The eyeball is moved away from the muscle being tested; this is accomplished by grasping with a forceps the conjunctiva and episclera close to the limbus.

1. Supraduction - infraduction

 A. Resistance
  (1) Abnormal fascial or muscle attachments
  (2) Congenital fibrosis syndrome
  (3) Double elevator palsy
  (4) Orbital floor fracture
  (5) Orbital mass
  (6) Thyroid myopathy of inferior rectus muscle
 B. Unrestricted
  (1) Elevator paresis
  (2) Paresis of inferior superior rectus muscle

2. Supraduction in adduction

 A. Brown superior oblique tendon sheath syndrome-resistance (see p. 132)
 B. Paresis of inferior oblique muscle-unrestricted

3. Adduction

 A. Resistance
  (1) Chronic third nerve palsy with contracture lateral rectus
  (2) Congenital fibrosis syndrome
  (3) Duane retraction syndrome because of fibrosis of lateral rectus muscle
  (4) Orbital mass
  (5) Tight lateral rectus following excessive resection operation
  (6) Thyroid myopathy
 B. Unrestricted
  (1) Extensive medial rectus recession
  (2) Duane retraction syndrome because of central or peripheral cocontraction of medial and lateral rectus on attempted adduction

4. Abduction

 A. Resistance
  (1) Abnormal fascial or muscle attachments including strabismus fixus
  (2) Blowout fracture
  (3) Chronic sixth nerve palsy with contracture medial rectus
  (4) Myositis
  (5) Orbital mass
  (6) Thyroid myopathy
Tight medial rectus following excessive resection operation
 B. Unrestricted
  (1) Extensive lateral rectus recession
  (2) Paralysis of lateral rectus muscle

Beyer-Machule C. von Noorden OK. Atlas of ophthalmic surgery, Vol I: Lids, orbits extraocular muscles. New York: Thieme Medical, 1984.