Certified Ophthalmic Medical Technologist (COMT) Practice Exam

In retinoscopy, what does the term "skew" refer to?

1. The movement of the streak reflex

2. A measurement error

3. Off-axis motion during examination

4. Alignment of visual pathways

The correct answer is: Off-axis motion during examination

In the context of retinoscopy, "skew" specifically refers to off-axis motion during the examination. During retinoscopy, the examiner observes the movement of a light streak as it is moved across the retina. If the light is not aligned properly with the optical axis of the eye, this results in a skewed reflex, which is an indication that the retinoscope is not directly in line with the visual axis. This can lead to inaccurate results in determining the refractive error because the reflex may not accurately represent the true location of the retina or the necessary correction needed. The other options do not capture the essence of "skew" in this context. Movement of the streak reflex pertains to the normal response following adjustments in the retinoscope, while a measurement error refers to any inaccuracies in reading the findings, and alignment of visual pathways relates more to the neuroanatomy and functioning of the visual system rather than the technical aspects of retinoscopy. Thus, understanding skew as off-axis motion is crucial for accurate retinoscopic assessment and measurements.