Philadelphia, Nov. 6, 1902.
To the Editor:
—In reference to the courteous note of Dr. Hale I would say that in my opinion:
The best method of retinoscopy, when carried out by the most expert, is not trustworthy when subjective methods are possible with intelligent people.
No method of retinoscopy is accurate, not even the best one, except under cycloplegia. The Germans do not use cycloplegia.
The only use of retinoscopy advocated in my paper was for children. The Germans do not refract little children of from 2 to 6 years of age.
The great value of refraction is to diagnose and correct astigmatism. The Germans do not diagnose, correct or care for astigmatism, at least in those minor degrees, which produce the greatest eyestrain.
The method of retinoscopy used by the Germans is the old-fashioned one of Cuignet, which is utterly inaccurate and untrustworthy. The new method of Thorington,