As part of a proper Schoolvision assessment, there are 8 tests necessary to complete the child’s eye examination. With thanks to Geraint Griffiths, the founder of the schoolvision technique, in the current series of blog posts we have been describing each test separately through series of questions and answers.
Here is a list of the eight tests:
- Brock string
- Dynamic fixation
- Accommodation facility
- Measuring Muscle Balance
- Trial Frame Challenges
- Follow – up
Here below are the questions and answers on the Retinoscopy test.
Q: For near ret – do you need to take out your working lens, or is that not relevant?
A: For near Ret you are looking at the reflex as the patient looks at your forehead without any working distance lens in situ. This will tell you if there’s a bright reflex and very quick movement that accommodation and convergence are in the same place. This is normal or a very well controlled accommodation convergence insufficiency
If there is WITH movement this is an accommodation lag, if there is against movement it is an accommodation lead. Each of these situations has a different remedy.
Q:What do you find is the ‘normal’ difference between distance ret and near ret results? E.g. If someone was +0.50 R & L with distance ret, would a result of +1.25 for near ret (without a working lens) be normal?
A: When I see obvious plus in the distance or that latent sort of reflex which is indeterminate, I look for the sort of +1.25 lag you suggest. It is very important in long sight to expect an accommodative insufficiency and always be prepared to correct it with varifocals. Malignant hyperopia is a term I would associated with this poor benighted group who often go unnoticed until it is too late. So a +1.25 lag without the working lens is beginning to be a concern.