What is the primary clinical use of Bell retinoscopy?

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Bell retinoscopy is a near-vision refraction technique used to assess accommodative function by estimating how much plus is needed at a near working distance to place the eye’s reflex in a neutral state. By presenting a near target and slowly adding plus lenses until the retinoscopic reflex neutralizes, you measure the amount of plus that relaxes the eye’s accommodation to a normal level for that age. If the required plus falls within the expected range for the patient’s age, accommodation is considered adequate; if it’s greater, accommodative insufficiency or limited amplitude may be present. This focus on near accommodative ability is why it’s particularly helpful in pediatric assessments and in detecting accommodative problems. It’s not a test for pupil size, color vision, or broad refractive error—the latter is typically assessed with standard distance retinoscopy and subjective refraction.