Incomitant strabismus associated with instability of rectus pulleys.

Abstract

Pulley instability, resulting in EOM sideslip during ductions, occurs in some cases of incomitant strabismus. Resultant patterns of strabismus may depend on static pulley positions, pulley instability, and coexisting globe translation that alters pulley locations relative to the globe. Translational instability of pulleys and the globe could produce abnormalities in actions of otherwise normal EOMs, and connective tissue disorders causing these instabilities should be considered as potential causes of strabismus.