Hold your hands to the side half way between you and the patient. Wiggle the fingers on one hand. Repeat two or three times to test both temporal fields. If an abnormality is suspected, test the four quadrants of each eye while asking the patient to cover the opposite eye with a card. The corneal reflections should be centered over the pupils.
Asymmetry suggests extraocular muscle pathology.
Extraocular Movement Stand or sit 3 to 6 feet in front of the patient. Ask the patient to follow your finger with their eyes without moving their head. Check convergence by moving your finger toward the bridge of the patient's nose. Pupillary Reactions Light Dim the room lights as necessary. Ask the patient to look into the distance.