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Extraocular Muscles and Strabismus

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Extraocular muscles and strabismus
Extraocular muscles and strabismus

To direct our gaze wherever desired, and to be able to track the moving objects, human eyes are equipped with specialized muscles that move our two eyes jointly in our eye sockets. Humans have six extraocular muscles, which origin in the back of the orbit and insert on the eyeball.

Four of them are rectus muscles – medial, lateral, superior and inferior rectus – and two of them are oblique muscles – inferior and superior oblique. They are innervated by three different cranial nerves that derive from deep in the brainstem and are under voluntary as well as involuntary control. In this blog post, we will talk about the extraocular muscles in connection to the vision disorder called strabismus.

In this blog post, we will talk about the extraocular muscles and their connection to strabismus.

Extraocular Muscles are Responsible for Eye Movement: 6 Muscles of the Eye

Extraocular muscles are the effectors of one extremely complicated process, that is eye movement. Eye movement, as such, is a complex concert of different eye movement patterns in different situations, some of them being smooth pursuit, saccades, movements pursuit, vestibulo-ocular reflex, and rapid eye movement (REM) during sleep.

We may be going into more detail on that in some of the future blogs, but today we just want to emphasize that eye movement is not as simple as one might perhaps imagine.

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If we go back to the extraocular muscles, the healthy coordination of all 6 muscles in both our eyes is needed for us to be able to perceive a single image with good depth perception. However, if the latter is not so, strabismus can occur.

Humans have six extraocular muscles, which origin in the back of the orbit and insert on the eyeball.

Strabismus and problems with extraocular muscles are frequently present whenever there are issues with an uneven development of the eyes.

Types of Strabismus

Strabismus, also named squint or crossed eyes, is a disorder in which the two eyes misalign with each other.

There are different types of strabismus that include esotropia (eyes are turned inward), exotropia (eyes deviate outward), and hypertropia (eyes are vertically misaligned).

Furthermore, strabismus can be divided into concomitant (eyes deviation is independent of the position of gaze) and incomitant (eyes deviation changes with the position of gaze). In some cases, strabismus can also be present occasionally, whereas in most instances, it is present constantly (until properly addressed).

The Onset of Strabismus

Regarding the time of onset, strabismus can be classified as congenital, acquired, or secondary to other ocular pathology.

Congenital strabismus is quite frequent as many infants are born with a slight deviation of their eyes. Thankfully, in the majority of cases, the two eyes align correctly with no treatment in months after birth. Strabismus often commences in early childhood and in many cases no specific cause can be identified – referred to as acquired strabismus.

In some other cases, though, strabismus occurs as a complication of many ocular and neurological diseases or trauma to the eyes and adnexal parts of the eye.

Strabismus Development Later in Life as an Adult

If strabismus arises later in life, when the binocular function of the two eyes is already fully developed, a person will most likely experience very bothersome diplopia or double vision, as the two images one received from the eyes are of equal quality, but not aligned as they should be.

If, on the other hand, strabismus commences early, when one’s binocular vision is not fully developed, a child might not notice any symptoms at all, as the brain can easily shut down the image from the deviating eye that is of lesser quality than the one from the leading eye – contributing to the development of amblyopia and impaired binocular vision.

Treatment and Management of the Strabismus

Whilst amblyopia development due to strabismus in children is very likely, strabismus is otherwise a disorder of binocular vision, so the primary goal of treatment is a single, clear, binocular vision in all directions of gaze. The latter can be achieved by a combination of specialized prism glasses, medication such as botulinum toxin, or surgery.

In children, however, eye patching and vision therapy are often needed in order to treat amblyopia in the deviating eye.

Read about the Experiences of Individuals with Strabismus using AmblyoPlay

Fort Myers, FL

Jay: ”I highly recommend AmblyoPlay”

Amblyoplay has worked wonders in helping to improve my daughter’s vision. We are so happy that her eye no longer turns. The exercises are fun and my daughter looks forward to playing them. I highly recommend Amblyoplay.

Kerry AmblyoPlay Review
Orkney, Scotland

Kerry: ”The light at the end of the tunnel for us”

I have noticed an improvement with my son’s eye already after only using this excellent app for a short period. The app was easy to set up. The team at AmblyoPlay responded very quickly to any queries that I had, they were very efficient. Would definitely recommend this app. The light at the end of the tunnel for us. Thank you very much.

Makati, Philippines

Kerry: Father of son struggling with strabismus

My son has been having eye deviations that’s why we sought intervention at Vision Therapy Philippines. And one of their protocol treatment is using Amblyoplay with eyeglasses. After 3 months of using there has been an improvement in his eyesight and now at 20-20 vision. Thank you AmblyoPlay.

Frequently Asked Questions

What are the 6 extraocular muscles?

Four of them are rectus muscles – medial, lateral, superior and inferior rectus – and two of them are oblique muscles – inferior and superior oblique. They are innervated by three different cranial nerves that derive from deep in the brainstem and are under voluntary as well as involuntary control.

What are extraocular muscles for?

Extraocular muscles are the effectors of one extremely complicated process, that is eye movement. Eye movement, as such, is a complex concert of different eye movement patterns in different situations, some of them being smooth pursuit, saccades, movements pursuit, vestibulo-ocular reflex, and rapid eye movement (REM) during sleep.

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Why Do We Suggest a Minimum Time of 6 Months for Success?

Based on the data from over 15,000 patients using AmblyoPlay, improvements start within 4 months, while optimal results take anywhere between 6-18 months on average. The duration of required training depends on the patient’s age, the severity of the problem, accompanying diseases, and adherence to the training program.