ReviewMiddle East African journal of ophthalmology
The Role of Extraocular Muscle Pulleys in Incomitant Non-Paralytic Strabismus.
Review in Middle East African journal of ophthalmology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 37 citations in OpenAlex.
- Anterior horizontal rectus anatomy in children with concomitant strabismus.BMC ophthalmology · 2026Article
- Comitant strabismus etiology: extraocular muscle integrity and central nervous system involvement-a narrative review.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2023Review
- Altered Brain Network Centrality in Patients with Adult Strabismus with Amblyopia: A Resting-State Functional Magnetic Resonance Imaging (fMRI) Study.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- The Effect of Axial Length on Extraocular Muscle Leverage.American journal of ophthalmology · 2020Article
- NGF and CNTF expression and regulation mechanism by miRNA in acute paralytic strabismus.International ophthalmology · 2020Article
- Altered brain activity in patients with strabismus and amblyopia detected by analysis of regional homogeneity: A resting‑state functional magnetic resonance imaging study.Molecular medicine reports · 2019Article
- Magnetic Resonance Imaging of the Globe-Tendon Interface for Extraocular Muscles: Is There an "Arc of Contact"?American journal of ophthalmology · 2018Article
- The Globe's Eccentric Rotational Axis: Why Medial Rectus Surgery Is More Potent than Lateral Rectus Surgery.Ophthalmology · 2018Article
- Long-term Surgical Outcomes in the Sagging Eye Syndrome.Strabismus · 2018Article
- Altered brain network centrality in patients with adult comitant exotropia strabismus: A resting-state fMRI study.The Journal of international medical research · 2018Article
- Facial and Orbital Fractures: A Fifteen Years Retrospective Evaluation of North East Sicily Treated Patients.The open dentistry journal · 2017Article
- Altered intrinsic regional brain spontaneous activity in patients with comitant strabismus: a resting-state functional MRI study.Neuropsychiatric disease and treatment · 2016Article
- A Modern Approach to Incomitant Strabismus.Middle East African journal of ophthalmologyArticle
- Orbital magnetic resonance imaging is useful in age-related distance esotropia.Journal of optometryArticle
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The rectus extraocular muscles (EOMs) and inferior oblique muscle have paths through the orbit constrained by connective tissue pulleys. These pulleys shift position during contraction and relaxation of the EOMs, dynamically changing the biomechanics of force transfer from the tendon onto the globe. The paths of the EOMs are tightly conserved in normal patients and disorders in the location and/or stability of the pulleys can create patterns of incomitant strabismus that may mimic oblique muscle dysfunction and cranial nerve paresis. Developmental disorders of pulley location can occur in conjunction with large, obvious abnormalities of orbital anatomy (e.g., craniosynostosis syndromes) or subtle, isolated abnormalities in the location of one or more pulleys. Acquired disorders of pulley location can be divided into four broad categories: Connective tissue disorders (e.g., Marfan syndrome), globe size disorders (e.g., high myopia), senile degeneration (e.g., sagging eye syndrome), and trauma (e.g., orbital fracture or postsurgical). Recognition of these disorders is important because abnormalities in pulley location and movement are often resistant to standard surgical approaches that involve strengthening or weakening the oblique muscles or changing the positions of the EOM insertions. Preoperative diagnosis is aided by: (1) Clinical history of predisposing risk factors, (2) observation of malpositioning of the medial canthus, lateral canthus, and globe, and (3) gaze-controlled orbital imaging using direct coronal slices. Finally, surgical correction frequently involves novel techniques that reposition and stabilize the pulley and posterior muscle belly within the orbit using permanent scleral sutures or silicone bands without changing the location of the muscle's insertion.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.