Ocular balance and ductions

Binocular patients should be examined for latent or manifest ocular deviations and the approximate extent of uniocular ductions in the four cardinal positions estimated.

A forced duction (traction) test under topical anaesthesia will assist differentiation of neurological from mechanical causes of restricted eye movements. Likewise, retraction of the globe during an active duction suggests fibrosis of the ipsilateral antagonist muscle, this being a common sign with chronic orbital myositis.

(a)

Figure 10.2 Periocular dermoids: (a) typical lesion in the supero-temporal quadrant; (b) the superomedial dermoid has a differential diagnosis of anterior encephalocoele.

Figure 10.2 Periocular dermoids: (a) typical lesion in the supero-temporal quadrant; (b) the superomedial dermoid has a differential diagnosis of anterior encephalocoele.

Conjunctival "salmon patch" lesion of

Figure 10.3 lymphoma.

Conjunctival "salmon patch" lesion of

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