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</div><div><span>Extraocular muscle function testing</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Extraocular muscle function testing</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Extraocular muscle function testing examines the function of the eye muscles. A health care provider observes the movement of the eyes in eight specific directions.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>How the Test is Performed</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>You are asked to sit or stand with your head up and looking straight ahead. Your provider will hold a pen or other object about 16 inches or 40 centimeters (cm) in front of your face. The provider will then move the object in several directions and ask you to follow it with your eyes, without moving your head. </p><p>A test called a cover/uncover test may also be done. You will look at a distant object and the person doing the test will cover one eye, then after a few seconds, uncover it. You will be asked to keep looking at the distant object. How the eye moves after it is uncovered may show problems. Then the test is performed with the other eye.</p><p>A similar test called an alternate cover test may also be done. You will look at the same distant object and the person doing the test will cover one eye, and after a couple of seconds, shift the cover to the other eye. Then after a couple more seconds, shift it back to the first eye, and so on for 3 to 4 cycles. You will keep looking at the same object no matter which eye is covered.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>How to Prepare for the Test</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>No special preparation is necessary for this test.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>How the Test will Feel</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>The test involves only normal movement of the eyes.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Why the Test is Performed</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>This test is performed to evaluate weakness or other problems in the extraocular muscles. These problems may result in double vision or <a test="test" href="./003037.htm">rapid, uncontrolled eye movements</a>.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Normal Results</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Normal movement of the eyes in all directions.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>What Abnormal Results Mean</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Eye movement disorders may be due to abnormalities of the muscles themselves. They may also be due to problems with the nerves that connect to these muscles or in the sections of the brain that control these muscles. Your provider will talk to you about any abnormalities that may be found.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Risks</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>There are no risks associated with this test.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Considerations</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>You may have a small amount of uncontrolled eye movement (<a test="test" href="./003037.htm">nystagmus</a>) when looking to an extreme left or right position. This is normal.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>EOM; Extraocular movement; Ocular motility examination</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div name="Images" class="section-body" id="section-tnails"><ul class="img-grid group">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1094t.jpg" alt="Eye" title="Eye" class="side-img"/><a href="../imagepages/1094.htm">Eye</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/9310t.jpg" alt="Eye muscle test" title="Eye muscle test" class="side-img"/><a href="../imagepages/9310.htm">Eye muscle test</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Cioffi GA, LIebmann JM. Diseases of the visual system. In: Goldman L, Schafer AI, eds. <em>Goldman-Cecil Medicine</em>. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 395.</p><p>Demer JL. Anatomy and physiology of the extraocular muscles and surrounding tissues. In: Yanoff M, Duker JS, eds. <em>Ophthalmology</em>. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 11.1.</p><p>Forrester JV, Dick AD, McMenamin PG, Roberts F, Pearlman E, Physiology of vision and the visual system. In: Forrester JV, Dick AD, McMenamin PG, Roberts F, Pearlman E, eds. <em>The Eye</em>. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 5.</p><p>Shuey NH. Ocular myasthenia gravis: a review and practical guide for clinicians. <em>Clin Exp Optom</em>. 2022;105(2):205-213. PMID: 35157811 <a href="https://pubmed.ncbi.nlm.nih.gov/35157811/" target="_blank">pubmed.ncbi.nlm.nih.gov/35157811/</a>.</p><p>Wallace DK, Morse CL, Melia M, et al. Pediatric eye evaluations preferred practice pattern: I. vision screening in the primary care and community setting; II. Comprehensive ophthalmic examination. <em>Ophthalmology</em>. 2018;125(1):P184-P227. PMID: 29108745 <a href="https://pubmed.ncbi.nlm.nih.gov/29108745/" target="_blank">pubmed.ncbi.nlm.nih.gov/29108745/</a>.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 2/12/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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