the double corneal refractive rings in myopic eyes.

Adolescent↗
PubMed2002

Value of transesophageal echocardiography, esophago-gastroduodenoscopy and retinoscopy prior to intra-arterial fibrinolytic therapy in patients with peripheral arterial disease.

BACKGROUND: We prospectively investigated the need for esophagogastroduodenoscopy (EGD), transesophageal echocardiography (TEE) and retinoscopy for pre-interventional screening in patients with peripheral arterial occlusive disease (PAD) prior to intraarterial fibrinolytic therapy. PATIENTS AND METHODS: 212 consecutive patients suffering from PAD (164 male and 48 female, mean age: 64 +/- 11 years, 161 patients stage II of Fontaine's classification, 10 patients at stage III and 41 patients at stage IV) referred for interventional treatment were included. 173 EGDs, 169 TEEs and 188 retinoscopies were performed within one week prior to fibrinolysis. 114 patients had all three examinations. RESULTS: Pathologic findings were detected in 56 (49%) of the 114 patients: 23 erosions, 12 ulcers, 2 esophagites, 1 gastric carcinomata, 3 intracardiac thrombi, 5 aortic thrombi, 11 diabetic and 5 hypertensive retinopathies and 1 with retinal aneurysms. 30 patients (25%) received fibrinolytic therapy, despite a contraindication: The one patient with ventricular thrombus was treated as an ultimate therapy, and amputation was prevented. Two patients showing plaques covered by large thrombi in the descending thoracic aorta were treated because cranial embolism should not occur. Four diabetic patients with multilevel disease, severe claudication and prior retinal bleeding were treated. Fibrinolytic therapy was started on 23 patients after complete healing of the mucosal lesions. CONCLUSION: TEE revealed potential sources of embolization in 4% of the patients and is justified to reduce the individual risk. Retinoscopy should be done in patients with diabetes mellitus and hypertension, and if prior bleeding is present fibrinolysis should be done only if other treatment-regimes are not available.

Aged↗