Examination of supranuclear eye movement disorder
The examiner should:
- sit in front of the patient
- have a good light on their eyes
- be methodical, i.e. right, left, up and down tests:
- command saccades i.e. "look right"
- fixation saccades i.e. "look from my thumb to my finger and back again as fast as you can"
- pursuit eye movements
- convergence - important to test. In intranuclear ophthalmoplegia it is usually retained, despite the adduction deficit in lateral gaze.
- Doll's head movements
- Bell's phenomenon
- optokinetic response
- caloric testing
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