The ocular motility cases will include cover/uncover tests. As a general
rule, if you were given a child the probability of a concomitant squint
is higher than in an adult. If you were asked to perform cover/uncover
test, remember that you need to do it with the patient fixating at distance,
6 metres and near (this is laborious and most examiners would make do with
6 metres and near fixation). Also remember that the test also involve alternating
cover test. Do not just look for the presence of tropia, also look for
the presence of latent nystagmus or dissociated vertical deviation in the
occluded eye.
In the examination of ocular motility, do not forget to test for saccade
and convergence as part of the examination. Myasthenia gravis can mimick
many ocular motility problems and may itself produce unusual eye movements,
do not forget to consider it in your differential diagnosis.
Ocular motility
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