Results 1 to 14 of 14

Thread: Cyclo refraction coming tomorrow - HELP

  1. #1
    OptiBoard Apprentice
    Join Date
    Dec 2006
    Location
    England
    Occupation
    Optometrist
    Posts
    19

    Cyclo refraction coming tomorrow - HELP

    Thankyou for the appology Fezz; very gracious of you. Applogy accepted.

    My question (that I'm not going to repeat) did make me sound inexperienced but I am full of experience.

    Any way, I know I was doing the right thing by the kid with the cyclo. In the end I decided to refer kid to a medic. I fully informed parent of my reasons for what I was doing as I went along and why this refraction had baffled me so.
    I did not pretend infront of the parents that was a super-confident Hero NOR did I make them feel uncomfortable by acting as if I did not know what I was doing.
    Last edited by Hero; 12-28-2006 at 05:20 PM.

  2. #2
    Master OptiBoarder
    Join Date
    Oct 2004
    Location
    Down in a hole!
    Occupation
    Dispensing Optician
    Posts
    13,078

    Oh My!!!!

    I would suggest referring this patient to someone who knows what they are doing!

  3. #3
    OptiBoard Apprentice
    Join Date
    Dec 2006
    Location
    England
    Occupation
    Optometrist
    Posts
    19
    Quote Originally Posted by Fezz View Post
    I would suggest referring this patient to someone who knows what they are doing!
    NOT VERY FUNNY OK:p

  4. #4
    Master OptiBoarder
    Join Date
    Jan 2005
    Location
    Back in NYC.....Shenzhen, China and Hong Kong
    Occupation
    Other Optical Manufacturer or Vendor
    Posts
    1,155
    I never was satisfied with the information from a cyclo refraction. If you scope the child without cyclo you will see the plus even if it does not come out in the subjective refraction. Also, if you over plus the child based upon the cyclo refraction it creates other problems for the child. If the reason for doing this is to confirm an accomodative esotrope, placing plus in front of the eye will give you that information anyway.

  5. #5
    Master OptiBoarder
    Join Date
    Oct 2005
    Location
    new york
    Occupation
    Optometrist
    Posts
    3,749
    Quote Originally Posted by Fezz View Post
    I would suggest referring this patient to someone who knows what they are doing!
    You could say the same thing to all the opticians on this board who ask for help in measuring seg heights, adjusting adds for working distance, and the like.

    Let's make fun of people who ask for help or want to start up a conversation. It'll do wonders for the exchange of ideas.

    I think an apology to Hero is in order.
    Last edited by fjpod; 12-27-2006 at 08:51 PM.

  6. #6
    Master OptiBoarder
    Join Date
    Oct 2004
    Location
    Down in a hole!
    Occupation
    Dispensing Optician
    Posts
    13,078
    Quote Originally Posted by fjpod View Post
    I think an apology to Hero is in order.

    fjpod,

    I fully apologize to Hero and did not mean to be so abrupt. Sorry if it was taken that way. I felt that maybe this situation may be better served by someone more familiar with pediatric eyecare. If I have stepped out of line, by all means....I am sorry. I just know that I would feel mighty uncomfortable if this was my child, wouldn't you? Honestly?


    I applaud your efforts in pointing out my rudeness.
    Oddly, you found it appropriate to chastise me and not help the original poster with the questions at hand.
    But then, as usual, any time an OD can put down an optician, they do. Too bad the original question is not there, because, I would suggest a re-read and maybe a helpful tip, pointer, advice, or conversation starter on your part.
    Last edited by Fezz; 12-27-2006 at 09:49 PM.

  7. #7
    Master OptiBoarder
    Join Date
    Oct 2005
    Location
    new york
    Occupation
    Optometrist
    Posts
    3,749
    Quote Originally Posted by Fezz View Post
    fjpod,

    I fully apologize to Hero and did not mean to be so abrupt. Sorry if it was taken that way. I felt that maybe this situation may be better served by someone more familiar with pediatric eyecare. If I have stepped out of line, by all means....I am sorry. I just know that I would feel mighty uncomfortable if this was my child, wouldn't you? Honestly?


    I applaud your efforts in pointing out my rudeness.
    Oddly, you found it appropriate to chastise me and not help the original poster with the questions at hand.
    But then, as usual, any time an OD can put down an optician, they do.
    Maybe you should re-read the original question.
    Not that I want to turn this into a spitting contest, but I think it was you who did the put down in this thread. You would never have said what you said if the poster was an optician. You didn't attempt to answer his question either. Don't try to transfer the blame to me.

    I would also feel uncomfortable, filling my child's bifocal Rx for esotropia with an optician who had little experience in doing so, and that doesn't stop it from being done every day...but that wasn't the question of the thread, and neither was your response an appropriate answer.

    Hero, while I know some people swear by performing cyclo refractions, I have never done one that told me something I didn't know already. That being said, I do them occasionally, but they rarely change my Rx. It's mostly a check on your retinoscopy.

  8. #8
    OptiWizard
    Join Date
    Sep 2000
    Location
    plymouth, MA, USA
    Occupation
    Optometrist
    Posts
    1,036
    Hero,

    What is your concern about the cyclo?

    Are you uncomfortable trying to get drops in the little darlings eyes?

    Or are you uncomfortable with what to do with the cyclo numbers?

    I disagree with fjpod about the uselfulness of the cyclo. About once a month i have a kid with no history of problems and dry refracts at +0.50. Things don't seem quite right, so I drop him, then the cyclo shows a +4.00.

    And then the Mom decides to tell me the kid is way behind in reading.

    Moral: Parents are hesitant to tell you their kid is not performing in school, they will tell you the blackboard is blurry when they are nearsighted, but not that they are having comprehension issues which screams hyperopia and the need for plus/cyclo.


    Harry

  9. #9
    Master OptiBoarder
    Join Date
    Oct 2005
    Location
    new york
    Occupation
    Optometrist
    Posts
    3,749
    But Harry, in these cases doesn't your static or MEM show more plus than the dry manifest?...telling you that more plus exists?

    If my static shows +2, and my dry manifest is +.50, (which happens) I know the actual amount of plus is greater than 2. Even if it is +4, I am not likely to Rx it all at once.

    I'm not trying to be arguementative, here, just trying to lay out some reasoning for Hero to consider when evaluating a child with cycloplegia.

  10. #10
    Master OptiBoarder
    Join Date
    Jan 2005
    Location
    Back in NYC.....Shenzhen, China and Hong Kong
    Occupation
    Other Optical Manufacturer or Vendor
    Posts
    1,155
    Quote Originally Posted by fjpod View Post
    But Harry, in these cases doesn't your static or MEM show more plus than the dry manifest?...telling you that more plus exists?
    If my static shows +2, and my dry manifest is +.50, (which happens) I know the actual amount of plus is greater than 2. Even if it is +4, I am not likely to Rx it all at once.
    I'm not trying to be arguementative, here, just trying to lay out some reasoning for Hero to consider when evaluating a child with cycloplegia.
    We are of the same school, this is why I rarely used cyclo and resorted to it if I had an uncooperative or severely handicapped person.

    Addionally, if you scope alot of plus, you can let the patient sit for a few minutes looking at the chart and watch the chart become clearer. You can then keep teasing out more plus. As fjpod pointed out, it will not direct you on how much plus to prescribe but tell you where they will be heading over time and what subjective symptoms they can expect.

  11. #11
    OptiBoard Apprentice
    Join Date
    Dec 2006
    Location
    England
    Occupation
    Optometrist
    Posts
    19
    Apology accepted Fezz

  12. #12
    OptiWizard
    Join Date
    Sep 2000
    Location
    plymouth, MA, USA
    Occupation
    Optometrist
    Posts
    1,036
    fjpod and china doc,

    I'm very big on retinoscopy, went to SUNY (I suspect you both did also, looking at your posts) back when we all trained on spot retinoscopes, and still always do retinoscopy as my first step in refraction.

    It's usually the retinoscopy that tells me something is off and I would like a better endpoint with cyclo. But I have had a few kids that were +0.50 on dry retinoscopy then later when to +4.00 wet.

    I use cyclo sparingly, not routinely.

    Harry

  13. #13
    Master OptiBoarder
    Join Date
    Jan 2005
    Location
    Back in NYC.....Shenzhen, China and Hong Kong
    Occupation
    Other Optical Manufacturer or Vendor
    Posts
    1,155
    Quote Originally Posted by harry888 View Post
    fjpod and china doc, I'm very big on retinoscopy, went to SUNY (I suspect you both did also, looking at your posts) back when we all trained on spot retinoscopes, and still always do retinoscopy as my first step in refraction. It's usually the retinoscopy that tells me something is off and I would like a better endpoint with cyclo. But I have had a few kids that were +0.50 on dry retinoscopy then later when to +4.00 wet. I use cyclo sparingly, not routinely.Harry
    Yes, we SUNY people can recognize one another. Many of my classmates were switching to streak but I never made the switch. Spot always gave me alot more info.

  14. #14
    Master OptiBoarder
    Join Date
    Oct 2005
    Location
    new york
    Occupation
    Optometrist
    Posts
    3,749
    Actually, Doc and Harry, I went to PCO, class of '78. Learned on a streak, but tried spot after graduation. I've switched to it and have never gone back. It's faster, and I think, easier to find the proper axis with spot.

    Hero, I use various intresting colored targets at distance, or have a parent stand in front of the eye chart and make silly faces to get the childs attention. You only need a fleeting few seconds to get in the ballpark.

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. Who's coming to VEW?
    By karen in forum Just Conversation
    Replies: 0
    Last Post: 08-24-2006, 05:38 PM
  2. Vote Pn Luxottica Takover Tomorrow.............
    By Chris Ryser in forum General Optics and Eyecare Discussion Forum
    Replies: 0
    Last Post: 07-21-2004, 02:52 AM
  3. NEW! www.ibuyframes.com Coming 5-17-02!
    By Cheryl Iaquinta in forum Optical Marketplace
    Replies: 2
    Last Post: 05-10-2002, 04:17 PM
  4. The Brit(ish) Are Coming! The Brit(ish) Are Coming!
    By Pete Hanlin in forum Just Conversation
    Replies: 15
    Last Post: 08-15-2001, 09:21 PM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •