This reflex manifests as bradycardia (and occasionally cardiac dysrhythmias) that is elicited by pressure on the globe and by traction on the extraocular muscles (strabismus surgery), especially the medial rectus.
Monitoring of the electrocardiogram is useful for early recognition of this reflex.
Atropine given intravenously within 30 minutes of surgery is thought to lead to a reduced incidence of the reflex (controversial). Atropine as administered intramuscularly for preoperative medication is not effective for preventing this reflex.