Athletic Training & Sports Medicine Center

 

Examination Links:

 

Cranial Nerve Assessment: III. Oculomotor

Examination type Neurological
Patient & Body Segment Positioning Patient needs to be in a comfortable position, either sitting or standing
Examiner Position The examiner needs to be anterior to (in front of) the patient
Performing the Test

Pen light test:  Have the patient close their eyes. Next use your fingers to open one eye lid and shine the light into that eye.  You should see a constriction of the pupil.  Be sure to the test the contralateral eye. It helps to have the lights dim to see the reaction. Make sure both pupils are the same size  and are receiving the same amount of light.  Unequal constriction is strong evidence for increased intracranial pressure.

Tissues Being Tested Cranial nerve III. Oculomotor nerve; Ventral midbrain of the superior orbital fissure
Positive Test Unequal reaction bilaterally; no constriction of pupil(s) when light is present
Interpretation Intracranial involvement
Common errors in performing exam Not testing both eyes for equal constriction
Factors possibly resulting in misinterpretation Make sure that the athlete understands what you are doing when performing the test
Related tests Consensual light reflex test:  Have the patient look at a fixed object with both eyes open. Use a pen light to test the constriction of the pupil in each eye individually.  Compare size bilaterally.
References Booher M. James. Athletic Injury Assessment. 4th edition. McGraw Higher Education 2000
Links:

http://www.richmondeye.com/apd.asp

MOUSE OVER PICTURE TO VIEW MOVIE  

(Push the "Back" Button on your browser to return to this page)