Ocular motility(movements)test

Ocular motility(movements)test:

Aim: to test the ocular motility & the actions of extra ocular muscles

Methods:

a)-Following movements(center in area 18): Binocular(test conjugate movements=versions of both eyes together) then uni-ocular(test ductions of each eye separately)

b)-Order(command)movements (center in area 8)

Steps:

a)-Following movements:

1)-Place your finger (or pen) 30-50 cm in front of the patient

2)-Ask him to follow the movements of your finger

3)-Move your finger in 6 cardinal positions:

i)-Binocular

*Start from 1ry positionàUp & right then return to 1ry position then,

*Start from 1ry positionàdirectly to the right then return to 1ry position then,

*Start from 1ry positionàdown & right then return to 1ry position then,

*Start from 1ry positionàUp & left then return to 1ry position then,

*Start from 1ry positionàdirectly to the left then return to 1ry position

*Start from 1ry positionàdown & left then return to 1ry position .

ii)-Uni-ocular

*Start from 1ry positionàUp & out then return to 1ry position then,

*Start from 1ry positionàdirectly out then return to 1ry position then,

*Start from 1ry positionàdown & out then return to 1ry position then,

*Start from 1ry positionàUp & in then return to 1ry position then,

*Start from 1ry positionàdirectly in then return to 1ry position then,

*Start from 1ry positionàdown & in then return to 1ry position .

b)-Order(command)movements:

1)-Place your finger (or pen) 30-50 cm in front of the patient

2)-Order him to move his eyes in 6 cardinal position (No movement of the examiner's hand at all)

Results:

Regarding Following movements:

*There is normal ocular motility in all directions (bi- & uni-)

*There is limitation of ocular motility (e.g. up & out or down ) uniocularlyàmeans (paralytic squint)or binocularly(e.g. up & right)àmeans loss of conjugate movement.

Regarding order movements:

*There is normal ocular motility in all directions or

*There is loss of ocular motility up & out or down & out etc..

Oral questions:

*How to test for S.R action or I.O action or….

*Extra-ocular muscles(actions,nerve supply,cardinal position…)

*Limitation of ocular motility lost in paralytic squint intact in concomitant squint