We want to see if the eyes have the ability to move completely to each side – horizontal gaze, and up and down – vertical gaze. What we are looking for here is baring of the sclera. The sclera is the white part of the eye. And when we look to the left, we want to see that the eyeballs to the left have no sclera, that the brown part or blue part or green part – the iris – is all the way over, you don’t see white in that side; then you go, same thing to this side and then up and then down. So, let’s test this.
-“Now, look at my finger, please.”
Now, the first thing I am doing is checking primary gaze. Primary gaze is just his direct forward gaze. I want to see if the eyes have any abnormal movements such as nystagmus or any other movements.
-“Okay, look at my finger.”
It looks normal. Now, I like to put my finger of his chin so he doesn’t move his head, and I say:
-“Sir, move your eyeballs, not your head, and just follow my finger as I move it.”
He is baring the sclera on the left side, he is baring the sclera on the right side.
-“Look up, all the way up. Well. And then look down.”
And as he looks down I like to lift up the eyelids, because that way I can see the eyes better, because if he looks down, his eyelids are going to cover his eyes.