CLINICAL DO'S & DON'TS: Checking for oculocephalic reflex

June 2005 
Volume 35  Number 6
Pages 24 - 24
  PDF Version Available!


  • DO

  • DON'T



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    TEST FOR THE oculocephalic reflex (doll's eye movement) to assess cranial nerves III and VI in a comatose patient. Absence of this reflex indicates severe brain stem injury from the midbrain level to the pons. The presence of this reflex verifies intact brain stem gaze centers and ocular motor nerves in a comatose patient. The reflex is suppressed in an alert patient.


    * Assess your patient's level of consciousness. Place her in a supine position with the head of her bed elevated at least 30 degrees to minimize intracranial pressure while you assess her eye movements.

    * Hold her eyelids open with the thumb and index finger of one hand so you can watch her eyes.Briskly but gently rotate her head from side to side and assess her eye movements. ...

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