Retinoscopy

[optometrystudent2024]

Hey guys I'm a first year optometry student and we just had our proficiencies a couple weeks ago which included retinoscopy and I unfortunately I have to redo that part. Im still not confident at it and worried I will not pass again. Do you guys have any tips? I feel like I'm never going to master ret. It's discouraging since I know how to do all the other clinical tests (ie. refractions/bv testing/entrance exams etc) and my grades are fairly good. Im worried the school might dismiss me because of this. Has anyone else had similar issues? I've been practicing alot but i always tend to over-minus.

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[Loptometriste]

Are you fairly accurate other than the over-minus aspect? Have someone measure your working distance. You might be taking out the wrong working distance. i.e. you think you are at 50 cm, but you are really closer to 67cm and removed -2.00 rather than -1.50. Therefore, making the patient to be overminused.

Another type is to error on the more plus when you are doing ret. Think it's neutral? Stop when it's close-to-neutral with a little bit of against movement rather than close-to-neutral with a little bit of with motion.

Otherwise, keep practicing. Keep doing retinoscopy on as many people as possible. It's a skill. It needs to be practiced to be come efficient. Trust yourself with what you see.

 

[UnicornOpt]

I wouldn't sweat it. You're not expected to get a perfect result with retinoscopy; subjective refraction will always be the most accurate and sensitive test for precision. Retinoscopy just has to be good enough to either start the subjective refraction step or to be good enough for the daily activities and reduce risk for amblyopia in the patient's you'd normally only prescribe off retinoscopy for: intellectually disabled patients and young children.

I totally screwed up retinoscopy on my boards examination, but was still able to pass because subj manifest brought me to clarity, and I earned enough points on the module. I see toddlers as a pediatric optometrist in a hospital, and I'm not perfect either today still, what with children not opening their eyes or getting few glances, but I'm good enough to know that I'm not inducing amblyopia, that I'm prescribing good enough to prevent amblyopia when indicated, and that the toddler can see well enough to see flash cards and navigate a house safely. I can always fine tune the refraction results as they get older.

Take-away: don't sweat it. Nobody gets perfect retinoscopy results, you just have to be within the ball park of "good enough"

 

[optometrystudent2024]

Are you fairly accurate other than the over-minus aspect? Have someone measure your working distance. You might be taking out the wrong working distance. i.e. you think you are at 50 cm, but you are really closer to 67cm and removed -2.00 rather than -1.50. Therefore, making the patient to be overminused.

Another type is to error on the more plus when you are doing ret. Think it's neutral? Stop when it's close-to-neutral with a little bit of against movement rather than close-to-neutral with a little bit of with motion.

Otherwise, keep practicing. Keep doing retinoscopy on as many people as possible. It's a skill. It needs to be practiced to be come efficient. Trust yourself with what you see.

Thank you so much for the tip of leaning to the side of more plus. I had my CSE this morning and it looks like I got it spot on! My patient read 20/15 so I very happy with that!

 

[optometrystudent2024]

I wouldn't sweat it. You're not expected to get a perfect result with retinoscopy; subjective refraction will always be the most accurate and sensitive test for precision. Retinoscopy just has to be good enough to either start the subjective refraction step or to be good enough for the daily activities and reduce risk for amblyopia in the patient's you'd normally only prescribe off retinoscopy for: intellectually disabled patients and young children.

I totally screwed up retinoscopy on my boards examination, but was still able to pass because subj manifest brought me to clarity, and I earned enough points on the module. I see toddlers as a pediatric optometrist in a hospital, and I'm not perfect either today still, what with children not opening their eyes or getting few glances, but I'm good enough to know that I'm not inducing amblyopia, that I'm prescribing good enough to prevent amblyopia when indicated, and that the toddler can see well enough to see flash cards and navigate a house safely. I can always fine tune the refraction results as they get older.

Take-away: don't sweat it. Nobody gets perfect retinoscopy results, you just have to be within the ball park of "good enough"

Thank you so much! It's reassuring to hear that you can survive without being perfect with ret! I had my CSE this morning and seems like I got ret spot on!