Certified Ophthalmic Assistant Practice Exam

A "with" reflex in retinoscopy is most commonly observed in which refractive error?

1. Myopia

2. Hyperopia

3. Astigmatism

4. Presbyopia

The correct answer is: Hyperopia

The "with" reflex in retinoscopy indicates that light is being focused in front of the retina, which is typically associated with hyperopia, or farsightedness. In this condition, the eye is either too short or the cornea has too little curvature, causing distant objects to be seen more clearly than near objects. When performing retinoscopy on a hyperopic eye, the light reflex will move in the same direction as the direction of the retinoscope beam, thus producing the "with" reflex. This reflex is important for practitioners to recognize, as it guides them in determining the appropriate prescription needed to correct the patient's vision. In contrast, myopia (nearsightedness) would produce a "against" reflex, and astigmatism could result in a combination of responses depending on the specific orientation of the astigmatism. Presbyopia, which is age-related vision change, does not produce a specific reflex in retinoscopy. Understanding these nuances is crucial for effective assessment and treatment of refractive errors.