Ocular motility cases
.................. 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. 

          Cover / uncover test
           
        • infantile esotropia
        • fully accommodative esotropia
        • intermittent exotropia
        • fourth nerve palsy


          • Ocular motility
           

        • myasthenia gravis
        • chronic progressive external ophthalmoplegia
        • blow out fracture
        • Brown's syndrome
        • Duane's syndrome (always consider this in patients whom you 

          • think may have sixth nerve palsy)
        • Mobius's syndrome
        • third nerve palsy
        • sixth nerve palsy
        • progressive supranuclear palsy
        • internuclear ophthalmoplegia
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