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 |
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