A Verification Study Of Dark Room Retinoscopy.

In an effort to assess the refractive state of a nonverbal patient two objective techniques such as retinoscopy under cycloplegia, and static retinoscopy can be used. In performing static retinoscopy, accommodation must be relaxed at infinity and distant fixation must be steady. Uncontrolled fixation which can be characteristic of young children not only makes it difficult to perform this technique but also produces an inaccurate accommodative response
which will give you an incorrect refractive error. In an effort to control the patients accommodation, the cycloplegic technique is an alternative method to determine the patient's refractive error. The cycloplegic refraction can be unreliable because of possible factors that involve the ciliary tonus values such as age, refractive error, and eye alignment.
The type of cycloplegic agents, concentration, amount and amount of induced residual astigmatism must also be taken into consideration. Often in cases where a cycloplegic is necessary the refractive evaluation will be based largely on retinoscopic findings. Retinoscopy may be difficult due to aberrations in the reflex with widely dilated pupils, and only the central area of the reflex should be utilized, which may be difficult. It should be brought out that one should not overlook the various ocular and local side effects of
cycloplegic agents.