How to perform retinoscopy

Re: How to perform retinoscopy

Mike Tyner schreef:
> "douglas" <Protoman2050@gmail,com > wrote
>
>> But I'm sure you could use a direct ophthalmoscope for retinoscopy, if
>> you lacked a retnoscope, would the procedure be any different for
>> using an ophthalmoscope for static retinoscopy?
>
> The ophthalmoscope lacks any optics to focus the beam.

No need to, some skiascopes/retinoscopes didn't have either.
The ones that are without such a facility most of the time are using a
divergent lightbeam as seen in the old plano mirror ophthalmoscope.

I don't think I could
> do ret with parallel light.

I'm sure you could

> Your mileage may vary.
>
>> Which provides better
>> bva, cyclo, or non-cyclo?
>
> "BVA" is a term usually applied to subjective refraction. Which ret techique
> comes closer to the subjective refraction? Probably dry (non-cyclo.)

I think that's for sure.

Jan (normally Dutch spoken)

PS, pictures of an old ophthalmoscope/skiascope set
skiascope = retinoscope

http :// picasaweb.google.nl/jan.oudesluys/OldOphthalmoscopeSkiascope

Re: How to perform retinoscopy

On May 4, 4:19 pm, Jan <nos...@nospam.nl> wrote:
> Mike Tyner schreef:
>
> > "douglas" <Protoman2...@gmail,com > wrote
>
> >> But I'm sure you could use a direct ophthalmoscope for retinoscopy, if
> >> you lacked a retnoscope, would the procedure be any different for
> >> using an ophthalmoscope for static retinoscopy?
>
> > The ophthalmoscope lacks any optics to focus the beam.
>
> No need to, some skiascopes/retinoscopes didn't have either.
> The ones that are without such a facility most of the time are using a
> divergent lightbeam as seen in the old plano mirror ophthalmoscope.
>
>   I don't think I could
>
> > do ret with parallel light.
>
> I'm sure you could
>
> > Your mileage may vary.
>
> >> Which provides better
> >> bva, cyclo, or non-cyclo?
>
> > "BVA" is a term usually applied to subjective refraction. Which ret techique
> > comes closer to the subjective refraction? Probably dry (non-cyclo.)
>
> I think that's for sure.
>
> Jan (normally Dutch spoken)
>
> PS, pictures of an old  ophthalmoscope/skiascope set
> skiascope = retinoscope
>
> http :// picasaweb.google.nl/jan.oudesluys/OldOphthalmoscopeSkiascope

So, could any one compare the refraction abilities of an
ophthalmologist vs. those of an optometrist, or are they both equal?
And why do they let optometrists --in the US-- treat things like
glaucoma, cataracts, convergence disorders, accomadation pathologies,
conjunctivitides, etc.? Optometrists should refer their patients to
one who is more qualified to treat them, ie an ophthalmologist. And
why do ophthalmologists refract patients for lenses, or treat low
vision? They too should refer their patients to one who is more
qualified to treat them, ie an optometrist. Both types of eye doctors
have their place in the healthcare system...but they shouldn't do each
other's jobs, it's less productive and could lead to misadventures.

Re: How to perform retinoscopy


"douglas" <Protoman2050@gmail,com > wrote

> So, could any one compare the refraction abilities of an
> ophthalmologist vs. those of an optometrist, or are they both equal?

For that task, probably optometrists are better in general. Many
ophthalmologists would gladly agree. As a group, they don't like refracting
or fitting contacts. Many of them delegate it to a technician.

Medical insurance never pays for refraction. Why would they want to be
better at refraction?

> And why do they let optometrists --in the US-- treat things like
> glaucoma, cataracts, convergence disorders, accomadation pathologies,
> conjunctivitides, etc.?

The same reason they let dentists work on teeth. Do you really need an oral
surgeon to fill your cavities or design your braces?

In the US, optometrists get the same length and scope of training as
dentists.

In some US universities, students of optometry, dentistry and medicine all
take classes from the same professors, in the same classrooms.

In my class, optometry students did cadaver dissection, pharmacology,
bacteriology and several other "ologies". In other countries it is not so.

In the US, optometry schools receive government funding and it's bad
investment to waste that training. Optometry was favored by the US military
after WWII, as a profession where returning pilots and officers could be
gainfully employed.

In the US, optometry participates in regulation of drugs (FDA) and public
health.

Optometrists serve as officers and administrators in the military.

There are optometrists on the faculty of medical schools, teaching
ophthalmology residents.

There are optometrists with hospital admitting privileges.

Most surgeons do not want to treat pink eye, amblyopia and contact lens
problems. And in the US, there aren't enough ophthalmologists to treat all
those non-surgical problems.

There are almost three times as many US optometrists as ophthalmologists.

> Both types of eye doctors have their place in the healthcare system...but
> they shouldn't do each other's jobs, it's less productive and could lead
> to
> misadventures.

Then it's fortunate that you aren't in charge. Learn some more before you
pass judgement.

In the last 30 years there's been significant improvements in training, more
standards, CE requirements and stringent board examinations, In the same
period, every US state has passed new laws allowing optometrists to
prescribe drugs in the treatment of medical disease. US Medicare and
private insurance companies recognize optometrists as participating
providers on par with ophthalmology.

Does it mean anything to you that optometry malpractice premiums have hardly
changed in those 30 years?

What's it like on your planet? Nurses digging for foreign bodies with a
Q-tip? Barefoot doctors and general practitioners prescribing
chloramphenicol for every red eye?

-MT

Re: How to perform retinoscopy

On May 7, 10:23 pm, "Mike Tyner" <mty...@mindspring,com > wrote:
> "douglas" <Protoman2...@gmail,com > wrote
>
> > So, could any one compare the refraction abilities of an
> > ophthalmologist vs. those of an optometrist, or are they both equal?
>
> For that task, probably optometrists are better in general. Many
> ophthalmologists would gladly agree. As a group, they don't like refracting
> or fitting contacts. Many of them delegate it to a technician.
>
> Medical insurance never pays for refraction. Why would they want to be
> better at refraction?
>
> > And why do they let optometrists --in the US-- treat things like
> > glaucoma, cataracts, convergence disorders, accomadation pathologies,
> > conjunctivitides, etc.?
>
> The same reason they let dentists work on teeth. Do you really need an oral
> surgeon to fill your cavities or design your braces?
>
> In the US, optometrists get the same length and scope of training as
> dentists.
>
> In some US universities, students of optometry, dentistry and medicine all
> take classes from the same professors, in the same classrooms.
>
> In my class, optometry students did cadaver dissection, pharmacology,
> bacteriology and several other "ologies". In other countries it is not so.
>
> In the US, optometry schools receive government funding and it's bad
> investment to waste that training. Optometry was favored by the US military
> after WWII, as a profession where returning pilots and officers could be
> gainfully employed.
>
> In the US, optometry participates in regulation of drugs (FDA) and public
> health.
>
> Optometrists serve as officers and administrators in the military.
>
> There are optometrists on the faculty of medical schools, teaching
> ophthalmology residents.
>
> There are optometrists with hospital admitting privileges.
>
> Most surgeons do not want to treat pink eye, amblyopia and contact lens
> problems.  And in the US, there aren't enough ophthalmologists to treat all
> those non-surgical problems.
>
> There are almost three times as many US optometrists as ophthalmologists.
>
> > Both types of eye doctors have their place in the healthcare system...but
> > they shouldn't do each other's jobs, it's less productive and could lead
> > to
> > misadventures.
>
> Then it's fortunate that you aren't in charge. Learn some more before you
> pass judgement.
>
> In the last 30 years there's been significant improvements in training, more
> standards, CE requirements and stringent board examinations, In the same
> period, every US state has passed new laws allowing optometrists to
> prescribe drugs in the treatment of medical disease.  US Medicare and
> private insurance companies recognize optometrists as participating
> providers on par with ophthalmology.
>
> Does it mean anything to you that optometry malpractice premiums have hardly
> changed in those 30 years?
>
> What's it like on your planet? Nurses digging for foreign bodies with a
> Q-tip? Barefoot doctors and general practitioners prescribing
> chloramphenicol for every red eye?
>
> -MT

Okay, well now I know: optometrists for the "easy, simple" --
relatively speaking, of course--, and ophthalmologists when you really
need one, like if your retina's detaching, or you have fourth nerve
palsy, etc, or you've got a refractory case of herpes retinitis --
well, then you'd need an infectious disease specialist, as well as an
ophthalmologist--. Thanks for filling me in!