Model-based improvements in the treatment of patients with strabismus and axial high myopia

Robert Hoerantner, Thomas Kaltofen, Siegfried Priglinger, Christian Michael Fock, Michael Buchberger, Thomas Haslwanter

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


PURPOSE. Eye motility disorders with axial high myopia and an enlarged globe are often characterized by a hypotropia of the affected eye, usually referred to as heavy-eye syndrome. Based on an intuitive interpretation of magnetic resonance (MR) images, the cause of the hypotropia has typically been assigned to the rectus muscles. In this study, the hypothesis that the oblique muscles play an important role in the underlying biomechanical disorder of this type of strabismus was investigated. METHODS. The hypothesis was tested by (1) a retrospective analysis of surgical results in one patient with unilateral axial high myopia; and (2) MR images of orbital tissues in two further patients with unilateral axial high myopia. RESULTS. MR images demonstrated a pattern of extraocular muscle path displacements similar to those described previously, but also a uniform decrease in the cross-sectional area of the inferior oblique muscles. Computer modeling required decreased inferior oblique contractility in addition to displaced extraocular muscle paths to recreate the observed motility pattern accurately. CONCLUSIONS. Patients with axial high myopia regularly show a reduction in the diameter of the inferior oblique. The resultant reduction in muscle-strength is important for the correct explanation of this complex eye movement disorder.

Original languageEnglish
Pages (from-to)1133-1138
Number of pages6
Issue number3
Publication statusPublished - Mar 2007


  • Adult
  • Computer Simulation
  • Eye Movements/physiology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Muscle Contraction/physiology
  • Muscle Strength/physiology
  • Myopia/physiopathology
  • Oculomotor Muscles/physiopathology
  • Retrospective Studies
  • Strabismus/physiopathology
  • Syndrome
  • Tendon Transfer


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