Bradycardia, nausea, and faintness occur and are dependent on trigeminal sensory stimulation evoked by pressure on or within the eyeball or from sensory impulses by stretching of ocular muscles.

1. Acute glaucoma
2. Anophthalmic socket
3. During ophthalmoscopy examination of premature infants
4. Exaggerated in epidemic encephalitis
5. Intermittent exophthalmos due to congenital venous malformations of the orbit
6. Intraocular injections
7. Orbital hematoma
*8. Pressure on globe
9. Retinal detachment operation
10. Severe injury to eye or orbit
*11. Traction on extraocular muscles including levator palpebrae superioris

Arnold RW, et al. Lack of global vagal propensity in patients with oculocardiac reflex. Ophthalmology 1994; 101: 1347-1352.

Clarke WN, et al. The oculocardiac reflex during ophthalmoscopy in premature infants. Am J Ophthalmol 1985; 99:649-651.

Ginsburg RN, et al. Oculocardiac reflex in the anophthalmic socket. Ophthalmic Surg 1992; 23:135-137.

Walsh FB, Hoyt WF. Clinical neuro-ophthalmology, 4th ed. Baltimore: Williams & Wilkins, 1985.