Abstract:

Orbital connective tissue plays an important role in eye movements. Its degenerative change along with the aging change can cause change of pulley position, which controls the extraocular rectus muscle movement in human eyes, leading to some special types of strabismus, namely "sagging eye syndrome", including divergence insufficiency esotropia or divergence paralysis esotropia, and the occurrence of a small degree of vertical strabismus or cyclovertical strabismus. Orbital magnetic resonance imaging examination revealed that the occurrence was related to the Pulley location degeneration of extraocular rectus muslces. The treatment and surgery of the strabismus caused by orbital connective tissue degeneration is different. Either medial rectus muscle recession or lateral rectus resection is adopted for divergence paralysis esotropia, but different degree partial tenotomy of vertical rectus muscles for treatment of hypertropia is employed.   (Int Rev Ophthalmol,  2017,  41:   14-18)