Extraocular muscles The examiner guides the patient to look in 8 directions (up, up and right, right, down and right, down, down and left, left, left and up) with a moving finger, penlight, or transillumination light, observing for gaze deviation, limitation of movement, disconjugate gaze, or a combination consistent with cranial nerve palsy, orbital disease, or other abnormalities that restrict movement.