Clinical Examination
See also: Eye examinationThe initial clinical examination of the extraoccular eye muscles is done by examining the movement of the globe of the eye through the six cardinal eye movements. When the eye is turned in (nasally) and horizontally, the function of the medial rectus muscle is being tested. When it is turned out (temporally) and horizontally, the function of the lateral rectus muscle is tested. When turning the eye down and out, the inferior rectus is contracting. Turning the eye up and out relies on the superior rectus. Paradoxically, turning the eye up and in uses the inferior oblique muscle, and turning it down and in uses the superior oblique.
All of these six movements can be tested by drawing a large "H" in the air with a finger or other object in front of a patient's face and having them follow the tip of the finger or object with their eyes without moving their head. Having them focus on the object as it is moved in toward their face in the midline will test convergence, or the eyes' ability to turn inward simultaneously to focus on a near object.
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