Eye Movement

Course Name: Biological Modeling and Simulation

Course Code: BME-4205
 Contents

 Eye movement
 four types of eye movement
 Correcting Eye Movement Problems
 Anatomy of the Extraocular Muscles
 Movements of the Extraocular Muscle
 Yoked Eye Movements
 Laws of Eye Movements

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 Eye movement
 Eye movement refers to the voluntary and involuntary movements of the
eyes that assist with obtaining, fixating and following visual stimuli. The eyes
are each connected to a system of six muscles.
 Light is sensed by the retina, which is a type of tissue that contains cells
known as photoreceptors. These cells translate light into electrochemical
signals that move along the optic nerve fibers to the brain.
 Once they reach the brain, the signals are interpreted as vision in the visual
cortex and the brain applies meaning to what is being seen.

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 How Your Eyes Interpret Movement

And just as the eyes send signals to the brain, the brain sends signals to the eyes.
Three cranial nerves transport signals from the brain to the muscles attached to
each eye. This ultimately controls both voluntary and involuntary eye movements.
There are four types of eye movement:
• Saccades – rapid, flying movements of the eyes that suddenly change the point of fixation. These
movements range in scale from the tiny movements made while reading to greater movements
made while scanning a room
• Vergence movements – these movements bring into the line the area of the retina (fovea)
designed for high perception
• Smooth pursuit movements – steady tracking movements that are meant to keep moving
stimulus in focus
• Vestibulo-ocular movements – helps stabilize the eyes when the head’s position moves

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 Cont.….
Poor eye muscle control or injury/trauma can affect the eyes’ ability to move in harmony,
leading to eye movement disorders like:

Nystagmus – fast, uncontrollable movements of the eyes. This can sometimes be referred
to as dancing eyes

Strabismus – the eyes are misaligned and not aimed in the same direction. This may cause
crossed eyes or other vision problems like lazy eye

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 Correcting Eye Movement Problems
 If an individual has problems with eye movement, vision therapy is one treatment
that can help by using vision exercises and specialized equipment to strengthen the
eye muscles, leading to more fluid, cooperated eye movement.

 Performed under the guidance of an optometrist, vision therapy is conducted in an

office setting up to twice a week for an hour.

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Equipment that may be used during a vision therapy session includes:
 Therapeutic or corrective lenses
 Optical filters
 Prisms
 Occluders or eye patches
 Balance boards
 Computer software
 Vision-motor-sensory training equipment
 Electronic target with programmed apparatuses

When vision therapy is over, and all necessary sessions have concluded, the patient
should be able to perform the four types of eye movement with greater ease and
should be more efficient when it comes to processing and interpreting visual
information.
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 Extraocular Muscles and Movements

There are six muscles (per eye) responsible for generating all movements of the
eyes in their bony orbits:
• Lateral Rectus (LR)
• Medial Rectus (MR)
• Superior Rectus (SR)
• Inferior Rectus (IR)
• Superior Oblique (SO)
• Inferior Oblique (IO)

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 Extraocular Muscles and Movements

Anatomy of the Extraocular Muscle

Anatomy of the Extraocular Muscle

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 Extraocular Muscles and Movements

 The superior rectus and superior oblique muscles attach to the top of the eye.
 The inferior rectus and inferior oblique attach to the bottom of the eye.
 The lateral rectus and medial rectus attach the sides furthest from and closest to
the nose, respectively.

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 Movements of the Extraocular
Muscle

• A simple bedside ocular motility test (e.g. part of a standard bedside cranial
nerve examination) invokes the six cardinal directions of gaze and therefore tests
all six extraocular muscles of both eyes. For those unfamiliar with this test, the
patient simply holds the head still and follows the clinician's finger (or other
object) as he "draws" a capital "H" in front of the patient (bellow figure).

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 Yoked Eye Movements

• We have learned the six cardinal directions of gaze from examining figure 2. All of
these movements are "yoked," which means EOM in both eyes are working
together to move the eyes in the same direction at the same time; what one eye
does, the other eye does automatically.
• For example, if something catches your eye off to the left and your left eye moves
quickly to focus the scene, you do not consciously and separately have to tell
your right eye to move leftward. Because this direction of gaze ("left") is a yoked
eye movement, both eyes respond.

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 Looking Right (Dextroversion)

• Looking Right (Dextroversion): The lateral rectus attaches to the side of the eye
furthest from the nose. Keeping in mind that muscles can only contract, it makes
perfect sense that the LR rotates the eye away from the nose. Thus when looking to
the right, the LR of the right eye causes the rightward rotation in the orbit. Eye
movement away from the nose is called abduction.
• But what about the left eye? The LR of the left eye would rotate the eye to the left, so
that is of no use in this case. You learned the medial rectus attaches to the side of the
eye closest to the nose, which would pull the left eye to the right side. The MR rotates
the eye toward the nose. Movement toward the nose is called adduction. And just like
that, you have encountered your first yoked pair of extraocular muscles: the right LR
and left MR (see figure 3).

Figure: 3

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 Looking Left (Levoversion)

 Looking Left (Levoversion): This gaze requires the same movements as looking to

the right, but in the opposite direction.
 It really is as easy as reversing the EOM we just learned above to achieve leftward
gaze: right MR and left LR (see figure 4). 4
figure
 In other words, the right eye now needs to move toward the nose, while the left
eye needs to move away from the nose.

Figure: 4

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 Looking Right and Up
(Dextroelevation):
• Looking Right and Up (Dextroelevation): This direction has a little more nuance
to it, but is still easy to comprehend.
• As seen above, looking right involves the right LR (abduction) and the left MR
(adduction). Due to the mechanics of the EOM, when the right eye is fully
abducted (away from the nose) it can only be elevated by the superior rectus.
figure 4
• Conversely, when the left eye is fully adducted (toward the nose) it can only be
elevated by the inferior oblique. Thus we encounter another pair of yoked
muscles in looking right and up: the right SR and the left IO (see figure 5).

Figure: 5

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 Looking Right and Up
(Dextroelevation):
• Looking Right and Up (Dextroelevation): This direction has a little more nuance
to it, but is still easy to comprehend.
• As seen above, looking right involves the right LR (abduction) and the left MR
(adduction). Due to the mechanics of the EOM, when the right eye is fully
abducted (away from the nose) it can only be elevated by the superior rectus.
figure 4
• Conversely, when the left eye is fully adducted (toward the nose) it can only be
elevated by the inferior oblique. Thus we encounter another pair of yoked
muscles in looking right and up: the right SR and the left IO (see figure 6).

Figure: 6

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 Looking Right and Up
(Dextroelevation):
• Looking Left and Up (Levoelevation): Just as with gaze right vs. left, looking right
and up vs. looking left and up involves the same principles and muscles, but
applyed to the opposite eyes. That means the left eye is now abducted (away
from the nose), so can only be elevate with the SR.
• The right eye is now adducted (toward the nose), so it can only be elevated by
figure 4
the IO. This yoked pair of muscles is: the right IO and the left SR (see figure 7).

Figure: 7

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 Looking Right and Up
(Dextroelevation):
• Looking Right and Down (Dextrodepression): Looking right and down still
involves the right LR (abduction) and the left MR (adduction) - that much is the
same in this direction of gaze. Similar but new, due to the mechanics of the EOM,
when the right eye is fully abducted (away from the nose) it can only be
depressed by the inferior rectus. Conversely, when the left eye is fully adducted
(toward the nose) it can only be depressed
figure 4 by the superior oblique. Therefore,
looking right and down invokes the following yoked muscles: the right IR and the
left SO (see figure 8).

Figure: 8

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 Looking Right and Up
(Dextroelevation):
• Looking Straight Down (Infraversion): Downward gaze also involves two muscles,
but this time the LR and MR are not involved. Instead, both downward rotating
muscles are engaged simultaneously: the right IR and SO, and the left IR and SO.
• The mechanics behind this (greatly simplified) relate to the different angles of
attachment of the IR and SO; this is also the reason behind the IR and SO being
figure 4
restricted to depressing the eye during adbuction and adduction, respectively.
• When the IR and SO contract simultaneously, the toward-the-nose and away-
from-the-nose forces cause the eye to rotate straight down (see figure 10).

Figure: 10

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 Looking Right and Up
(Dextroelevation):
• Looking Straight Up (Supraversion): This pair of yoked muscles offers no
surprises: looking straight up uses the same principles as looking straight down,
but with the opposite muscles: the right SR and IO, and the left IO and SR (see
figure 11).

figure 4

Figure: 11

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 Looking Right and Up
(Dextroelevation):
• Crossing the Eyes (Convergence): Convergence occurs when the left and right MR
muscles are contracted simultaneously, rotating both eyes horizontally toward
the nose (see figure 12). This is more than a way to view certain 3D images - the
eyes converge as an object of focus moves closer to the viewer. The opposite,
divergence, is not listed here because one cannot (voluntarily) contract both LR
muscles simultaneously. figure 4

Figure: 12

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 Laws of Eye Movements

• Hering's Law states that yoked muscles receive the same amount of innervation,
and at the same time. This may seem painfully simple, but this is an important
principle which underscores the connection between muscles and movements
that are considered "yoked".
• In fact, this priniciple partly explains why both eyes are effected during
figure 4
pathologic nystagmus. An example of this law would be the equal and
simultaneous innervation of the left LR and right MR when looking to the left.
Hering's Law is the essence of what makes these movements yoked.

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 Laws of Eye Movements
 Sherrington's Law explains that any increase in innervation to an agonist muscle must also include a simultaneous
decrease in innervation to the antagonist muscle. Let's define these two terms to understand this law more fully.
 Agonist Muscle
 A muscle that on contracting is automatically checked and controlled by the opposing simultaneous contraction of
another muscle—called also agonist muscle, prime mover. 4
 Antagonist Muscle
figure
 An agent that acts in physiological opposition: a muscle 4
that contracts with and limits the action of an agonist with which
it is paired—called also antagonistic muscle.  4

 The short version of these formal definitions can be reworded as an agonist muscle being the muscle that works to
achieve a desired action (e.g. looking left), while an antagonist muscle exists to perform the opposite action (e.g. looking
right). What is important to keep in mind is that these labels are relative: for example, if the desired action is to look right,
the muscles involved become the agonist muscles and the those responsible for looking left become the antagonist.

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 Thank you

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