How to use retinoscopy simulator ?
Procedure of retinoscopy simulator are as below mentioned 10 steps.
Online retinoscopy practice
Before starting practice on retinoscopy simulator software 10 step should be remembered and then proceed to practice.
Start Online Retinoscopy Simulator
Step 1: Under the explore tab, enter the patient’s refractive error.
Step 2: Set your working distance offset. This correlates to your arm’s length or the distance between your retinoscope and the patient’s eye.
An average length is 67 cm, which correlates to 1.50 D working distance offset.
Step 3: Streak the beam of light across the eye to determine “with motion,” “against motion,” and “neutrality.”
Step 4: PLUS CYLINDER REFRACTION: Determine the angle/axis with the least WITH motion.
When the light intercept moves in the same direction as the reflex from the pupil, you have WITH motion.
Neutralize this motion by adding sphere power.
When the intercept moves in the opposite direction from the reflex, you have against motion.
Subtract plus power until the motion is neutral.
When the pupil fills with light and there is no movement, you are at neutrality and have determined the sphere power.
Step 5: PLUS CYLINDER REFRACTION: Now angle the streak 90 degrees from the previous position.
Add plus power to the cylinder until any with motion is neutralized, or minus power until any against motion is neutralized (against motion moves the opposite direction of the light streak).
Record the axis as the direction of this final streak when it is neutralized.
Step 6: PLUS CYLINDER REFRACTION: Record the refractive error, which is your neutralizing sphere minus your working distance then your cylinder and axis.
Example: if your working distance is 2.00 D as shown and the phoropter reads +3.50 + 0.75 x 90,
the final reading is: (+3.50 -2.00 = +1.50) +1.50 + 0.75 x 90.
Step 7: MINUS CYLINDER REFRACTION: Determine the angle/axis with the most WITH motion.
When the light intercept moves in the same direction as the reflex from the pupil, you have WITH motion.
Neutralize this motion by adding sphere power.
When the intercept moves in the opposite direction from the reflex, you have AGAINST motion.
Subtract plus power until the motion is neutral.
When the pupil fills with light and there is no movement, you are at neutrality and have determined the sphere power.
Step 8: MINUS CYLINDER REFRACTION: Now angle the streak 90 degrees from the previous position.
Add minus power to the cylinder until any AGAINST motion is neutralized, or plus power until any with motion is neutralized (against motion moves the opposite direction of the light streak).
Record the axis as the direction of this final streak when it is neutralized.
Step 9: MINUS CYLINDER REFRACTION: Record the refractive error, which is your neutralizing sphere minus your working distance then your cylinder and axis.
Example: if your working distance is 2.00 D as shown and the phoropter reads +3.50 - 0.75 x 90,
the final reading is: (+3.50 -2.00 = +1.50) +1.50 - 0.75 x 90.
Step 10: Click the “new patient” button under the test tab to generate a randomized refractive error.
Enter the plus and minus refractive errors of the patient and click “check answer” to compare the results.
