The Reflex Image Capture Kit (RICK)

The use of photorefraction has been discussed for vision screenings for years.  Its reliability and efficacy have been debated as a stand alone screening device.  We have found that it is an extremely valuable tool in assessing infants and non-verbal patients as part of a comprehensive eye health and vision examination.

The greatest value is in answering one simple question:  How do you examine the vision of a baby who cannot talk or communicate to the doctor?  The answer is well known to eye care professionals.  We have diagnostic instruments that allow us to assess the visual capabilities of even a small baby.  The RICK allows us to share that information by examining the data that is exhibited on specific digital camera images.

A simple photo taken with a specifically designed digital camera at a 4 to 5 foot distance from an infant, child, or non-verbal patient can give us valuable clues as to eye alignment, gross refractive error (need for corrective eyeglasses), lid structure, and pupil structure.  All are risks for amblyopia (lazy eye).

Notice the image below, then look at the cropped (maginified) image directly below it.  By studying the small white dot reflecting off the pupil we can determine if the two eyes are aligned - both white dots (called Hirschberg reflex) should be slightly nasal to the center of the pupil.  The white crescents in the inferior of the pupil indicate farsightedness (hyperopia).  Pupils are equal in size, and lid structure is normal.  Parents are happy, and so is this baby!

Information on the RICK may be obtained by emailing

Instructional CDs on the use of photorefraction using the RICK camera may be obtained by ordering via email to

RICK cameras using Image Consultant software can be ordered at
Below are several vision issues that can be studied by using RICK photorefractive images:
Capturing the image is non-threatening to even the smallest of babies - done at 4 to 5 feet - as demonstrated by Dr. Moore.
High refractive error-
+5 Dioptor Hyperope
OD emmetropia
OS hyperopia
Anisocoria can be studied and documented by acquiring an image with the lightrs off (iris relaxed) and a second image with the lights on (iris constricted).  This is evidence physiological, rather than pathological anisocoria.
Documentation of ptosis of the left lid.
High Myopia (-8D myope)
Left eye esotropia with a hyper component
Oblique astigmatism

Click on the left icon to read an article about the RICK printed in the December 5, 2006 edition of the Warren Times Observer.  This article is in a pdf format.