What do meridians mean in skiascopia graphics. What if the results of skiascopia and refractometry diverge? Study with a wide pupil

24.07.2020

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Violation of visual acuity can be at any age. Modern ophthalmology is equipped with high-precision equipment, which allows diagnostics and vision correction in both adults and very small patients. However, along with the newest devices, there are methods of research functional state visual organs developed for a very long time and based on the experience and professionalism of the ophthalmologist. We are talking about skiascopia, or shadow sample.

Skiascopia allows you to check the condition of the person's eye, determine the most remote point of a clear vision. The essence of the method lies in determining the clinical refraction of the eye through the directional illumination of the pupil.Refraction is the ability to refract the light rays by the optical structures of the organ of vision.

Skiascopia synonyms - retinoscopy and keratoscopy.

The optical system includes a cornea, anterior chamber, filled with liquid, lens and jelly content fiscame body. After passing all these areas, the light falls on the mesh shell, which is capable of converting light particles into the pulses entering the brain where the image is folded. Units of measurement of visual acuity are diopter.

Clinical refraction is the location of the main focus, that is, the points in which the light rays intersect with respect to the mesh shell. If this rear focus is located on the retina, it means that the vision is 100%, that is, absolutely normal - emmetropy. In the event of a change in the position of the focus of visual acuity is violated. So, when the location, the location of the intersection point is behind the mesh shell of the eye, and in the peace - in front of it.

Skiascopia determines the clinical refraction, which is the location of the intersection point of the refracted light rays relative to the retina

Skiascopia allows you to objectively assess the degree of violation of refraction with almost any person, including the youngest children. This is especially important if there is no possibility to determine vision through a visometry (using tables) or to carry out refractometry (evaluate the visual sharpness using special equipment).

Skiascopia can be carried out in the conditions of cyclopellegia (artificial shutdown of the muscle responsible for accommodation using medicines) or the active accommodation (adaptive eye ability to focus the look to see the objects that are far or close in the same way).

The study is shown in various violations of visual acuity:

far -landic, when a person does not see the well-known objects;
myopia, in which the patient sees well close, but distant objects are blurred for it;
astigmatism - pathology at which there are several focus at once, while in one eye can be combined with various types of refractures (+ or -).

The shadow sample is a valuable diagnostic method of toddler surveys, in which it is still impossible to carry out refractometry with the help of the device and perform diagnostics using ophthalmological tables. The method is used to form a diagnosis to evaluate the effectiveness of the therapy and during the dispensary monitoring phase.

The hardware refractometry is carried out using instruments that cannot be applied relative to very small children.

Contraindications to the procedure are:

the intolerance of cyclopelles - preparations used for temporary paralysis of the ciliary (ciliary) muscle responsible for the accommodation;
glaucoma is a progressive disease that flows with an increase in intraocular pressure and leading to blindness;
photoFobia - the fear of bright light, manifested by increased tear;
mental disorders with inadequate patient behavior;
condition of intoxication (alcohol or narcotic drugs).

Currently, the research of refraction is carried out not only by the shadow sample, but also with the help of computer devices - refractometers. Both of these methods are objective, reliable and easily accessible to estimate the refractive ability of the optical system of the eyes.

The advantage of Skiascopia is that it can be carried out to the smallest patients who cannot be seated for the device, and the dignity of automatic refractometry is in a more accurate determination of the degree of astigmatism in humans. The advantages of refractometry can be attributed to its faster implementation in comparison with skewscopia, as well as the possibility of visometry immediately after the procedure due to the absence of a blinding effect, which has a skiascop when performing retinoscopy.

Conducting a shadow sample requires certain professional skills from an ophthalmologist, and the data that is obtained during this manipulation may have minimal errors, as well as during the examination by means of the device.

Preparation for the procedure is to carry out cycloplegia. In order to turn off the ciliated muscle, in both eyes, the atropine solution is buried in a certain age dosage twice for three days and in the morning of the fourth day. The shadow sample can be started in an hour after the last instillation. With controversial results, the atropinization is prolonged up to 7 or 10 days. Standard three-day cyclopelgia is carried out in front of the first skiascop in children, as well as in adults in difficult cases. The use of atropine has a certain disadvantage - after injection, the patient has been difficult for a long time with a short distance, such as reading.

Before skescoping, the cycloplegia is carried out - the drugs causing a temporary paralysis of the ciliary muscle responsible for accommodation in the eye

Recently, ophthalmologists are used to relax accommodations short action - solutions of scopolamine, homatropine, cyclobore, amizila or ready-made drugs - tropics, mydriacyl, cyclassic. They are buried 1 drop with an interval of 10 minutes and conduct a shadow sample after 45 minutes. Such drugs ophthalmologists are used in repeated retinoscopy procedures in children and, if necessary, disconnect accommodation in adults. Patients over 40 years old preparations for cyclopellegia are used after the mandatory measurement of eye pressure and only in those situations where it is impossible to do without them. This is due to the fact that such drugs can provoke the attack on glaucoma predisposed to glaucoma.

Classical cycloplegia is in the corpusing of the atropine solution

Cycloplegia is necessary for a full-fledged patient examination - the pupil expands, and the doctor has the ability to see not only the central region of the eye dna, but also peripheral sections.

Shadow sample is carried out in a darkened office. The surveyed sitting on the chair, from the side of which the light source is located - at the patient's ear level. Most often it is an ordinary incandescent lamp. The light should not fall on the face of someone who spend a skiascop. The ophthalmologist sit down opposite by observing the distance of 67 cm or 1 meter. For the procedure, a skiascop is needed - the device that is concave on one side and even with another round mirror with a hole in the middle and handle. The doctor takes a device in hand and directs the light reflected from the lamp to the eye being examined so that it gets through the pupil on the eye bottom.

Skiascopia is carried out with a skiascop - mirror with a hole in the middle

If the cycloplegia was previously carried out, the patient is instructed to look at the Skiascop center, while the accommodation saved - past an ophthalmologist's ear on the side of the examined eye.

The doctor then begins to slowly move the device around the vertical and horizontal axis of the handle, while the eye illumination area is shifted, the shadow (dark spot) is formed. Usually, a flat mirror side of the skiascop is used to examine, since in this case the spot is more clear and expressed, it is easier to evaluate it. Based on which direction the darkening site is moving, the ophthalmologist concludes about the nature of the patient's refraction.

When carrying out Skiascopia, the doctor may be from the patient at a distance of 1 meter or 67 cm

After determining the type of violation of vision, the doctor conducts more accurate measurements of the refracting force of the optical structure of the eyes, for which the device uses the skiascopic rules. They represent the framework between which the lenses of different optical power are fixed, only negative or only positive windows are located on each instrument.

The method of neutralizing the movement of the dark spot is applied. A ruler with the necessary lenses is given in hand to the examined, while it should be vertically not closer than 12 mm from the cornea of \u200b\u200bthe eye. The doctor sends a ray into the pupil through the lenses since the smaller diopter (0.5) and gradually, moving towards the strongest stalk, determines the one at which the dark spot disappears. Neutralization of the shade occurs when the eye is located in the very center of the focus of rays, reflected from the eye bottom.

After determining the type of refraction, the ophthalmologist is measured by the degree of myopia or hypermetropy using skiascopic lines

Instead of skiascopic lines, lenses are sometimes used with different optical power, which are inserted into a special frame. This technique requires temporary costs, but it has advantages - greater accuracy in comparison with the rules and the possibility of diagnosis during astigmatism by means of cylindrical lenses (cylindrosecopy). Before this study, the doctor can apply the hemucky, or barcopy. At the same time, special nozzles on a skiascap, having no hole, and a strip shaped slot.

If, when conducting a survey using a flat skiascop, a dark spot moves to the same side, in which the doctor turns the mirror, then this suggests that the person has emmetropy (vision in normal), hyperopia or weak myopia (when placing a doctor at a distance of one meter From the patient - 1.0 d, at a distance of 0.67 m - 1.5 d).

If the shadow slides to the side opposite to the rotation of the skiascop, this speaks about the myopia above 1.0 diopter (or above 1,5 diopter in the case of a distance of 67 cm).

If there is no movement of the dark spot during skiascopia, the doctor concludes: in the patient myopia in 1.0 d, that is, the point of the very clear vision coincides with the skiascale located at a distance of 1 meter (1.5 D with a distance of 0.67 meters).

In the direction of the movement of the shadows during the movement of the Skiascop, the doctor concludes about the nature of refraction

Blackout can move in multidirectional when complex astigmatism. This phenomenon is called the symptom of scissors and requires additional surveys.

At the second stage of retinoscopy, the doctor determines the magnitude of myopia or hypermetropy with an accuracy of 0.25 to 0.5 diopters with an accuracy of a skewscopic line. To calculate the refraction to the line of the lens on which the examination was stopped (the shadow was neutralized), add 1.0 d at myopia and take 1.0 d at hyperbating. The most correct sample results can be obtained only after turning off the accommodation.

The first examination of the ophthalmologist should be carried out in 1 month (no later than three months old). In addition to the standard examination, the doctor can determine the refraction of the body of the child using the shadow sample. For six months and per year, repeated inspections are carried out with the control of the dynamics of the refraction of the eye. At this age, the toddles are normally from +1 to +3 diopters (hypodies). The re-conducting of skiascopia is applied in view of the fact that newborns are hard to cause full-fledged relaxation of accommodation even with potent means.

Skiascopia - objective method Refraction studies in young children

Modern devices allow you to explore refraction and inspect the eye bottom with a narrow pupil. However, children early age Skiascopia is more often used, and be sure to with an extended pupil, since many pathological changes on the periphery of the eyeboard can remain out of the visibility of the doctor. Children, as a rule, in the eyes of short-acting drugs - mydriacyl (tropicid) or an atropine solution.

For cycloplegia, small children use short-acting drugs, such as Midyriacyl

Another feature of the skiascopia for the kids up to the year is to place a doctor from the patient at a distance of 67 cm, while the skiascopic rules of the oculist holds and moves himself. With four or five years, children can already determine refraction using devices and ophthalmological tables.

Despite the fact that the method of studying the refraction of the eye with the help of a skiascop was developed almost 150 years ago, it is still successfully used by ophthalmologists. The high accuracy and objectivity of the shadow sample allows you to identify violations in adults and children in time and in a timely manner to conduct an optical correction.

Skiascopia - one of the diagnostic methods used in ophthalmology to determine the status of the ability of the eye to refract light (refraction).

This procedure based on the observation of the movement of the shadowwhich is formed when light hit the patient's pupil.

Reference! Skiascopia method involves the collection and analysis of the information obtained by illuminating the patient's pupil light by the directional beam.

The light reflected from the mirror is used, when moving shadows in the pupil area are formed on the pupil.

Based on the position of such a shade, we can conclude about certain violations of refraction in the patient.

For the first time, this objective way of determining the refraction applied the French doctor by the surname Kujun back in 1873.

This method used B. modern medicine And besides skiascopia is also known as keratoscopy, retinoscopy or shadow sample.

Procedure performed with an ophthalmic device called Skiascop.

This is a mirror of a special design with a handle, which on one side has a flat, and on the other - a concave surface.

In the center of this device there is a hole to monitor the eyeball of the examined.

The beam of light into the eye of the patient is sent by the location of such a mirror at the desired angle, as a result of which the light spot is formed on the eye.

Indications for the application of this method

Skiascopia is appointed as the main or additional examination in the following situations:

due to age the patient cannot objectively and correctly describe its feelings and complaints.associated with violation of visual acuity;
a patient intentionally simulates disorders of refraction;
the patient is diagnosed intellect violationsat which he also cannot clearly describe his complaints;
available suspected by Astigmatism, myopia or hyperopia, but for various reasons other survey methods cannot be performed.

Most often, skiascopia serves as an additional method of diagnosing ophthalmic diseases, which allows you to put a more accurate diagnosis and assign optimal treatment.

Before conducting Patient procedures altopine is buried (Alternative to the drug - cyclodol).

Keep in mind! Finding into the conjunctival bag and penetrating the eyes of the eye tissues, such drugs are paralyzed by the ciliary muscle, as a result of which its mobility is limited and errors are excluded during the survey.

Before instillation of the drug, it is necessary to make sure that there is no allergies to its active ingredients, and it is also worth considering that the elderly people have such means can cause glaucoma attacks.

After the administration of the drug patient is located on a black chair, but at the level of his viewspecialist Sets the lighting device.

The ophthalmologist himself is at the same time at the distance of the meter from the patient and from its position controls the direction of light, which at a certain position of the skiascop falls through the pupil on the eye bottom (it is painted in a red shade).

Doctor moves and turns the mirror in different directions, resulting in shadows appear on the eye day, which are also moving in certain directions.

Determine Quantitative the values \u200b\u200bof refraction violations can be using inflicted on Skiascop. digital scalewhich reflects different refractive indices for different device lenses.

Important! Using for the examination, the flat surface of the mirror, the doctor moves it in different directions, and if the shadow has been formed, it will be moved just - the diagnosis of refractive disorders (astigmatism, myopia or hyperopia) is diagnosed.

But at the same time, the degree of violation of refractures is considered insignificant.

Violations are recognized as essential in terms of 1-1.5 dioptersAt the same time, the shadow will navigate not parallel to the movement of the skiascop, and in the opposite, mirror direction.

An important role in the examination plays the distance on which the mirror is relative to the eye of the patient.

If this distance is 67 centimeters - the deviation of the refraction more than one and a half diopter says the movement of the shade opposite to the movement of the skiascop.

In the case when the doctor has a skiascal at a meter from the eye of the surveyed - such an opposite movement indicates the development of myopia with a deviation from the norm by no more than one diopter.

Confirmation of the diagnosis is performed by re-conducting the procedure, but already using a concave lens surface.

You should know! In this case, the diagnosis will be confirmed if the results described above will be opposite. The complete lack of shadow testifies to normal refraction.

Contraindications to conduct

Such a procedure is contraindicated in certain states of the patient and in the presence of some ophthalmological diseases:

glaucoma or suspicion of the development of the disease;
photophobiadue to the presence of ophthalmic diseases or the natural sensitivity of the patient's organs;
alcohol or narcotic intoxication patient;
psychological diseaseswhere the risk of attacks of aggressive behavior as a result of the impact of bright light on organs of vision.

Also, the procedure is not appointed for children under the age of seven.

This video shows the procedure for holding skiascopia in detail:

With all the accuracy of the results obtained, skiascopia not used as an independent diagnostic method.

This method is used in the complex of diagnostic measures, allowing you to more accurately interpret the results obtained in other types of surveys.

What is skiascopia? - This is one of the diagnostic methods in ophthalmology, which allows you to determine the refraction - the ability of pupil to refract light.

Skiaskopia was proposed back in 1873 by scientists. In the literature, this study is found under the name of the shadow sample, retinoscopy and keratoscopy.

The undoubted advantage of the method lies in its simplicity, availability and, most importantly, the accuracy of the results.

Skiascop is a tool that is a rounded mirror with a handle. One of his face concave, and the other is flat. The Skiascop Center is equipped with a hole, through which the doctor is observed outside the test.

With this tool, the ophthalmologist sends a ray of light into the patient's pupil and watches the reflex - a light spot that is formed on the eye day. When turning the skiascop, the shadow moves and reports about certain changes in refractive.

Skiascopia makes it possible with great accuracy to determine the degree of violation of refraction. This is especially important in the following cases:

The patient deliberately simulates the disease;
Survey of young children who cannot tell about their complaints;
Patients with impaired intelligence.

Skiascopia is carried out for the diagnosis of the following diseases of the eye:

Hypermetropia (hyperophase);
Myopia (myopia);
Astigmatism.

In addition, the technique can be used to control the rate of progression of eye diseases and the effectiveness of conductive treatment.

Despite the simplicity and harmability of the method, skiascopia has a number of contraindications:

Photo jobs (increased light sensitivity);
Glaucoma or suspicion of it (the study can cause acute attack of this disease);
Skiascopia in children, contraindicated to 7 years;
State of alcohol or narcotic intoxication;
Sharp mental diseasesIn which patients may cause damage to themselves and others.

The study is carried out in a dark room.. It should have the following equipment:

Skiascop;
Electrical lamp;
A set of skiascopic lines: one with negative lenses, the other with positive.

Sometimes instead of a skiascop uses retinostacope, and instead of skiascopic lines - ordinary lensesused when selecting glasses.

Before studying the patient, the cyclopelgia is performed - the expansion of the pupil with the extraction of cyclodol or atropine. Such an event increases the accuracy of the result.

The patient seats the chair from 0.67 to 1 m from the doctor. On the left side at the level of the test, the lamp is located. The doctor with a skiascop directs a light beam to the patient's eye, which falls on the eye bottom, and then turns the mirror in different directions. The shadow is moving and allows you to judge the refraction of the eye.

If cycloplegia has been held, the patient looks at the opening of the skiascop during the study. If the pupil was not expanded, it is necessary to watch the doctor's ear.

Determination of the type of refraction

If a flat mirror is used: with hypermetropy, myopia (less than 1.0 diopthesis) and emmetropi (normal refraction) shadow on the eye day moves in the same direction as the skiascop mirror. If there is more pronounced myopia (more - 1.0 d), then the shadow moves in the direction opposite from the skiascop.

If a concave mirror is used: the result is the opposite described above.

To do this, you must apply the method of neutralizing the shadow. For this purpose, skiascopic rules or lenses are used for selection of glasses. The patient holds them at a distance of 12 mm from the cornea.

The following results are possible:

If the shadow is absent, it means that the degree of myopia is no more - 1,2.
If the degree of myopia is more than - 1.0 d, the shadow will move. Then to the eye put negative lensesstarting with the weakest. An indicator of the optical force of the lens, in which the shadow disappears, add to - 1.0 d and, thus, calculate the degree of myopia.
To determine the degree of hypermetropy, the same procedure is carried out, but already with positive lenses. To calculate the refraction, it is necessary to take away from 1.0 e of the optical glass lens indicator, in which the shadow disappears.

To clarify the degree of refraction during astigmatism, a special study is carried out, which is called cylindroscopy. From ordinary skiascopia, the study differs in the use of cylindrical lenses.

To accurately determine the degree of astigmatism, additional research methods are needed. You can learn more about them here.

We hope that from our article you have learned what skiascopia is for what it is needed and in what cases it cannot be applied if you have any questions - ask them in the comments, and our specialists will answer you in the shortest possible time.

Skiascopia is the diagnostic method for determining the refraction or the ability of pupil to the refraction of light. This research methodology was proposed by scientists back in 1873. Diagnostic research has many advantages, among which it is worth noting the simplicity, availability of the method, as well as obtaining the most accurate results.

The study of pupils or skiascopia is carried out with the help of a special device called a skiascop. It has a rounded mirror shape with a handle. One part of the mirror is concave inside, and the second is flat. In the central part, Skiascop has a hole through which the eye study is carried out.

Skiascopia is carried out by directing the flow of light into the patient's pupil, and the doctor in the meantime controls the reaction of the light spot. This stain is formed on the eye day. When a skiascop is rotated, then the shadow can move, indicating violations of refraction.

Skiascopic examination allows with the maximum accuracy to identify the degrees of refraction violations. This technique is appropriate in the following cases:

allows you to explore refraction in children if they cannot tell about the symptoms;
identify untruth information when the patient simulates when testing vision;
define refraction in people with impaired intelligence.

Skiascopia technique is carried out in a special dark room. At the same time, the following tools are required for the following tools for la in skescopical manipulations:

Skiascop.
A set of lines for a skiascop, which are equipped with negative and positive lenses.
Electric incandescent lamp.

Before conducting diagnostics, the doctor burst into the patient's patient special preparations for the expansion of pupils. This is done in order to get the most accurate results. After that, the doctor seats the patient to a regular chair and proceeds to research:

at the level of the eye on the left side there is an inclusive lamp;
with the help of a skiascop, the direction of the light beam in the patient's eye is carried out;
the beam reaches the eye bottom, after which the doctor begins to rotate the mirror in different directions.

At this point, there is a movement of the shadow, according to which the conclusions are made about eye refraction.

It's important to know! To carry out such diagnostics, it is not necessary to use a skiascap. Instead, retinostacope can be applied, and the rules are replaced by ordinary lenses.

Skiascopia does not require an obligatory expansion of pupils. The doctor when conducting skiascopia may ask the patient simply to look at his ear.

Skiascopia is an eye research procedure, so it is intended for those people who have problems with vision. Skiascopia is shown in the following ophthalmic diseases:

hyperity;
myopia;
astigmatism.

Skiascopia is also shown in cases where it is required to determine the effectiveness of the treatment carried out, as well as to determine the rate of progression of eye ailments. This method has many advantages, but despite this, there are a number of contraindications.

Contraindicated shadow refraction of eyes to persons having the following diseases and pathology:

Fear of light by which the patient is experiencing increased sensitivity To light stream.
Conduct Skiaskopy Children not earlier than from 7 years.
If the patient is influenced by alcoholic or narcotic intoxication.
With glaucoma and suspicions on it.
In the presence of sharp chronic diseasesThrough which the likelihood is not excluded that the patient can "break away" and cause harmless to themselves or others.

If a flat mirror (with farnicide, myopia and astigmatism) is used in the course of a skiascopic study), then the shadow on the eye day will move in the same direction as the mirror. Such results are due to the fact that the patient has minor degrees of the aforementioned diseases.

With bright-pronounced symptoms of myopia, when the value is more than 1-1.5 diopthesis, then the shadow will move in the opposite direction from the movement of the skiascop. Such a study allows you to quickly, and most importantly determine the refraction of the eyes.

It's important to know! The information content of the results depends on such an important factor as the distance on which the doctor is located from the patient.

If the distance is 67 cm, the movement of the spots in the opposite direction says that the patient is myopia to more than 1.5 diopters. If the doctor is located at a distance of 1 meter, and during the study there is a similar picture, this means that in a patient myopia on 1 diopter. When using a concave mirror, all the results described above will be opposite.

The norm of research results is when the stain does not move at all in the direction of the mirror. The decoding of the data obtained is not required, as often the study conducts the attending physician. In order to determine the degree of violation of refraction, the patient should take a skiascoping line on which there are lenses. He alternately needs to be applied to the eye of the lenses. The process continues until the doctor detects the lack of displacement of the eye shadows. Obtaining these results allows us to estimate the degree of violation of vision.

If it is necessary to carry out the procedure for a child skiacopy, then the study with it is allowed to attend mom. Diagnostic research of this kind is not easy accessible, but also does not require any preparation, except that alcohol cannot be used on the eve.

Samples during skiascopia is the optimal diagnostic method that makes it possible to put the correct diagnosis and assign timely treatment. Based on the results, glasses or lenses for the patient are selected.

Man's eyes - a complex systemwhich perceives electromagnetic radiation and ensuring the performance of visually function. With a decrease in the level of sight - the patient is worth visiting the doctor and to undergo diagnosis using this method as skiascopia. It is he who will determine the ability spectator nerve refract the light.

Skiascopia or shadow sample - the diagnostic method, in which the doctor conducts the lighting of the pupil, where the shadows are formed in the event of the development of pathology. It is according to how the shadows behave can be drawn about the defects of refraction.

Conduct diagnostics using a skiascop - a mirror having one flat and concave surface. In his center there is a hole - the light is refracted through it so that its angle formed on the bottom eyeball Light spot. By moving the mirror, the doctor seeks the movement of the shadow in the area under study and this determines possible disorders.

What is a skiascop

The main task of skiascopia is diagnosing on initial stages pathologies and violations of vision. It is precisely the purpose of the skiascopia that is spelled out in the testimony.

This method has such advantages:

the cost-effective method of diagnosis that does not require the use of expensive equipment, complex diagnostic techniques;
exact method that allows you to get objective and informative results, put a correct diagnosis;
the method is painless, which does not cause negative sensations, any discomfort, the optical system of the eye does not suffer.

Skiascopia method itself is simple in conducting, but the results of decrypting diagnostics depend on the doctor.

Indications and contraindications

Indications for the diagnosis of eye of the skiascopia doctors call such items:
When submitting diagnostics and diagnosis, an ophthalmologist is obliged to take into account such moments:

the ruler is placed vertically, at a distance of at least 12 mm from the top, convex point of the eyeball - only this is what the diagnostic tones are obtained.
if cyclodol is used or - the patient looks at the hole itself in the mirror. If the eye adapts to changing external conditions - the patient is watching the doctor of an ophthalmologist.
deciphering the results is directly determined by which the mirror is applied - flat or concave.

And ultimately, the shadow sample itself is carried out in a darkened room - just so you can get accurate and reliable diagnostic results.

Vision in babies is a visual basis for the development of physical, mental and emotional abilities. With the help of him, they know the new unexplored world. However, the vision itself in a newborn baby is imperfect and for the first months there are certain stages of development. And only by 6-8 months, Kroch begins to see the world Just as adults.

What sees a newborn baby can not treat his brain, hence the imperfect visual perception. Over time, along with the development of the brain, the baby appears a visual understanding and recognition of what is happening around. Each month the infant's vision is detailed, becomes clearer and long.

What is interesting, immediately the field of appearance of newborns is almost nothing to see anything.

The reason for this is the underdevelopment of the brain departments and visual structures. Eye bottom continues to grow, and the retina of the eye is formed. A child can focus on something, but still does not see clearly and volume. For the most part, it distinguishes the silhouettes and outlines of objects, the person can recognize at a distance of no more than 30 cm.
Often, only the born baby is observed by the squint, which takes place in the first days. It should not scare you. As for the color scheme, the children are best perceived black and white shades. But in the first months it will be able to see red, yellow, green and blue. And gradually all the rest.

If you compare with the vision of an adult, the baby sees much worse, about a thousand times. But this is a temporary phenomenon.

In general, the organs of vision and their functions in newborns are in constant development. This process will last an average of the six-year-old age.

Vision of the newborn, stages of development

Vision in babies is developing in accordance with age and has such steps:

first month. In this period, the crumbs often scold, it can not focus the look. There is a recognition of the mother's face, provided that it bends low above it;
second month. There is an opportunity to distinguish contrasting items, black and white colors;
third-fourth month. There is an improvement in visual capabilities. There is a perception of depth and distance. It provokes a kid to grabbing movements;
five to six months. The child is already able to distinguish between objects in motion, as well as to perceive complex shades of colors;
seven or eight months. At this age, the baby sees almost adults. A feature of this period is the final acquisition by the eyes of its color.

Skiascopia in children

The main way to verify vision in newborns is skiascopia. Skiascopia is a study of the character of the shade in pupils. It is carried out with the help of a special oblong mirror and lenses. Before the procedure to determine the exact diagnosis of the eye, the atropine is already buried for five days.

With the help of sackesopy, infants can be installed. The norm for kids is refraction
+3.0 D, +3.5 D.

Features Skescopia

Skiascopic examination allows with the maximum accuracy to identify the degrees of refraction violations. This technique is appropriate in the following cases:

allows you to explore refraction in children if they cannot tell about the symptoms;
identify untruth information when the patient simulates when testing vision;
define refraction in people with impaired intelligence.

How the study is carried out

Skiascopia technique is carried out in a special dark room. At the same time, the following tools are required for the following tools for la in skescopical manipulations:

Skiascop.
A set of lines for a skiascop, which are equipped with negative and positive lenses.
Electric incandescent lamp.

at the level of the eye on the left side there is an inclusive lamp;
with the help of a skiascop, the direction of the light beam in the patient's eye is carried out;
the beam reaches the eye bottom, after which the doctor begins to rotate the mirror in different directions.

At this point, there is a movement of the shadow, according to which the conclusions are made about eye refraction.

It's important to know! To carry out such diagnostics, it is not necessary to use a skiascap. Instead, retinostacope can be applied, and the rules are replaced by ordinary lenses.

Skiascopia does not require an obligatory expansion of pupils. The doctor when conducting skiascopia may ask the patient simply to look at his ear.

Who shows the procedure

Skiascopia is an eye research procedure, so it is intended for those people who have problems with vision. Skiascopia is shown in the following ophthalmic diseases:

hyperity;
myopia;
astigmatism.

Contraindications for research

The shadow refraction of eyes to persons having the following diseases and pathology is contraindicated:

Fear of light by which the patient experiences increased sensitivity to light flow.
Conduct Skiaskopy Children not earlier than from 7 years.
If the patient is influenced by alcoholic or narcotic intoxication.
With glaucoma and suspicions on it.
In the presence of sharp chronic diseases, through which the likelihood is not excluded that the patient can "break" and cause harm to both others.

As evidenced by the results

It's important to know! The information content of the results depends on such an important factor as the distance on which the doctor is located from the patient.

Skiascopia (retinoscopy, keratoscopy, shadow sample) - it tool method Surveys of the refractive ability of the visual apparatus (the ability of the optical system of the eye to refract the flow of light and change its direction).

Description of the method

The eye is a visual analyzer, a complex optical system, which, due to the cornea and lens, refracts the light stream. Retinoscopy allows you to define refractive ability, even if the patient simulates the disease. With its help, it is possible to identify the functionality of the visual organs in patients of the younger category, in people with a delay in development, in cases where it is impossible to conduct a visometrium or refractometry.

During keratoscopy, expensive medical appliances are not applied. But despite this, the shadow sample is a reliable way to determine the refractive ability of the visual analyzer. Only an experienced and qualified ophthalmologist with special skills should conduct the procedure.

Indications

Skiascopia is prescribed by an ophthalmologist in the presence of the following violations of the visual function:

for the first time, visual acuity decreased (there were no such disorders);
myopia is a visual anomaly, in which the object image is focused before the retina;
hypermetropia - visual pathology, in which images of distant objects focus on the retina;
astigmatism is a disorder of vision, in which the optical structure of the eye is disturbed (the irregular form of the lens or horny shell), as a result of the patient, does not clearly sees the items surrounding it.

Astigmatism is often combined with myopia and hypermetropy.

Contraindications for retinoscopy

In some cases, skiascop is prohibited:

if the patient is under the influence of drugs or alcoholic beverages;
the patient has mental illness;
with high light sensitivity of the visual analyzer;
with a constant or periodic increase in intraocular pressure (glaucoma);
with allergies on cyclopelic preparations (atropine and cyclodol);
children under 8 years old.

In other cases, it is allowed to carry out keratoscopy.

Holding

Skiascopia is an instrumental research method, which is carried out using a skiascop. This is a special device to determine the refractive ability of the eye, which looks like a mirror on a long handle, its surface on one side is smooth, and with another concave.

Retinoscopy move.

Before starting the procedure, the eye is treated with cyclopelic drugs.
The patient sits on a chair opposite the doctor, at a distance from 65 to 100 cm. Side of him, at the level of his eye there is a light source.
The ophthalmologist places a skiascap opposite the patient's eye and directs light rays on the mirror so that they penetrate through the pupil on the inner surface of the eyeball. After that, the eye dock is painted red.
Then the doctor begins to move the vertical skiacope. As a result of these movements, the illuminated zone is shifted, creating an increasingly darkened zone (it looks like a dark spot on the inner surface of the eyeball).

The doctor assesses the refractory ability of the eye in accordance with the direction of moving this dark section, it was because of this that the "shadow sample" name occurred.

The next stage of the survey is the definition of anteropy (a change in the refractive ability at which the refractive ability of the eye and the length of its axis does not correspond to each other). During research, the doctor uses a skiascopic line on which lenses with varying degrees of refraction of light are placed. The patient alternately brings the line to the right, then to the left eye until the shadow area stops moving along the inner surface of the eye.

This method of examination is not informative if there is a suspicion of astigmatism. To calculate the degree of refraction It is necessary to carry out additional studies, for this is used a special formula.

Medical conclusion

The dark plot ceases to move if the far point of clear visa coincides with the location of the doctor (that is, it is located at a distance of 1 m.).

At the same time, medical conclusions will be such.

If the dark area moves in the direction as the flat mirror, then the surveyed hypermetropium, emmetropium or myopia is about 1 DPTR.
If the dark spot moves the oppositely flat mirror, then the surveyed hypermetropium or myopia from 1 DPTR. and more.
If the doctor uses a concave mirror, then all the results are opposite to the use of direct.
If, when using both mirrors, the dark plot was missing or its movement cannot be tracked, then the surveyed myopia 1 DPTR.

So, what is skiascopia (keratoscopy)? Keratoscopy is a highly informative method for studying the refractive ability of organs of vision. This is a popular procedure, which is carried out in public and private ophthalmological clinics.

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