Facing the patient, hold an object such as a pencil about 24 to 36 inches away from the patient. Instruct the patient to focus on the object and then slowly move the object closer to the patient at a steady rate, stopping 1 to 2 inches away from the patient's nose. The patient should demonstrate symmetrical convergence until the eyes symmetrically break away from the object. Document normal or abnormal responses.

Special Instructions and Considerations

• Let the adult patient know that the pencil may get blurry
• Pupillary constriction is observed with convergence
• The breaking away point should be 5 inches or less
• Note if one eye breaks away sooner, smoothness, etc.