Retinoskopi

Retinoskopi, or retinoscopy, is a clinical technique used to estimate refractive error by projecting a light into the eye and watching the movement of the retinal reflex as the examiner moves the light across the pupil. The observed reflex, together with the examiner's working distance and the lenses used, provides an estimate of the eye's refractive state without requiring subjective responses from the patient.

Indications include assessment of refractive error in infants and young children, uncooperative patients, preoperative evaluations, and verification of refraction when objective methods are inconclusive. It also helps detect anisometropia and astigmatism and can guide decisions about cycloplegia and corrective lenses.

Procedure: A retinoscope is used in a dimly lit room. The patient is seated, and the examiner views the pupil from a fixed distance, typically about 67 cm. A streak or point source of light is swept across the pupil in multiple meridians while the patient fixes on a distant target. The reflex can move in the same direction as the light (with movement) or the opposite direction (against movement). Neutralization is sought by placing corrective lenses until the reflex stops moving; the resulting lens power estimates the refractive error, adjusted for the working distance.

Dynamic retinoscopy and cycloplegia may be used to separate accommodative effects from true refractive error, particularly in children. Retinoscopy complements autorefractors and other refraction methods and remains a foundational tool in pediatric and general optometry.