MedSchool: Ace Your OSCEsThe Medical Company
GET - On the App Store

Limitation of Extraocular Movement

August 18th, 2017


  • How to Perform

  • Ask the patient to follow your finger with their eyes, without moving their head. Move the testing finger in a modified H pattern - up and down to the left, right and centrally.
  • Causes of Limited Ocular Movement

  • Upper motor neuron lesion - trauma, tumour, ischaemia, haemorrhage, demyelination
  • Lower motor neuron lesion - oculomotor (III), trochlear (IV) or abducens (VI) nerve palsy
  • Neuromuscular disorder - myaesthenia gravis
  • Myopathy - e.g. muscular dystrophies
  • Interpretation

  • Oculomotor nerve (III) lesion - eye deviated downward and outward, with ptosis and loss of pupillary reflexes
  • Trochlear nerve (IV) lesion - eye turned upward, with vertical diplopia and inability to look down and in
  • Abducens nerve (VI) lesion - eye turned inward (strabismus), with horizontal diplopia and inability to look laterally

Muscles Involved in Eye Movement

  • Muscles Involved in Eye Movement
  • Muscles

  • Occulomotor Nerve (III)

  • SR 
    Superior rectus - intorsion and elevation
  • IR 
    Inferior Rectus - abduction and depression
  • MR 
    Medial rectus - adduction
  • IO 
    Inferior oblique - extorsion, abduction and elevation
  • Trochlear Nerve (IV)

  • SO 
    Superior oblique - intorsion, abduction and depression
  • Abducens Nerve (VI)

  • LR 
    Lateral rectus - abduction
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge
Sign Up Now

Snapshot: Initialising...