Subjective Refraction and Prescribing Glasses

Richard J. Kolker, MD is an Assistant Professor of Ophthalmology at the Wilmer Eye Institute of Johns Hopkins Hospital. Dr. Kolker has taught refraction at the American Academy of Ophthalmology and the Joint Commission of Allied Health Personnel in Ophthalmology Annual Meetings. His awards include the Wilmer Resident Teaching Award, the Wilmer Medical Student Teaching Award (three-time recipient), the Johns Hopkins School of Nursing Nurse Practitioner Program Best Course of Year Award (two-time recipient), and the University of Maryland School of Nursing Nurse Practitioner Program Best Course of Year Award. Dr. Kolker’s hobbies include teaching refraction, tennis (former Maryland State Champion and member of the University of Pennsylvania tennis team), oldies music, studying religion, singing, theater, and travel. He lives in Baltimore, Maryland with his wife and cocker spaniel. They have four children. Andrew F. Kolker, MD is a comprehensive ophthalmologist who practices in Clinton, Maryland. He received his undergraduate degree from University of Pennsylvania, where he graduated summa cum laude with a BA in English. He completed his post-baccalaureate pre-medical training at Johns Hopkins University and received his medical degree from Sackler School of Medicine in Tel Aviv, Israel. He completed his internship at Maryland General Hospital and his ophthalmology residency at The George Washington University. In his free time, Dr. Kolker enjoys creative writing, listening to music, and playing drums and guitar. Tennis is also a passion of his and, as an undergraduate, he was a 4-year varsity tennis letter winner and was co-captain of the team during his senior year. Following college, Dr. Kolker played tennis professionally, earning a world ranking in singles and doubles. He lives with his wife, Grace, in Washington, DC.

Dedication Acknowledgments About the AuthorsPreface Foreword by David L. Guyton, MDIntroduction Chapter 1 Practical OpticsGoal of RefractionSix Principles of RefractionSnellen Visual AcuitySpherical Refractive ErrorsAstigmatismPresbyopiaFour Points About Correcting Presbyopia With an AddBifocalsReading GlassesTrifocalsProgressive Addition LensesComputer GlassesTwo Formulas: Spherical Equivalent and Plus-Minus Cylinder ConversionPinhole Chapter 2 Subjective Refraction and Lens PrescriptionThe PhoropterFeatures of the PhoropterPositioning the PatientThe Three Types of RefractionThe Four Steps of Subjective RefractionThe Adjustment Within Step 3Instructing the PatientNo ConversationManaging PausesWhen Straddling the AxisOver-MinusingEncouragementThree Patient ConcernsSixteen Tips for Accurate Subjective Refraction ResultsBefore Writing a Glasses PrescriptionShow and Compare What You Plan to Give—Always!Trial RunAdditional Factors to Consider Prior to Making a Prescription ChangeNew PresbyopeTwo MythsSpecial SituationsFinal ConsiderationsSubjective Refraction Over Current Lenses (Spherical Over-Refraction)Near VisionUsing the Trial FrameRefraction Reminders Chapter 3 Case StudiesMyopiaHyperopiaAstigmatismPresbyopiaPresbyopia CorrectionRefractionSpecial Considerations When Prescribing GlassesAppendix How to Use the Manual Lensometer: Plus Cylinder MethodHow to Use the Manual Lensometer: Minus Cylinder MethodRetinoscopy Primer: Plus Cylinder MethodRetinoscopy Primer: Minus Cylinder Method Index