What are DOLL EYES?

Good point Sharann - suspicion of c-spine injury always goes hand in hand with head injury. Even Hickey (the long time bible of neuro nursing) states that doll's eye reflex should be performed by a medical practitioner.

wow as a new grad i had my first dolls eyes last week......
turn the pateints head and the eyes don't move opposite.
The doc was with me the entire time and said it........ finally as a new grad i saw it.........

In the UK the Doll's Eye test is one of the tests that we make to ascertain brain stem death.

There is a comatose pt in our unit from very low blood sugar for so long. When we hold her eyelids up and look at her eyes, they move back and forth. You can tell that she is not focusing on anything around. The eyes just move on their own. What could this be from? Is it an indication of severe brain damage?

An experienced critical care nurse told us to remember dolls eyes this way:

Expensive dolls have eyes that move, and it is better to have an expensive doll vs. one with eyes that do not move!

The test or assessment of "Dolls eyes" in a Neurologically impaired patient is most often done as you are assessing for brainstem function, herniation and brain death.

In a patient or person who is neurologocally intact, (meaning all brainstem function is present), when you move their head from side to side, or up and down, a neurologically intact patient's eyes will deviate to the oposite side of the movement of the head.

If the patient is not neurologically intact, when you move their head side to side or up and down, their eyes will be fixed and move in the same direction or "with" the movement. This is indicative of a patient who's brainstem is not intact or has a brainstem injury and either begun the process of brain herniation or is brain dead.

this is one of the many assessments we will do in the neuro icu along with cold calorics, apnea test, corneals, cough and gag... and then if there is still a question we may do a perfusion test to see if there is any bf to the brain.