Retinoscopy

[cpw]

Hello all...
well, our class endeavors into Ret this week. I was wondering if any of the older and wiser OD students had some words of wisdom as I venture forth into the area that as my profs put it "seperates the men from the boys". (as they say this to a group of SEVENTY women and twenty men) Any helpful tips to get me through this?
*off to buy my training bra*

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[TPMOH]

70 women to 20 men! I should have applied to UHCO (our class is 37 women to 27 men- not bad I guess)!

 

[UWSO2003]

Hi CPW,

Retinoscopy is something that can easily be explained, but takes lots and lots of practice (like most of the techniques we do)before you can do the "I'll whip out the ret and do a quite retinoscopy"!

The easiest way I've found (with my beloved Heine Ret) is to simply scope the horiz meridian (ie. the light is vertical) until you see neutral/near neutral.

Sometimes it will be sooo obvious that they have cyl because you will see the textbook reflex at a certain axis.

Most of the time it's not blatantly obvious what the axis is at. What I do is after seeing neutral with the slit vertical, I start rotating the slit around the clock. If there is cyl you will start to see an against motion .... this motion will become increasingly exaggerated (sp?) as you approach the correct axis. So basically all you have to look for is where you see the "biggest" against motion. Here I just quickly go to 90 degrees from that axis and make sure that it's still netrual ... if not neutral than just make it so .... now go back to the cyl axis and neutralise that.

Let me know if this helps .... everyone has their own "favorite" way of doing ret ...

 

[abs1]

Hey, cpw, we just started ret last week. Its pretty cool I must say! I have the schematic eye pretty much figured out, but real eyes are a little tougher at first.

Have fun!

 

[OD2BMike]

Yes retinoscopy definitely takes practice. I found that ret is one of the many things we learn in school that can be explained in about 10 minutes, but take years to master. Freddy's advice was good, and I'm sure you'll be able to get lots of good tips and tricks in Lab when you're there. My advice is to just be patient and to practice as much as you can. I didn't get really comfortable with my ret results untill we had our pediatric rotation 4th year. In peds we used the dreded skiascopy bars for ret. They really make you think about what you're actually doing as you're scoping and you can actually be more quick and accurate once you get good.
Another challenging skill is BIO, which can be learned in a few minutes, but takes a while to get really comfortable with.

 

[TomOD]

Hey Mike,

Your going to graduating VERY SOON. What do you have in plans next?

Just wondering?

Tom

 

[OD2BMike]

Hey Tom,

Yes graduation is coming too FAST. Currently I'm busy applying to several residency programs; 3 VAs and the Family Practice residency at NSU. At this point I'm not absolutely sure what type of practice I want to be in, or even where in the country I want to practice. I think a residency would be a good way to learn more about disease, open up new doors, and also give me more time to decide what I want to to do before going into the real world. Interestingly I am looking into a brand new SCO VA residency program in Roanoke Virginia. Tom do you, or anyone, know anything about this program?

If I don't end up with a residency, which is a distinct posibility, I'll start looking into practice opportunities somewhere in the US. Wow, so much to do before graduation, but I'm excited about it all. Take care.

Mike

 

[cpw]

let us know when you hear from residency programs.. I'd be curious to follow your progress through one to see what they're like. At this point I can't even fathom wanting anothe year in school.

 

[TomOD]

No Mike, I am not familiar with the particular VA program your talking about BUT.... I do have a VA hospital 2.5 miles from my office and I secured a VA contract to see many of their patients at my office. (one of their OD's got called to active duty for 2 yrs. and the other is a lazy slob). So anyway, they can't handle the volume so they contract out to me (lucky me). This was a case of me being in the right place at the right time :wink:

Mostly these VA patients are old guys with lots of health problems. I think you get diabetes just from walking through the doors of a VA hospital because I swear, 98% of the pts. I get in my office from there has DM. I just don't think that is statisticly possible......

All in all I image you would see your fair share of ocular pathology at a VA residency. I had a friend do a VA residency and he thought it was great. Some of these guys (or gals) are true American Hero's. I have met a Medal of Honor Winner and a guy who was a P.O.W. for 4 years in WWII.

The rest are just sorry welfare type losers who spent 6 month in the Army and sprained their ankle who are trying to get a free ride from the gov't.