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There are patients who are unable to participate in a subjective refraction, because of limitations of understanding or communication. The very young, those with Alzheimer's disease or a learning disability may require that a prescription is arrived at purely from the objective findings.
We should have realistic expectations of retinoscopy. It has been found that there is only a 50 per cent probability that two consecutive measurements of sphere power would be within 0.40D. They found that cylinder axis was the most repeatable, followed by cylinder power, then sphere power. And, unless you are fully ambidextrous, you are likely to be better with one eye than the other. Of course, the skill of the examiner will influence both accuracy and repeatability.
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