Ace the COT Challenge 2026 – Shine Bright as a Certified Ophthalmic Technician!

The "scissors reflex" is a specific type of retinoscopic reflex that appears during the examination of patients with irregular astigmatism, which is commonly associated with conditions like keratoconus. When the beam of light is moved across the retina in such patients, the irregular curvature of the cornea leads to an abnormal and distorted reflex that may resemble the opening and closing of scissors. This phenomenon occurs when the meridians of light reflect at different rates due to the uneven corneal surface characteristic of keratoconus, thus causing this distinctive reflex pattern.

The other choices do not present the same optical irregularities. In myopia, hyperopia, and regular astigmatism, the retinoscopic reflex would typically show more straightforward reactions, such as a direct or with-the-rule/refraction reactions, rather than the more complex scissors movement noted in keratoconus. Therefore, recognizing the scissors reflex is essential for diagnosing keratoconus and differentiating it from other refractive errors.