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Astanga Hrudaya

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तर्जनीमध्यमाङ्गुष्ठैः शलाकां निश्चलं धृताम् । दैवच्छिद्रं नयेत्पार्श्वादूर्ध्वमामन्थयन् इव ॥१२॥

holding the metal rod tight between the middle finger, index finger and the thumb, draw the natural aperture (pupil) to the sides, twisting from above and then puncture (push the less outside)

english translation