Hi, everyone, thank you very much for any suggestions
I am a student currently taking exam in UK, for the cycl ret-
I feel it is very difficult to detect the reflection from fundus, as it is very diffuse and a lot of them have cissors movement though they don t have astig-
do you guys have any better ideas about it?
Tks
I agree cycloplaeged retinoscopy can be difficult to perform. The "logical" thought is it would be very easy, as the pupil is large, allowing a bright reflex. The fact in my experience is, ideal pupil-size for retinoscopy is roughly between four and six millimeters. Much smaller, and the reflex is very difficult to detect; quite larger, and peripheral aberrations lead to challenging interpretation, as well as to an overall broader, even dimmer reflection.
I would suggest trying to concentrate on the central reflex when performing retinoscopy through a well-dilated pupil in which interpretation feels challenging. Also, dialing in enough power to effect an obvious with- or against-pattern, then pulling away said power and looking for the point of reversal (which may cover as many as maybe three "clicks" of sphere power) has been helpful to me.
My goal in retinoscopy usually is to determine a reasonable idea of where the patient's error lies, and not to directly prescribe from the measurement; thus, I also do no usually record objective and subjective findings separately. Once you realize where in the ballpark you are, you (usually) would refine your position with subjective refraction, then decide what the most sensible prescription is.
Probably one of the most important aspects of prescribing is knowledge of the patient's habitual correction, as well as determination of her or his history (i.e., happy with vision? Symptomatic? Specific complaints? Etc.).
