The effect of off-the-visual-axis retinoscopy on objective refractive measurement

To determine the effect of off-axis retinoscopy on objective refractive measurement. Prospective experimental study. Eight volunteers underwent cycloplegic retinoscopy of their right eye on-the-visual-axis, and 5, 10, 15, and 20 degrees off-the-visual-axis in adduction. A single masked examiner perf...

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Bibliographic Details
Published in:American journal of ophthalmology 2004-06, Vol.137 (6), p.1101-1104
Main Authors: Jackson, David W, Paysse, Evelyn A, Wilhelmus, Kirk R, Hussein, Mohamed A.W, Rosby, Gina, Coats, David K
Format: Article
Language:English
Subjects:
Adult
Astigmatism
Biological and medical sciences
Cyclopentolate - administration & dosage
Drug Therapy, Combination
Humans
Investigative techniques, diagnostic techniques (general aspects)
Medical research
Medical sciences
Mydriatics - administration & dosage
Ophthalmology
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Pediatrics
Phenylephrine - administration & dosage
Prospective Studies
Pupil - drug effects
Refraction, Ocular
Refractive Errors - diagnosis
Reproducibility of Results
Retinoscopy - standards
Tropicamide - administration & dosage
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Summary:To determine the effect of off-axis retinoscopy on objective refractive measurement. Prospective experimental study. Eight volunteers underwent cycloplegic retinoscopy of their right eye on-the-visual-axis, and 5, 10, 15, and 20 degrees off-the-visual-axis in adduction. A single masked examiner performed all retinoscopy with random order of the patient and axis refracted. The average spherical retinoscopic value at 0, 5,10,15, and 20 degrees of off-axis alignment was −0.40, −0.90, −1.00, −1.38, and −1.80 diopters, respectively. The average spherical equivalent retinoscopic value obtained for each of the above positions of eye alignment was −0.02, −0.59, −0.45, −0.64, and −0.98 diopters, respectively. The induced cylinder power increased by an average of 3% for each degree of off-axis retinoscopy, though the axis of the cylinder was not predictable. Objective refractive measurement by retinoscopy is significantly altered by off-the visual-axis retinoscopy. The induced error may be clinically important even with small degrees of eccentricity.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2004.02.012