How to examine eye movements
Nov 17, 2025
Source: Cainiu Health
Dr. Wang Shuai
Introduction
To examine eye movements, one can generally use methods such as observing fixation on a moving target, assessing bilateral synchrony, performing horizontal movement tests, conducting vertical movement tests, and evaluating rotational movements. Use a pen tip or finger as the target, held approximately 30 cm from the eyes. Slowly move the target up, down, left, and right while the patient follows it with their eyes. Observe whether the eye movements are smooth and check for any hesitancy, restriction, or pain.
Examination of eye movement can generally be performed by observing fixation on a moving target, assessing binocular synchrony, conducting horizontal movement tests, performing vertical movement tests, and evaluating rotational movements. Specific procedures are as follows:
1. Fixation on a moving target: Use a pen tip or finger as the target, held approximately 30 cm from the eye. Slowly move the target up, down, left, and right while the patient follows it with their eyes. Observe whether eye movements are smooth and note any hesitation, restriction, or pain.
2. Assessing binocular synchrony: Keep the head still and slowly move the target. Check whether both eyes move simultaneously and in the same direction. Asymmetry in speed or limitation in one eye may indicate coordination problems.
3. Horizontal movement test: Slowly move the target from the center forward position to the farthest left point the eye can follow; record the range. Repeat to the right side and compare the amplitudes bilaterally to assess flexibility of horizontal eye movement.
4. Vertical movement test: Slowly move the target upward from the central position until the eye can no longer elevate, observing the range. Then move it downward to evaluate whether upward and downward movements are smooth and identify any difficulty or discomfort.
5. Rotational movement test: Move the target slowly in clockwise and counterclockwise circular paths around the central visual axis while the patient follows with their eyes. Observe whether tracking is steady and check for jerking, deviation, or soreness.
If significant restriction or incoordination of eye movement is detected during examination, especially when accompanied by pain or double vision, prompt evaluation by an ophthalmologist is recommended to rule out abnormalities in ocular muscles or nerves.
