That's an acroread question, not a Perl question. I don't think acroread has the ability to do what you want, but check its available command-line options just in case.

In general, you can't simulate mouse clicks or something like that in Perl, at least not without loading some kind of automation tool akin to WinRunner. I don't know of any free, open-source alternatives to do that, and anyway that would be a platform-specific thing and not Perl-related at all. All you can really do in Perl is run some program with certain command-line arguments, feed it stdin, read its stdout, or maybe talk to any network sockets it might be listening on (not relevant in this case). If none of those techniques can give the functionality you desire, then you can't do it in Perl.