Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Call emergency services for eye-movement difficulty that begins suddenly, especially with:
Facial drooping, arm or leg weakness, or numbness
Slurred speech, confusion, or trouble understanding words
Sudden severe imbalance, collapse, or inability to walk
A sudden severe headache or repeated vomiting
Loss of vision, reduced consciousness, or seizure
Do not drive yourself for emergency assessment.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
These can be signs of a stroke, bleeding, or another urgent brain problem.
Prompt medical assessment is also important for new eye-movement difficulty after a head injury or when symptoms worsen quickly over hours or days.
And for anyone, someone who:
is getting rapidly more short of breath, or has gained several pounds in a few days with swelling
3
Does any of this apply?
Book an appointment
Arrange routine follow-up if an established problem is gradually changing, double vision is interfering with daily activities, or current glasses and visual aids are no longer helping.
New falls, swallowing trouble, increasing stiffness, or changes in speech should also be reported rather than waiting for the next planned appointment.
Every sign above is quoted from the sofidex article on Supranuclear ophthalmoplegia. If you are not sure, err upward — it is always reasonable to be checked.