Cranial Nerves 4: Eye movements (III, IV and VI)

Oculomotor (III), Trochlear (IV) and Abducens (VI):

Extraocular Movements
(III, IV and VI)
  1. Stand or sit 3 to 6 feet in front of the patient.
  2. Observe for abnormal eye position at rest.
  3. Ask the patient to follow your finger with their eyes without moving their head.
  4. Ask patient how many fingers they can see in each position (double vision?)
  5. Check gaze in the six cardinal directions using a cross or "H" pattern.
  6. Pause during upward and lateral gaze to check for nystagmus.
  7. Check convergence by moving your finger toward the bridge of the patient's nose. The pupil should get smaller.
  8. report any double vision or nystagmus.
 
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Eye movements
5th Cranial Nerve
Trigeminal