[Assessing refraction in children with cerebral damage]

In children with brain damage or multiple disabilities ophthalmological care may involve a variety of problems if it extends beyond mere diagnosis. Above all, difficulties can occur if a patient does not tolerate a trial spectacle frame and/or trial glasses in front of his/her eyes, so that it is impossible to perform retinoscopy in the usual way. If refraction has to be measured as a prerequisite for further treatment (in cases of squint, anisometropia etc.), close range retinoscopy and other modified refraction methods may be useful. The potential and limitations of these methods are described on the basis of the patient collective of a special outpatient department for children with brain damage.