Certified Ophthalmic Technician (COT) Test 2025 – 400 Free Practice Questions to Pass the Exam

A "with" reflex during retinoscopy at a distance of 66 cm indicates that the light reflex is moving in the same direction as the retinoscope's light beam, which typically suggests the presence of hyperopia, or farsightedness. In hyperopia, the image of distant objects is focused behind the retina when the eye is at rest, leading to a reflex that moves "with" the light as the observer moves the retinoscope light beam.

Retinoscopy assesses the refractive status of the eye by measuring the reflex of light as it is projected into the eye. The observation of a "with" reflex is significant as it suggests that the eye may need plus (convex) lenses to bring the image forward onto the retina to achieve clear vision, further corroborating the presence of hyperopia.

In contrast, conditions like myopia and astigmatism exhibit reflexes that may move "against" the light in specific contexts, while emmetropia would show a neutral reflex, meaning no lens adjustment is necessary. Thus, the identification of a "with" reflex is directly associated with hyperopia, making it the correct answer.