Eye muscle exercise

Introduction

Anatomy of eye

The eye divided into three parts; the outer layer is fibrous and forms a cornea with the central sclera of the eye being white and covering the rest of the eye. The second layer consists of tissue which is the choroid (blood supply). to the retina) the iris (containing the cornea and smooth muscles that regulate thickness[1]) and the ciliary body, which consists of muscles that extend from the sclera and are attached to the lens by a suspensory ligament. The middle layer contains the retina.

The extraocular nerve consists of seven muscles with cranial nerves responsible for eye movements under certain conditions when these muscles are affected thus affecting eye movements.

Eye Muscles

The movement of the eye continues around the triangle[2]:

• Adduction (movement of the inner eye to the nose)/ Abduction (movement of the outer eye) around the vertical axis.
• Elevation (higher motion)/ Depression (lower motion) around the transverse axis.
• Intorsion/ Extorsion (movement away and into the nose) we need when rotating the head around the anteroposterior axis

The seven muscles of the posterior eyelids divided into 4 recti 2 obliques muscles and one levator palpebrae superiors which are responsible for elevation of the upper eyelid.[3]

Extraocular muscles

MuscleOriginInsertionNerve supplyActionSuperior rectuscommon tendinous ringsuperior and anterior aspect of scleraoculomotor nerve (cranial nerve III)elevation and contributes to adduction and intorsionInferior rectusinferior and anterior aspect of scleradepression contributes to adduction and extorsionMedial rectusmedial aspect of scleraadducts eyeLateral rectuslateral aspect of scleraabducens muscle (cranial nerve VI)abducts eyeSuperior obliquebody of sphenoid boneat sclera posterior to superior rectusTrochlear nerve cranial nerve IV)abduction depression and eye insertionInferior obliqueanterior aspect of orbital floorat sclera posterior to lateral rectus.Oculomotor nerve (cranial nerve III)increased abduction and retrieval of eyesLevator palpebrae superiorssphenoid bonesuperior eyelidoculomotor nerve (cranial nerve III)ocular surface.

Oculomotor N palsy lt eye

Clinical Significance

Extraocular muscle paralysis can occur due to injury or disease as affected cranial nerve palsy of the oculomotor nerve will affect most of the extraocular muscles with eye disease recognized in the down and out position. Weakness of the abducens muscle will affect the back rectus and the eye becomes treated by the medial rectus. If the trochlear nerve is affected the patient complains of diplopia[4].

Strabismus from weakness of the nerve control nerves or injury to the inferior rectus muscle may be involved.[5]

Horner’s syndrome

Horner’s syndrome.

Assessment Of Extraocular Muscles

Extraocular muscle function can be assessed by asking the patient to look in nine directions by following the doctor’s finger as he draws an ”H” in the air. The patient will look up down right left and right and left and right and left.[5]

Visual alignment is tested by several methods for example the corneal-light reflex.

Effect Of Eye Muscle Exercises

Who benefits from exercises:

• Digital vision loss as in people who work on computers for long periods of time and can cause blurred vision blurred vision and headaches.
• Increased light sensitivity.
• Surgery needed to strengthen muscles
• If there is a problem with reading eye fixation.
• Convergence insufficiency.
• Lazy eyesight in some children – eye exercises stimulate vision areas in the brain[6][7].

Effects of oculomotor and eye stability exercises:

• Ocular-motor exercises improve dynamic visual acuity (DVA) in dynamic sports that have a significant impact on athlete performance for example basketball in this study of female basketball players, the intervention consists of four weeks 6 sessions per week for ten minutes twice a day ].
• Visual and visuo-motor improve balance and stability in healthy adults[9] and a study proves that it may be promising for improving balance after stroke[10]. . . . .
• This exercise improves symptoms of eye fatigue[11] it strengthens the muscles behind the eyes.
• Relief eye strain, improve blinking.

Eye Muscles Exercises

• Blinking exercises are like giving your eyes a break, it helps keep them looking fresh and focused for longer periods of time. Blinking can improve symptoms of digital eye strain, dry eye and blinking habit[12], and a 10-second blinking exercise every 20 minutes will help.
• Eye movement Slowly move the eyes up and down three times, then slowly move the eyes from right to left three times and then rest.

• Figure 8 Another Eye Movement Exercise Imagine a large figure of 8 8-9 feet away from you, then move your eyes in the direction of this infinite loop for about 30 seconds, then switch directions.
• Change focus Move your finger a few inches away from you, then focus on it, then focus on something else far away from you, now bring your gaze back to your finger.
• Pencil push-ups [13]. Patient places pencil/patient’s thumb on outstretched arm between eyes Instruct patient to attempt to hold single image of pencil while slowly moving pencil towards nose until now pencil is no longer visible in single image Consultation Patiently move it slowly to the nearest point where there is an image of a pencil. This exercise can help patients with symptomatic convergent insufficiency.
• Brock string can improve convergence and eye coordination [14][15].

For more exercises description:

Eye movement exercises. Physiology page.

Gaze stabilization exercises.