How is radical retinoscopy performed?

• A. At working distance
• B. Farther than working distance
• C. Twice the working distance
• D. Closer than working distance

Answer: (D)

The key idea is that where you hold the retinoscope relative to the eye changes what refractive errors you’re seeing and how the reflex moves. In radical retinoscopy, you position the retinoscope closer to the eye than the standard working distance. That closer position magnifies the retinal reflex and makes subtle refractive errors and astigmatic components easier to detect, while also helping you observe the reflex with less influence from small accommodative fluctuations. Once you’ve neutralized the reflex at this shorter distance, you account for the distance difference when reporting the final refractive result.