That's the consensual light reflex. Accommodation is the narrowing or widening of the pupil to accommodate focusing near and far respectively. I just say PERRL unless I actually assessed for accommodation. Cough/gag/pupils are assessed and charted Q15,30min,1,2,4hrs as ordered. I only check gag when appropriate (during oral care on vented pts, etc), or otherwise chart deferred. I first check lids when checking pupils by moving my other hand towards their eyes fast enough to illicit the reflex, and then progress by least invasive first as noted above. I only have to chart that once then chart 'no changes to prior assessment' and typically don't formally check it again unless there has been a change in the pt's condition.