PURPOSE Extraocular muscle (EOM) paths are constrained by connective tissue pulleys serving as functional origins. The quantitative structural features of pulleys and their intercouplings and orbital suspensions remain undetermined. This study was designed to quantify the composition of EOM pulleys and suspensory tissues. METHODS Five human orbits, ages 33 weeks gestation to 93 years, were im...

We report a patient with partial oculomotor paresis due to midbrain infarction. A 69-year-old man noticed diplopia suddenly. Ptosis, and impaired adduction and supraduction were found in the right eye. The pupillary size and light reflexes were normal on both sides. Magnetic resonance imaging disclosed an acute lesion in the right inferolateral oculomotor fascicle. These clinicoradiological fin...

Purpose To report a case of inferior rectus muscle hypoplasia with esotropia, which was treated successfully by resection and anterior transposition of the inferior oblique muscle. Observations A 1-year-old boy presented with esotropia. He had esotropia of 15-30° and intermittent left hypertropia. At the age of 3 years, the alternate prism cover test showed esotropia of 35Δ and left hypertrop...

PURPOSE Fibroelastic pulleys function like the trochlea to fix the position and pulling direction of the recti extraocular muscles within the orbit. This study characterized the fine structure of the human medial rectus muscle pulley. METHODS Human medial rectus muscle pulley tissue was dissected at autopsy, immersed in aldehyde fixative solution, and processed for and examined with light and...

Convergence excess esotropia has been treated with bifocals, miotics, medial rectus recession(s), fadenoperation, or a combination of these. However, comparatively few studies on the sensory status of these patients exist. We present the sensory findings in 31 children treated surgically. Twenty-one had fadenoperations combined with bimedial rectus recessions, one had a fadenoperation alone, an...

Computed tomographic (CT) findings in four patients with isolated blow-out fracture of the medial orbital wall are reported. CT delineated the fracture site and its extent in each case, and clearly demonstrated medial rectus muscle entrapement in two. This was confirmed by surgery. CT was found superior to poly tomography and proved to be the best radiologic means for the diagnosis of medial or...

A 66-year-old female presented with exotropia and hypertropia of her left eye. She had a previous history of lateral rectus recession and medial rectus resection of her left eye 20 years prior to old oculomotor and trochlear nerve pareses. She was treated with a botulinum toxin injection in the inferior oblique and lateral rectus muscles of her affected eye. In this case, the patient’s exotropi...