Extraocular motility testing evaluates how well the eyes move in different directions to assess the function of the extraocular muscles and their nerve supply. It helps identify misalignments and movement limitations.
Method
The examiner asks the patient to follow a target through the six cardinal positions of gaze and additional diagonals while observing eye movements. Cover tests and prism measurements may be added to quantify deviations.
- Checks for full range of movement and smooth pursuit
- Detects overactions, underactions, or restrictions
- Can reveal incomitant deviations that vary with gaze direction
- May be combined with diplopia charts to map double vision
Clinical Use
Motility testing is crucial in diagnosing strabismus, cranial nerve palsies, restrictive disorders, and orbital disease. It guides management plans including prisms, surgery, or observation.
- Findings help differentiate neurogenic from mechanical causes
- Serial examinations track recovery or progression
- Important in pre- and post-operative assessment for strabismus and orbital surgery
- Results are interpreted with history, imaging, and systemic evaluation
