Just Look Retinoscopy: Procedure and Uses

Jul 24, 2024

Just Look Retinoscopy: Procedure and Uses

Introduction

  • Speaker: Dr. Dean T. Still (OD, COVD, Fellow of the American Academy of Optometry, Retired Professor of Bariatric Optometry)
  • Host: Kapil Gautam Singh
  • Audience queries can be dropped in the chat box for discussion in the next session.

Key Concepts

  • Vision as the Leader: Vision is crucial in all human activities; it guides and leads development and behavior.
  • Eyes and Brain Integration: Eyes are an extension of the brain - activity in one reflects activity in the other.
  • Vision Development: Vision instigates action and overall development from crawling to complex tasks like driving.
  • Just Look Retinoscopy: Observing the patterns of visual engagement during tasks to assess development.
  • Importance of Observation: Observing without lenses initially; lenses are used as probes to see reflex changes.

Vision and Reflexes

  • Visual Manipulation: Engaging in a task involves focusing, refocusing, and visual manipulation.
  • Retinoscopic Reflexes: Changes in the reflex can indicate different levels of engagement and brain activity.
  • Developmental Observation: Observations are valid for all ages and help determine visual engagement and manipulation patterns.

Video Demonstrations

  • Infant's Eye-Hand Coordination: Visual hunger in infants and their use of eyes before hands for exploration and engagement.
  • Gaze Following: Following someone's gaze can predict cognitive abilities and understanding in infants.
  • Eye and Ear Coordination: Eye movements are coordinated with eardrum movements, signifying interconnected sensory systems.

Retinoscopy Observations

  • Procedure: Shine retinoscope light into the patient’s eyes, use lenses to observe changes in reflex brightness and stability.
  • Complexity: Simple procedure with complex observations; more experience leads to deeper understanding.
  • Observational Details: Look for alignment, focus, changes in brightness, and modulations in reflex.
  • Pupil Size: Changes in pupil size can indicate effort and focus levels.

Developmental Considerations

  • Early Interventions: Observing early and intervening can set strong foundations for visual development.
  • Infancy Program: Early visual assessments (6-12 months) help in setting developmental foundations.
  • Role of Vision in Learning: Vision plays a critical role in cognitive tasks and overall development.
  • Challenges: Children with foundational issues may face greater challenges and require more effort to engage.

Clinical Applications

  • Assessment of Eye Movements: Observe eye movements during various tasks to determine visual engagement and control.
  • Impact of Digital Devices: Extended use of digital devices can affect pupil size and focusing ability.
  • Management Strategies: Use retinoscopy for developmental insights, not just refraction. May need vision therapy or other interventions based on observations.
  • Follow-Up: Frequent monitoring and adjustments to lens prescriptions are crucial for optimal development.

Conclusion

  • Continual Learning: Practitioners should continuously observe and adapt their understanding of visual engagement and development.
  • Mental Video: The continuous observation over several seconds creates a mental video of reflex changes aiding in better diagnosis and treatment.
  • Future Sessions: Future webinars will include topics such as autism and visual strategies.

Contact Information

  • Email: Provided for follow-up questions and further insights.

Final Thoughts

  • Celebration Wishes: Wished audience well for upcoming celebrations.
  • Passion for Sharing: Dr. Still emphasizes the importance of ongoing education and sharing knowledge.