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Psychiatry (Edgmont). 2009 Nov;6(11):34-9.

Cranial Nerves III, IV, and VI: Oculomotor Function.

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  • 1Dr. Sanders is Associate Professor, Departments of Psychiatry and Neurology, Boonshoft School of Medicine, Wright State University, and Ohio VA Medical Center, Dayton, Ohio.

Abstract

Motor activity affecting the direction of gaze, the position of the eyelids, and the size of the pupils are served by cranial nerves III, IV, and VI. Unusual oculomotor activity is often encountered in psychiatric patients and can be quite informative. Evaluation techniques include casual observation and simple tests that require no equipment in addition to the sophisticated methods used in specialty clinics and research labs. This article reviews pupil size, extraocular movements, nystagmus, lid retraction, lid lag, and ptosis. Beyond screening for diseases and localizing lesions, these tests yield useful information about the individual's higher cortical function, extrapyramidal motor functioning, and toxic/pharmacologic state.

KEYWORDS:

abducens nerve; cranial nerve III; cranial nerve IV; cranial nerve VI; examination of the visual system; extraocular movements; eye movements; nystagmus; oculomotor; oculomotor nerve; psychiatry and neurology; pupil; trochlear nerve

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