Block of the superior oblique muscle of the eye. Muscles of the eyeball and their oculomotor functions
Oculomotor apparatus- a complex sensorimotor mechanism, the physiological significance of which is determined by its two main functions: motor (motor) and sensory (sensitive).
The motor function of the oculomotor system ensures the guidance of both eyes, their visual axes and the central fossae of the retinas to the object of fixation; the sensory function ensures the merging of two monocular (right and left) images into a single visual image.
The innervation of the extraocular muscles by the cranial nerves determines the close connection between neurological and ocular pathologies, as a result of which an integrated approach to diagnosis is necessary.
18.1. Anatomical and physiological features
Movements of the eyeball are carried out with the help of six extraocular muscles: four straight - external and internal (i.e. rectus externum, m.rectus internum), upper and lower (m.rectus superior, m.rectus inferior) and two obliques - upper and lower ( m.obliguus superior, m.obliguus inferior).
All rectus and superior oblique muscles begin at the tendon ring, located around the optic nerve canal at the apex of the orbit and fused with its periosteum (Fig. 18.1). The rectus muscles in the form of ribbons are directed anteriorly parallel to the corresponding walls of the orbit, forming the so-called muscular funnel. At the equator of the eye, they pierce Tenon’s capsule (the vagina of the eyeball) and, before reaching the limbus, they are woven into the superficial layers of the sclera. Tenon's capsule supplies the muscles with a fascial covering that is missing in the proximal region where the muscles begin.
The superior oblique muscle originates at the tendon ring between the superior and internal rectus muscles and goes anteriorly to the cartilaginous block located in the upper inner corner of the orbit at its edge. At the pulley, the muscle turns into a tendon and, passing through the pulley, turns posteriorly and outward. Located under the superior rectus muscle, it is attached to the sclera outward from the vertical meridian of the eye. Two-thirds of the entire length of the superior oblique muscle is between the apex of the orbit and the trochlea, and one-third is between the trochlea and its attachment to the eyeball. This part of the superior oblique muscle determines the direction of movement of the eyeball during its contraction.
In contrast to the five muscles mentioned, the inferior oblique muscle begins at the inferior inner edge of the orbit (in the area of the entrance of the nasolacrimal canal), goes posteriorly outward between the orbital wall and the inferior rectus muscle towards the external rectus muscle and is fan-shaped attached under it to the sclera in the posteroexternal part of the eye apple, at the level of the horizontal meridian of the eye.
Numerous cords extend from the fascial membrane of the extraocular muscles and Tenon’s capsule to the orbital walls.
The fascial-muscular apparatus ensures a fixed position of the eyeball and gives smoothness to its movements.
The muscles of the eye are innervated by three cranial nerves:
- oculomotor nerve - n. axis-lomotorius (III pair) - innervates the internal, superior and inferior rectus muscles, as well as the inferior oblique;
- trochlear nerve - n. trochlearis (IV pair) - superior oblique muscle;
- abducens nerve - p. abducens (VI pair) - external rectus muscle.
All these nerves pass into the orbit through the superior orbital fissure.
The oculomotor nerve, after entering the orbit, divides into two branches. Upper branch innervates the superior rectus muscle and the levator muscle upper eyelid, inferior - the internal and inferior rectus muscles, as well as the inferior oblique.
The nucleus of the oculomotor nerve and the nucleus of the trochlear nerve located behind and next to it (provides the work of the oblique muscles) are located at the bottom of the aqueduct of Sylvius (aqueduct of the brain). The nucleus of the abducens nerve (provides the work of the external rectus muscle) is located in the pons under the bottom of the rhomboid fossa.
The rectus oculomotor muscles are attached to the sclera at a distance of 5-7 mm from the limbus, the oblique muscles - at a distance of 16-19 mm.
The width of the tendons at the muscle attachment site ranges from 6-7 to 8-10 mm. Of the rectus muscles, the widest tendon is the internal rectus muscle, which plays a major role in the function of bringing together the visual axes (convergence).
The line of attachment of the tendons of the internal and extrinsic muscles, i.e. their muscular plane coincides with the plane of the horizontal meridian of the eye and is concentric to the limbus. This causes horizontal movements of the eyes, their adduction, rotation to the nose - adduction during contraction of the internal rectus muscle and abduction, rotation towards the temple - abduction during contraction of the external rectus muscle. Thus, these muscles are antagonistic in nature.
The superior and inferior rectus and oblique muscles perform mainly vertical movements of the eye. The line of attachment of the superior and inferior rectus muscles is located somewhat obliquely, their temporal end is further from the limbus than the nasal end. As a result, the muscular plane of these muscles does not coincide with the plane of the vertical meridian of the eye and forms an angle with it that is on average 20° and open to the temple.
This attachment ensures rotation of the eyeball under the action of these muscles, not only upward (during contraction of the superior rectus muscle) or downward (during contraction of the inferior rectus muscle), but simultaneously inwardly, i.e. adduction.
The oblique muscles form an angle of about 60° with the plane of the vertical meridian, open to the nose. This determines the complex mechanism of their action: the superior oblique muscle lowers the eye and produces its abduction (abduction), the inferior oblique muscle is an elevator and also an abductor.
In addition to horizontal and vertical movements, these four vertically acting oculomotor muscles perform torsional eye movements clockwise or counterclockwise. In this case, the upper end of the vertical meridian of the eye deviates towards the nose (intrusion) or towards the temple (extortion).
Thus, the extraocular muscles provide the following eye movements:
- adduction (adduction), i.e. its movement towards the nose; this function is performed by the internal rectus muscle, additionally by the superior inferior rectus muscle; they are called adductors;
- abduction (abduction), i.e. movement of the eye towards the temple; this function is performed by the external rectus muscle, additionally by the superior and inferior oblique muscles; they are called abductors;
- upward movement - under the action of the superior rectus and inferior oblique muscles; they are called lifters;
- downward movement - under the action of the inferior rectus and superior oblique muscles; they are called lowerers.
Complex interactions of the oculomotor muscles are manifested in the fact that when moving in some directions they act as synergists (for example, partial adductors - the superior and inferior rectus muscles, in others - as antagonists (superior rectus - levator, inferior rectus - depressor).
The extraocular muscles provide two types of conjugal movements of both eyes:
- unilateral movements (in the same direction - right, left, up, down) - so-called version movements;
- opposite movements (in different directions) - vergence, for example, to the nose - convergence (bringing together the visual axes) or to the temple - divergence (spreading the visual axes), when one eye turns to the right, the other to the left.
Vergence and version movements can also be performed in the vertical and oblique directions.
The functions of the oculomotor muscles described above characterize the motor activity of the oculomotor apparatus, while the sensory one is manifested in the function of binocular vision.
Binocular vision, i.e. vision with two eyes, when an object is perceived as a single image, is possible only with clear conjugal movements of the eyeballs. The eye muscles ensure that the two eyes are positioned on the object of fixation so that its image falls on identical points in the retinas of both eyes. Only in this case does a single perception of the object of fixation occur. Identical, or corresponding, are the central foveae and points of the retina, located at the same distance from the central fovea in the same meridian. The points of the retina, located at different distances from the central fovea, are called disparate, inappropriate (non-identical). They do not have the innate property of single perception. When the image of the object of fixation hits non-identical points of the retina, double vision or diplopia occurs (Greek diplos - double, opos - eye), a very painful condition. This occurs, for example, with strabismus, when one of the visual axes is shifted to one side or the other from the common point of fixation.
The two eyes are located in the same frontal plane at a certain distance from each other, so in each of them not quite identical images of objects located in front and behind the object of fixation are formed. As a result, double vision inevitably occurs, called physiological. It is neutralized in the central section of the visual analyzer, but serves as a conditioned signal for the perception of the third spatial dimension, i.e. depth.
Such a displacement of images of objects (closer and further away from the points of fixation) to the right and left of the macula on the retinas of both eyes creates the so-called transverse disparation (displacement) of the images and their entry (projection) onto disparate areas (non-identical points), which causes double vision, including physiological.
Transverse disparity- the primary factor of deep perception. There are secondary, auxiliary factors that help in assessing the third spatial dimension. This is linear perspective, the size of objects, the location of light and shadow, which helps the perception of depth, especially in the presence of one eye, when transverse disparity is excluded.
The concept of binocular vision is associated with terms such as fusion (the psychophysiological act of merging monocular images), fusion reserves that provide binocular fusion at a certain degree of convergence (convergence) and separation (divergence) of the visual axes.
The extraocular muscles help coordinate the movement of the eyeballs, and at the same time they provide high-quality perception. To have a three-dimensional image of the surrounding world, it is necessary to constantly train muscle tissue. A specialist will tell you what exercises to do after a thorough examination. In any situation, self-therapy should be completely avoided.
general information
There are six types of eye muscles, four of them are straight and two are oblique. They are called so because of the peculiarities of the course in the cavity (orbit) where they are located, as well as because of their attachment to the organ of vision. Their performance is controlled by nerve endings that are located in the cranial cavity, such as:
- Oculomotor.
- Abductors.
- Block.
The eye muscles have a large number of nerves that are capable of providing clarity and precision when moving.
Movement
Thanks to these fibers, the eyeballs can perform numerous movements, both unidirectional and multidirectional. Unidirectional turns include turning up, down, left, and others, while multidirectional turns include bringing the organs of vision to one point. Such movements help the tissues work harmoniously and present the same image to a person, thanks to its falling on the same area of the retina.
The muscles can provide movement of both eyes, while performing the main function:
- Movement in the same direction. It is called versioned.
- Movement in different directions. It is called vergence (convergence, divergence).
What are the structural features?
As mentioned earlier, the extraocular muscles are:
- Direct. They have a direct focus.
- The oblique muscles have an uneven course and are attached to the organ of vision by upper and lower tissue.
All of these eye muscles begin from a dense connecting ring that surrounds the external opening of the optic canal. In this situation, the exception is the lower oblique. All five muscle fibers form a funnel, which inside has nerves, including the main optic one, as well as blood vessels.
If you go deeper, you will see how the oblique muscle deviates upward and inward, creating a block. Also in this area there is a transition of fibers into the tendon, which is thrown through a special loop, and at the same time a change in its direction to oblique is observed. Then it attaches to the upper outer quadrant of the organ of vision under the upper direct type tissue.
Features of the inferior oblique and internal muscles
As for the inferior oblique muscle, it originates at the inner edge, which is located below the orbit and continues to the outer posterior border lower muscle straight type. The oculomotor muscles, the closer to the apple, the more they are surrounded by a capsule of dense fiber, that is, the shadow membrane, and then they are attached to the sclera, but not at the same distance from the limbus.
The performance of most fibers is regulated. In this situation, the external rectus muscle is considered an exception; the superior oblique muscle is also involved in its provision, which is provided by nerve impulses from the Internal muscles of the eye are located closest to the limbus, and the superior rectus and oblique muscles are attached in the middle to the organ of vision.
The main feature of innervation is that the branch of the motor nerve controls the performance of a small number of muscles, so maximum accuracy is achieved when moving the human eyes.
Features of the structure of the upper and lower rectus, as well as oblique muscles
How the extraocular muscles are attached will determine the movement of the apple. The internal and external straight fibers are located horizontally relative to the plane of the organ of vision, so a person can move it horizontally. These two muscles are also responsible for providing vertical movement.
Now let's look at the structure of the oblique-type oculomotor muscles. When contracted, they are capable of provoking more complex actions. This can be associated with some peculiarity of location and attachment to the sclera. The oblique muscle tissue, which is located on top, helps the organ of vision to lower and rotate outward, and the lower one helps to rise and also move outward.
It is necessary to take into account one more nuance that affects the upper and lower rectus, as well as the oblique muscles - they have excellent regulation of nerve impulses, there is coordinated work of the muscle tissue of the eyeball, and a person is able to perform complex movements in different directions. Therefore, people can see three-dimensional pictures, and the quality of the image also increases, which then enters the brain.
Accessory muscles
In addition to the above fibers, other tissues that surround the palpebral fissure also take part in the work and mobility of the eyeball. In this case, the orbicularis muscle is considered the most important. It has a unique structure, which is represented by several parts - orbital, lacrimal and eyelid.
So, the abbreviation:
- the orbital part occurs due to the straightening of the transverse folds, which are located in the frontal region, as well as by lowering the eyebrows and reducing the eye slit;
- the secular part occurs by closing the slit of the eyes;
- lacrimal part is carried out due to the enlargement of the lacrimal sac.
All three of these areas that make up the orbicularis muscle are located around the eyeball. Their beginning is located directly near the medial angle on the bone base. Innervation occurs through a small branch of the facial nerve. It is necessary to understand that any contraction or tension of the extraocular muscles of any type occurs with the help of nerves.
Other accessory muscle tissues
Also included among the auxiliary fibers are unitary and multi-unitary fabrics, which are of the smooth type. Multiunitary - these are the ciliary muscle and iris tissue. The unitary fiber is located near the lens, and the structure is capable of providing accommodation. If you relax this muscle, you can transfer the image to the retina, and if it contracts, this leads to a significant protrusion of the lens, and objects that are closer can be seen much better.
Functional Features
The function and anatomy of the extraocular muscles are interrelated. Since due attention has already been paid to the structure, now we will analyze in more detail the function of this type of muscle tissue, without which a person will not be able to correctly perceive the world around him.
home functional feature- ability to provide full movement:
- Bringing to one point, that is, there is a movement, for example, to the nose. This feature is provided by the internal rectus and additionally the superior inferior rectus muscle tissue.
- Abduction, that is, movement occurs to the temporal region. This feature is provided by the external rectus muscle and additionally by the superior and inferior oblique muscle tissues.
- The upward movement occurs due to the correct functioning of the superior rectus and inferior oblique muscles.
- The downward movement occurs due to the proper functioning of the inferior rectus and superior oblique muscle tissue.
All movements are complex and coordinated with each other.
Training exercises
In any situation, a violation of eye movement may occur, so at the first manifestation of a deviation, you should immediately contact a specialist who, after a thorough examination, will be able to prescribe effective treatment. In most cases, diseases and pathologies of muscle tissue are eliminated surgically. To avoid any complications and interventions, constant training of the extraocular muscles should be carried out.
Examples
- Exercise 1 - for external muscles. To relax not only muscle tissue, but also your eyes, you need to blink quickly for half a minute. Then rest and repeat the exercise again. Helps after a working day and long periods of sitting at the computer.
- Exercise 2 - for internal muscles. You need to place your finger in front of your eyes at a distance of 0.3 m and look at it carefully for several seconds. Then take turns closing your eyes, but continue to look at him. Then look carefully at the tip of your finger for 3-5 seconds.
- Exercise 3 - to strengthen the underlying tissues. The body and head should be motionless. You need to move your eyes right and left. Abduction to the side should be maximum. You need to do the exercise at least 9-11 times.
3. Accessory apparatus of the eye: muscles of the eyeball, conjunctiva, eyelids, lacrimal apparatus, their blood supply, innervation.
Muscles of the eyeball - 6 striated muscles: 4 rectus muscles - superior, inferior, lateral and medial, and two obliques - superior and inferior.
M muscle that elevates the upper eyelid,T.levator palpebrae superi oris. R It is located in the orbit above the superior rectus muscle of the eyeball, and ends in the thickness of the upper eyelid. The rectus muscles rotate the eyeball around the vertical and horizontal axes.
Lateral and medial rectus muscles,vol. recti late ralis et medialis, turn the eyeball outward and inward around the vertical axis, the pupil rotates.
Superior and inferior rectus muscles,vol. recti superior et inferior, rotate the eyeball around the transverse axis. The pupil, under the action of the superior rectus muscle, is directed upward and somewhat outward, and when the inferior rectus muscle operates, it is directed downward and inward.
superior oblique muscle,T.obliquus superior, lies in the superomedial part of the orbit between the superior and medial rectus muscles, turns the eyeball and pupil downward and laterally.
inferior oblique muscle,T.obliquus inferior, starts from the orbital surface of the upper jaw near the opening of the nasolacrimal canal, on the lower wall of the orbit, is directed between it and the inferior rectus muscle obliquely upward and backward, turns the eyeball upward and laterally.
Eyelids.Upper eyelid, palpebra superior , And lower eyelid, palpebra inferior , - formations that lie in front of the eyeball and cover it from above and below, and when the eyelids close, completely covering it.
The anterior surface of the eyelid, facies anterior palpebra, is convex, covered with thin skin with short vellus hair, sebaceous and sweat glands. The posterior surface of the eyelid, facies posterior palpebrae, faces the eyeball, concave. This surface of the eyelid is covered conjunctiva,tunica conjuctiva.
Conjunctiva, tunica conjunctiva , connective tissue membrane. It is distinguished conjunctiva of the eyelids,tunica conjunativa palpebrarum , covering the inside of the eyelids, and conjunctiva of the eyeball,tunica conjunctiva bulbAris, which on the cornea is represented by a thin epithelial cover. . The entire space lying in front of the eyeball, limited by the conjunctiva, is called conjunctival sac,saccus conjunctivae
lacrimal apparatus, apparatus lacrimalis , includes the lacrimal gland with its excretory canaliculi, opening into the conjunctival sac, and lacrimal ducts. lacrimal gland,glAndula lAcrimAlis, - a complex alveolar-tubular gland, lies in the fossa of the same name in the lateral corner, at the upper wall of the orbit. Excretory canaliculi of the lacrimal gland,ducxuli excretorii open into the conjunctival sac in the lateral part of the superior fornix of the conjunctiva.
Blood supply: Branches of the ophthalmic artery, which is a branch of the internal carotid artery. Venous blood flows through the ophthalmic veins into the cavernous sinus. Supplies the retina with blood central retinal artery,a. centrAlis retinae, Two arterial circles: big,circulus arteriosus iridis major, at the ciliary edge of the iris and small,cir culus arteridsus iridis minor, at the pupillary edge. The sclera is supplied with blood by the posterior short ciliary arteries.
Eyelids and conjunctiva - from the medial and lateral arteries of the eyelids, anastomoses between which form the arch of the upper eyelid and the arch of the lower eyelid, and anterior conjunctival arteries in the thickness of the eyelids. The veins of the same name drain into the ophthalmic and facial veins. Directed to the lacrimal gland lacrimal arterya. lacrimalis.
Innervation: Sensitive innervation comes from the first branch of the trigeminal nerve - the optic nerve. From its branch, the nasociliary nerve, long ciliary nerves extend to the eyeball. The lower eyelid is innervated by the infraorbital nerve, which is a branch of the second branch of the trigeminal nerve. The superior, inferior, medial rectus, inferior oblique muscles of the eye and the muscle that lifts the upper eyelid receive motor innervation from the oculomotor nerve, the lateral rectus - from the abducens nerve, the superior oblique - from the trochlear nerve.
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Description
The muscular apparatus of the eye is represented by 6 muscles: four straight lines - upper, lower, medial, lateral and two oblique - upper and lower. The origin of all of the listed extraocular muscles, except for the inferior oblique, is the apex of the orbit, where the muscles fuse to form a dense tendon ring located around the optic foramen and the medial part of the superior orbital fissure. All rectus muscles in the form of flat wide ribbons are directed anteriorly, to the place of their attachment. Gradually diverging, all four rectus oculi muscles form the so-called muscular funnel. The concept of the muscular funnel plays an important role in the topography of the orbit and in the differential diagnosis of pathological processes in the orbit, especially tumors, which give different symptoms and a different prognosis depending on the location inside or outside the funnel (Figure 2).
Figure 2.
Location of the external eye muscles in the orbit. Muscle funnel. The optic nerve passes between the diverging muscles along the axis of the muscular funnel. 1 - tendon ring of Zinn (annulus tendineus communis Zinnii); 2 - m. obliquus superior; 3 - the place of its passage through the block; 4 - m. rectus superior; 5 - m. obliquus inferior; 6 - m. rectus lateralis; 7 - m. rectus inferior; 8 - m. rectus medialis (no Beninghoff, 1957).
By perforating Tenon's capsule at the level of the equator of the eye, the muscles are attached to the eyeball by wide tendons that intertwine into the sclera.
Superior oblique muscle begins, just like the rectus muscles of the eye, in the depths of the orbit, but outside the ring of Zinn, in the immediate vicinity of it, and is directed along the superomedial wall of the orbit, to the spina trochlearis. The muscle looks like a round cord. Passing through the block, it sharply narrows, upon exiting the block it thickens again and turns posteriorly outward. Passing between the eyeball and the superior rectus muscle, it is attached behind the equator in the superior outer quadrant.
Inferior oblique muscle originates separately from all other muscles, from the inner bony wall of the orbit, goes downward outward, encircling the eyeball between the lower wall of the orbit and the inferior rectus muscle, rises upward and attaches to the sclera behind the equator in the same outer quadrant as the upper one.
According to their function, the muscles of the eyeball are divided into three pairs of antagonists acting in directly opposite directions:
- medial and lateral rectus- turn the eye inward and outward;
- upper and lower straight- raise and lower the eyeball;
- oblique muscles- impart rotational movements to the eye.
However Only the external and internal rectus muscles are pure antagonists, they rotate the eye in a horizontal plane, regardless of starting position eyeball. The remaining muscles act as pure antagonists only in the abduction position, when the orbital axis and the anatomical axis of the eye coincide. In the direct direction of gaze, when the anatomical axis of the orbit and the axis of the eye are at an angle of 25 - 27 degrees, muscle actions are more complex:
- inferior rectus muscle lowers the eyeball downwards, brings it in, tilts its vertical meridian outward.
- superior rectus muscle lifts the eyeball upward, brings it in, tilts the vertical axis of the eye inward.
- inferior oblique muscle raises the eye upward, moves it away, tilts the vertical meridian outward.
- superior oblique muscle lowers the eyeball downwards, retracts it, tilts the vertical axis of the eye inward.
In addition, the tone of the rectus oculi muscles tends to pull the eyeball posteriorly, and the two oblique muscles anteriorly.
Thus, the entire muscular system of the eye is in a very finely regulated equilibrium.
Upper and lower eyelids protect the eyeball from the front and due to their blinking movements, which promote the uniform distribution of tears, they protect it from drying out.
The eyelids regulate the amount of light entering the eyes. Reflex closure of the eyelids occurs in response to the influence of mechanical, visual or
sound stimuli. The reflex upward movement of the eye (Bell's phenomenon) when closing the eyelids protects the cornea from foreign bodies and drying out of the cornea during sleep.
The edges of the eyelids form palpebral fissure(rima palpebrarum). (Figure 3).
Figure 3. The structure of the eyelids.
Sagittal section through both eyelids, conjunctival sac and anterior eyeball.
1 - supreorbital edge of the frontal bone; 2 - orbital fat; 3 - levator musculus palpebrae superior; bundles of its tendon fibers penetrate from the left through the circular muscle of the eyelids into the skin; 4 - tendon m. rectus superior. Eyeball: 5- sclera; 6 - conjunctiva of the superior fornix - superior transitional fold; 7 - cornea; 8 - conjunctiva of the lower fornix; 9 - tendon m. rectus inferior; 10 - section of the inferior oblique muscle; 11 - lower orbital edge of the upper jaw bone; 12 - orbital fat; 13 - tarsoorbital fascia - septum orbitale; 14 - cartilage of the lower eyelid; 15 - conjunctiva of the cartilage of the lower eyelid; 16 - conjunctiva of the cartilage of the upper eyelid; 17 - cartilage of the upper eyelid; 18 - m. orbicularis palpebrarum (according to M. L. Krasnov, 1952).
The border of the upper eyelid runs along the eyebrow, the lower eyelid along the lower edge of the orbit. Both eyelids are connected at the corners of the palpebral fissure by the internal and external ligaments (l.palpebrale mediale et laterale). The width and shape of the palpebral fissure varies normally: its horizontal length in an adult is 30 mm, its height ranges from 10 to 14 mm, the edge of the lower eyelid does not reach the limbus by 0.5-1 mm, the edge of the upper eyelid covers the limbus by 2 mm. The outer edge of the palpebral fissure is sharp, the inner edge is blunted in the form of a horseshoe bend. The latter limits the space called the lacrimal lake, in which there are the lacrimal caruncle (caruncula lacrimalis) - a small pink tubercle, which has the structure of the skin with sebaceous and sweat glands, and the semilunar fold (plica semilunaris) of thickened mucous membrane, which are the rudiments of the third eyelid. The free edges of the eyelids, about 2 mm thick, fit tightly to each other. They distinguish between anterior, posterior ribs and intermarginal space. On the anterior, more rounded rib, eyelashes grow (75-150 pcs.), into the bulbs of which the excretory ducts of the sebaceous glands of Zeiss open. Between the eyelashes there are modified Moll's sweat glands. The excretory ducts of the meibomian glands open into the intermarginal space, the fatty secretion of which lubricates the edges of the eyelids, helping to seal them. At the inner corner of the eye, i.e. near the lacrimal lake, the intermarginal space narrows and turns into lacrimal papillae(papilli lacrimales). At the top of each of them there is a lacrimal punctum - an opening leading into the lacrimal canaliculus. The diameter of the lacrimal opening with open eyelids is 0.25 - 0.5 mm. The eyelids consist of 2 plates: the outer plate is formed by skin with muscles, the inner one - by cartilage (tarsus) and the cartilage conjunctiva tightly fused with it.
The skin of the eyelids is very thin, tender, poor in fatty tissue, loosely connected to the underlying tissues. On the skin surface of the upper eyelid there is a deep orbital-palpebral upper fold, on the lower - orbitopalpebral lower fold. The first is located just below the superior orbital margin and is caused by the tone of the anterior leg of the levator muscle attached to the posterior surface of the skin. The thinness and easy displacement of the skin of the eyelids relative to the underlying tissues are good conditions for execution plastic surgery. But in this regard, the skin easily swells with local inflammation, venous stasis, a number of general diseases, hemorrhages and subcutaneous emphysema.
Eyelid mobility is ensured by two groups of antagonistic muscles: orbicularis oculi muscle and levator veli to (m. levator palpebrae superior and m. tarsalis inferior).
Circular muscle of the eyelid- m.orbicularis oculi, s. palpebrarum, in which the palpebral, orbital and lacrimal parts are distinguished. The orbicularis muscle is involved in lowering the upper eyelid and closing the palpebral fissure. The palpebral part is located within the eyelids themselves and does not extend beyond their edges. The muscle fibers of both the upper and lower eyelids are woven into a dense medial ligament. Having described a semicircle along each eyelid, they are temporally attached to the external commissure (lateral ligament) of the eyelids. Thus, two half moons on each eyelid. When the palpebral part contracts, blinking and slight closing of the eyelids occurs, as in a dream. The muscle fibers running along the edge of the eyelids between the roots of the eyelashes and the excretory ducts of the meibomian glands constitute the ciliary muscle, or Riolan muscle (m.ciliaris Riolani), the contraction of which contributes to the release of the secretion of the meibomian glands, as well as the tight fit of the edges of the eyelids to the eyeball. Orbital part: fibers start from the medial ligament and from the frontal segment of the maxilla and pass along the periphery of the palpebral part of the orbicularis muscle. The muscle has view of a wide layer extending beyond the edges of the orbit and connects to the facial muscles. Having described a full circle, the muscle is attached near its origin. When this muscle contracts, together with the contraction of the palpebral part, the eyelids are tightly closed.
Lacrimal part of the orbicularis oculi muscle(Horner's muscle) is represented by a deep portion of muscle fibers that begin somewhat posterior to the posterior crest of the lacrimal bone (crista lacrimalis posterior os lacrimale). They then pass behind the lacrimal sac and become woven into the palpebral fibers of the orbicularis muscle, coming from the anterior lacrimal crest. As a result, the lacrimal sac is surrounded by a muscle loop, which, when contracting and relaxing during blinking movements, either expands or narrows the lumen of the lacrimal sac. The absorption and movement of tear fluid along the lacrimal ducts is also facilitated by the contraction of those bundles of lacrimal muscle that cover the lacrimal canaliculi.
Participates in raising the upper eyelid and opening the palpebral fissure striated- m.levator palpebrae superior and smooth muscle- superior and inferior tarsal or Müller muscles. In the lower eyelid there is no muscle similar to the levator. The function of raising the lower eyelid is carried out by a weakly expressed muscle (m. tarsalis inferior) and the inferior rectus muscle of the eye, which gives an additional tendon to the thickness of the lower eyelid.
M. levator palpebrae superior - begins in the depths of the orbit, where at the apex it departs from the tendon ring (annulus tendineus communis) together with the rectus muscles of the eyeball, is directed under the roof of the orbit anteriorly and at the level of the supraorbital edge passes into a wide tendon, which diverge fan-shaped and divide into three departments. The anterior part of the tendon in the form of thin bundles of fibers passes through the tarso-orbital fascia and orbicularis muscle, diverges in a fan-shaped manner and merges with the subepithelial layer of the skin of the eyelids. Rear portion penetrates into the upper fornix of the conjunctiva and attaches here. Medium - the most powerful(Müller's muscle) is attached along the upper edge of the cartilage along its entire continuation. In its structure, the Müller muscle is reticulate, only part of its muscle bundles approach perpendicular to the edge of the cartilage, penetrating between the levator fibers and accompanying them in places to the upper edge of the cartilage. In this case, the levator tendon is separated by smooth muscle fibers. The other part of the fibers approaches in an oblique direction. The third forms a well-defined transverse beam, intertwined with the levator aponeurosis. Such contact with the levator aponeurosis provides not only elevation, but also prevents wrinkling of the eyelid. The lateral branches of the levator tendon fix it to the periorbita. Contraction of the muscle leads to upward simultaneous lifting of the skin, tarsal plate and conjunctival fornix. The main muscle is the muscle that lifts the upper eyelid, the auxiliary muscle underlying it is the Müller muscle, and when looking up - the frontal and superior rectus. The Müller muscle is innervated by the sympathetic nerve, and the remaining two portions are innervated by the third pair (oculomotor nerve).
With contraction of the palpebral part of the orbicularis oculi muscle blinking and slight squeezing of the eyelids is carried out. Electromyographically it has been established that during voluntary blinking movements the muscle, The levator palpebrae superioris and orbicularis muscles act reciprocally: the activity of one is accompanied by the passivity of the other. If the upper eyelid slowly droops, not only does the activity of the levator muscle decrease, but the antagonist (orbicularis muscle) also remains passive. However, the general mechanism of eyelid closure is more complex due to the combined connection of the orbicular muscle with the facial muscles on the one hand and the epidermis of the facial skin on the other. As a result of these connections, when closed, the eyelids move not only up and down, but also in the horizontal direction - inward, especially the lower one, which plays an important role in the movement of tear fluid. When the eyelids close, the palpebral fissure is shortened by 2 mm. In addition, the leading role in the lacrimal drainage mechanism belongs to the deep part of the palpebral portion of the orbicularis muscle.
Eyelid ligaments
Medial and lateral ligaments serve as the main apparatus that attaches various elements of the eyelid to the bony wall of the orbit: the edges of the eyelids themselves, the orbicularis oculi muscle, the edges of the cartilages and the tarso-orbital fascia. The medial ligament has two legs: front and back. The first, in the form of a powerful collagen cord formed by the tendon of the orbicularis muscle and merging with it by collagen fibers of the medial sections of the cartilage and orbicular fascia, runs horizontally in front of the lacrimal sac from the inner corner of the eyelids to the anterior lacrimal ridge (upper jaw). The cord can be easily palpated and becomes visible when the conjunctiva is pulled downwards, due to tension in the internal ligament. His back leg branches off slightly from the corner of the eyelids in the form of a tendon, bends around the lacrimal sac from the outside and behind and attaches to the posterior lacrimal crest of the lacrimal bone. Thus, the medial ligament covers the lacrimal sac both anteriorly and posteriorly. The lateral ligament of the eyelids, compared to the internal one, is poorly developed and is only a suture with a tendon bridge between the outer parts of the circular muscle of the upper and lower eyelids. The ligament is reinforced by the collagen fibers woven into it from the outer ends of the cartilages and the tarso-orbital fascia. It also runs horizontally from the outer corner of the eyelids to the bony tubercle of the zygomatic bone - tuberculum orbitae, where it is attached 2-3 mm from the edge of the orbit.
Cartilage of the century
It is a semilunar-shaped plate with pointed edges (when performing incision in the intermarginal space, it easily separates into 2 plates). The collagen tissue that forms this plate with an admixture of elastic fibers is distinguished by its special cartilaginous density. Therefore, the name cartilage has taken root, although histologically there are no elements of cartilage here. The pointed ends of the cartilage are firmly connected to each other by an interweaving of collagen fibers. Collagen fibers running from the edges of the cartilage to the medial and lateral ligaments of the eyelids fix the cartilage to the bony walls of the orbit. The density of cartilage determines its protective “skeletal” function. Cartilage follows the convex shape of the eyeball. The length of the cartilage of the upper eyelid is 2 cm, height 1 cm, thickness 1 mm, the cartilage of the lower eyelid is smaller, its height is 5 mm. The anterior surface is bordered by loose connective tissue, the posterior surface is closely connected with the conjunctiva.
The thickness of the cartilage contains modified sebaceous glands - Meibomian(on the upper eyelid - 27-30, on the lower - about 20). They have an alveolar structure and secrete fatty secretions. The very short ducts of the alveoli flow into the long common excretory duct. The glands are parallel to each other and perpendicular to the free edge of the eyelids, occupying the entire height of the cartilage. The openings of the ducts open in front of the posterior edge of the eyelid in the form of pores. The secretion of the meibomian glands serves as a fatty lubricant, protects the edges of the eyelids from maceration, and prevents tears from overflowing over the edge of the eyelids, promoting its proper outflow.
Thus, cartilage is, as it were, direct continuation of the tarsoorbital fascia, firmly connected to the orbital edge. This septum (septum orbitae) completely separates the contents of the orbit from the tissues of the eyelids, preventing the spread of pathological processes deeper. The back surface of the eyelids is covered with the conjunctiva, which is tightly fused with the cartilage, and beyond it forms a mobile arch. Deep upper and shallower and easily accessible lower arch.
The conjunctiva is a thin, transparent mucous tissue, which in the form of a thin shell covers the entire back surface eyelid (tunica conjunctiva palpebrarum), forms deep vaults (fornix conjunctivae superior et inferior) and extends onto the eyeball (tunica conjunctiva bulbi) ending at the limbus. In the conjunctiva of the eyelids, in turn, there is a tarsal part - tightly fused with the underlying tissue, and a mobile - orbital part, in the form of a fold transitional to the arches.
Conjunctival cartilage covered with a two-layer cylindrical epithelium and contains goblet cells at the edge of the eyelids, and the crypts of Henle at the distal end of the cartilage. Both of them secrete mucin. Under the epithelium there is reticular tissue tightly fused with cartilage. At the free edge of the eyelids the mucous membrane is smooth, but already 2-3 mm from it a roughness appears, due to the presence of papillae here.
Conjunctiva transitional fold smooth and covered with 5-6 layer transitional epithelium, also with a large number of goblet cells secreting mucin. Under the epithelium there is loose connective tissue, consisting of elastic fibers and containing plasma cells and lymphocytes. The conjunctiva here easily moves and forms folds that facilitate free movements of the eyeball.
On the border between the tarsal and orbital parts in the conjunctiva there are accessory lacrimal glands s, similar in structure and function to the main lacrimal gland: Wolfring - 3 at the upper edge of the upper cartilage and one more below the lower cartilage, and in the area of the vaults - Krause. The number of the latter reaches 6-8 on the lower eyelid and from 15 to 40 on the upper. The blood circulation of the eyelids is carried out by two systems: the system of the internal carotid artery (branch of a.ophthalmica). a.supraorbitalis, a.lacrimalis and the system of the external carotid artery (anastomoses a.facialis and a.maxillaris, a.temporales superfacialis).
From the nasal side, they penetrate into the thickness of both eyelids from the depths of the orbit. medial palpebral arteries of the eyelid- upper and lower (a. palpebralis mediales superiores et inferiores) - terminal branches of a.supraorbitalis. The a.palpebralis lateralis extends from the lateral side of the a.lacrimalis. In the loose connective tissue layer between the musculocutaneous and tarsal-conjunctival plates of the eyelid, these medial and lateral branches of the palpebral arteries are directed towards each other, merge and form transverse arterial arches: upper and lower (arcus tarseus sup. et inf., or arcus subtarsalis sup.et inf.). Both arterial arches run along the edges of the eyelid, the upper one is 1-2 mm from the edge of the eyelid, the lower one is 1-3 mm. At the level of the upper edge of the cartilage, a second peripheral arc or arcus tarseus sup is formed. It is not always pronounced on the lower eyelid. Between the peripheral and subtarsal arches there are vertical anastomoses with the arteries of the face. The vascularization of the lower eyelid and the surrounding area also involves branches of the infraorbital artery, arising from the maxillary artery (from the external carotid artery system). These arches nourish all the tissues of the eyelids. The veins of the eyelid follow the arteries, forming two networks: superficial and deep. There are significantly more anastomoses - with the veins of the face and the veins of the orbit. Because there are no valves in the veins, blood flows both into the venous network of the face and orbit and through the v.ophthalmica. superior, shedding blood into the cavernous sinus (hence, there is a high probability of infection entering the cranial cavity). On their way into the orbit, the veins that drain blood from the eyelid area also penetrate the orbital muscle. Its spasm in diseases of the eyeball (scrofulosis) can lead to swelling of the eyelids.
The most important anastomoses of the venous network of the eyelids- with the lacrimal vein (v.lacrimalis) and with the superficial temporal vein (v.temporalis superfacialis). Of particular importance are anastomoses with v. angularis, passing from the inner corner of the palpebral fissure and anastomosing with v. ophthalmica superior.
Lymphatic system- a network of widely branched lymphatic vessels in both the deep and subtarsal layers. Both networks anastomose widely with each other. The regional lymph node draining lymph from the upper eyelid is preauricular, from the area of the lower eyelid - submandibular.
Innervation of the eyelids
The third and seventh pairs of cranial nerves take part in the motor innervation of the eyelids.
Orbicularis oculi muscle- a branch of the facial nerve (VII pair), its motor fibers ensure the closure of the eyelids. The facial nerve has a mixed composition: includes motor, sensory and secretory fibers that belong to the intermediate nerve, closely connected with the facial nerve. The motor nucleus of the nerve is located in lower section The pons at the bottom of the IV ventricle, bending around the nucleus of the abducens nerve localized above, forms a knee (genu n. facialis) and reaches the base of the brain in the cerebellopontine angle. Then, through the internal auditory opening, it enters the canalis facialis, in which it makes two turns to form the genu and the genu ganglion (geniculum et ganglium gen.). From the ganglion node originates the large petrosal nerve (n. petrosus major), which carries secretory fibers to the lacrimal gland, extending from a special lacrimal nucleus, and itself facial nerve leaves the canal through the foramen stilomastoideum, giving off branches n at this level. auricularis posterior et r. digastricus. Then, with a single trunk, it penetrates the parotid gland and is divided into superior and inferior branches, which give off multiple branches, including to the orbicularis oculi muscle. The muscle that lifts the upper eyelid is innervated by the oculomotor nerve (III pair), only its middle part, i.e. Müller's muscle - sympathetic nerve.
Nucleus of the oculomotor nerve located at the bottom of the Sylvian aqueduct. The oculomotor nerve leaves the skull through the superior orbital fissure, joining sympathetic (from the plexus of the internal carotid artery) and sensory fibers (from the n.ophthalmicus), passes through the cavernous sinus. In the orbit, within the muscular funnel, it is divided into superior and inferior branches. The upper, thinner branch, passing between the superior rectus muscle and the levator palpebral muscle, innervates them.
Sensory nerves to the upper eyelid and skin of the forehead come from the orbital nerve (n.ophthalmicus) of the 1st branch of the trigeminal nerve, which exits through the superior orbital fissure and is divided into three main branches: n.lacrimalis, n.frontalis et n.nasociliaris. The n.frontalis plays a major role in the innervation of the skin of the eyelids., in the medial region of the upper eyelid, its branches n.supraorbitalis et n.supratrochlearis extend under the skin. The orbital nerve supplies sensitive innervation to the skin of the forehead, the anterior surface of the scalp, the upper eyelid, the inner corner of the eye, the back of the nose, the eyeball itself, the mucous membranes of the upper part of the nasal cavity, the frontal and ethmoid sinuses, and the meninges. The lower eyelid receives sensitive innervation from n.infraorbitalis, extending from the 2nd branch of the trigeminal nerve (n.maxillaris). Maxillary nerve exits the cranial cavity through the round foramen and innervates the dura mater, skin, cartilage and conjunctiva of the lower eyelid (except for the innermost and outer corners of the palpebral fissure), the lower half of the lacrimal sac and the upper half of the nasolacrimal duct, the skin of the anterior part of the temporal region, the upper part of the cheek , wings of the nose, as well as the upper lip, the upper jaw (and the teeth on it), the mucous membranes of the back of the nasal cavity and the maxillary sinus.
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For clear and clear vision, as well as coordinated work of the eyeball, extraocular muscles are needed. Their innervation is due to a large number of nerve contacts, which make it possible to make precise movements when examining objects that are at different distances. The work of six muscles (of which 4 are oblique and two rectus) is provided by three cranial nerves.
It is thanks to muscle fibers that we can direct our gaze up, down, left, right, or close our eyes when working at close range. Different muscle groups allow us to see clear images with a high degree of confidence. In this article we will talk in detail about muscle structure organs of vision. Let's consider its function, anatomy, as well as possible pathologies.
Anatomical structure
The extrinsic eye muscles are located inside the orbit and are attached to the eyeball. When they contract, the visual organ turns, directing the gaze to the right side. To a greater extent, the work of the muscular system is regulated by the oculomotor nerve. All the muscles of the eye begin in the area surrounding the optic nerve foramen and the superior orbital fissure.
Depending on the characteristics of attachment and movement, the muscle fibers of the eye are divided into straight and oblique. The first group goes in the forward direction:
- internal (medial);
- external (lateral);
- top;
- lower
The external rectus muscle rotates the eye toward the temple. Thanks to the shortening of the internal straight line, it is possible to direct the gaze towards the nose. The superior and inferior rectus muscles help the eye move vertically and toward the inner corner.
The remaining two muscles (upper and lower) have an oblique course and are attached to the eyeball. They perform more complex actions. The superior oblique muscle lowers the eyeball and turns it outward, and the inferior oblique muscle lifts it and also moves it outward. Eye movements depend on the characteristics of the attachment of striated muscle fibers.
At the end of the article, we’ll talk about the nerves that innervate the muscles of the visual apparatus:
- trochlear – superior oblique;
- abducens – lateral straight;
- oculomotor – all the rest.
INTERESTING! Overstrain of the oblique muscles of the eye becomes the main cause of myopia.
The extrinsic muscular system also includes the levator palpebrae superioris and the orbicularis muscle. The orbicularis oculi muscle (radial) is a plate that closes the entrance to the orbit. It goes along the entire circumference of the eye. Its main function is to close the eyelids and protect the eye socket. It consists of three main parts:
- century - responsible for closing the eyelids;
- orbital – with involuntary spasms, it causes the eyes to close;
- lacrimal - expands the lacrimal sac and removes fluid.
If the functioning of this muscle is disrupted, blepharospasm may develop. Involuntary contractions of the eye can last from a few seconds to several minutes. Lagophthalmos is also called "hare's eye". Due to muscle fiber paralysis, the palpebral fissure does not close completely. The above pathologies are characterized by the appearance of the following symptoms: eversion and sagging of the lower eyelid, convulsive twitching, dryness, photophobia, swelling, lacrimation.
The intrinsic muscles of the eye include:
- ciliary muscle;
- muscle that constricts the pupil;
- muscle that dilates the pupil.
The muscular apparatus configures the visual organ to examine objects. With their help, the eyelids open and close. Thanks to three-dimensional and bright vision, a person fully perceives the world around him. The coordinated operation of this system is possible due to two factors:
- correct muscle structure;
- normal innervation.
Main function muscular system– ensuring the movement of the eyeball in a given direction. Nerve fibers are the guiding elements of the entire movement process. Contractions of the visual muscles also cause a change in the size of the pupil.
Pathologies
Only with the correct operation of the oculomotor mechanism will the visual apparatus be able to realize all its functions. Any deviation in the functioning of muscle fibers is fraught with impaired visual function and the development of dangerous pathologies.
Most often, the oculomotor mechanism suffers from the following phenomena:
- Myasthenia. Weakness of the muscle fibers does not allow them to move the eyeballs properly.
- Paresis or paralysis. Manifests itself in the form of structural damage to the neuromuscular structure.
- Spasm. Expressed in excessive muscle tension.
- Strabismus - strabismus.
- Myositis is inflammation of muscle fibers.
- Congenital anomalies (aplasia, hypoplasia).
Diseases of the muscular system cause the following unpleasant symptoms:
- Diplopia – doubling of the image.
- Nystagmus is involuntary movement of the eyeballs. In other words, the eye twitches.
- Pain in the eye sockets.
- Loss of one or another eye movement.
- Dizziness.
- Changing head position.
- Headache.
Myositis
The outer muscles of the eyeball can become inflamed at the same time. This is a rare disease that usually affects one visual organ. Most often, young or middle-aged men suffer from myositis. At risk are people whose professional activities involve prolonged sitting.
Myositis is an inflammation of the extraocular muscles
Myositis can develop due to the following reasons:
- infectious diseases;
- helminthic infestations;
- intoxication of the body;
- incorrect position bodies while at work;
- long-term visual stress;
- injuries;
- hypothermia;
- mental stress.
The disease is accompanied by clearly defined pain and intense muscle weakness. Increased pain occurs at night and when weather conditions change. Minor swelling and redness of the skin may also occur. Patients complain of lacrimation and photophobia.
The more muscle fibers are involved in the pathological process, the more the inflamed muscles thicken. This manifests itself as exophthalmos, or protrusion of the eyeball. With myositis, the visual organ is painful and limited in mobility. Treatment of the disease includes a whole range of therapeutic measures, including physiotherapy, physical education, massage, diet, and the use of medications.
Myasthenia gravis
The development of myasthenia gravis is based on neuromuscular wasting. The pathology most often affects young people aged twenty to forty years. Muscle weakness of the visual organs is an autoimmune disease. This means that the immune system begins to produce antibodies to its own tissues.
ATTENTION! Symptoms of myasthenia gravis increase with exercise and decrease with rest.
Myasthenia gravis is characterized by a recurrent or constantly progressive course. The ocular form is manifested by weakness of the eyelids and muscles.
The exact causes of the disease are still unknown. Scientists suggest that the leading role in the occurrence of myasthenia gravis belongs to hereditary factors. When collecting a patient's history, it often turns out that one of the blood relatives suffered from the same illness.
Among the symptoms of pathology, the following come to the fore:
- double vision;
- unclear vision of objects;
- violation of the motor and rotational function of the eye muscles;
- drooping eyelids.
To relieve discomfort, patients are advised to wear dark glasses in bright light. Special adhesive tape can be used to hold the eyelids in place. To prevent diplopia (double vision), a blindfold is used over one visual organ. It is worn alternately on one and the other eye.
Spasm of accommodation
Normally, the organs of vision adapt and see images equally clearly at close and far distances. The focus of the eye is controlled by the ciliary muscle. If there are disturbances in its functioning, a spasm of accommodation is formed - a pathology in which a person cannot clearly see objects at different distances.
The disease is also called false myopia, or tired eyes syndrome. To view distant images, the lens relaxes, and to clearly see near objects, it tenses. With a spasm of accommodation, the lens does not relax, which is why the quality of distance vision suffers.
The main reason for the development of pathology is visual overload. Fatigue develops due to a number of reasons:
- regularly reading books in poor lighting;
- no breaks when working with small parts or at the computer;
- prolonged work requiring extreme concentration of vision;
- lack of sleep.
With a spasm of accommodation, a person has trouble seeing objects in the distance
A spasm of accommodation manifests itself in the form of myopia, periodic pain in the eyes, and increased fatigue. Patients complain of a burning sensation, pain, redness, dizziness, and a feeling of dryness. As the pathology progresses, the eyes begin to get tired even in the absence of complex visual work. Visual acuity gradually decreases.
Treatment of accommodation spasm involves complex measures. In addition to conservative therapy, hardware techniques and gymnastics are used. Doctors prescribe eye drops to relax the ciliary muscle: Midriacil, Cyclomide, Atropine. To dilate the pupil, stimulate the circulation of intraocular fluid and strengthen the ciliary muscle, Irifrin drops are prescribed.
Along with such drugs, vitamin complexes and drugs to moisturize the mucous membrane of the eye are prescribed. Neck massage helps relieve spasms.
Strabismus (strabismus)
This is a visual impairment in which one or both eyes deviate from the point of fixation. Strabismus occurs in both children and adults.
Strabismus is not a simple cosmetic defect. The pathology is based on impaired binocular vision. This means that a person cannot correctly determine the location of an object in space. The disease negatively affects the quality of life.
Normally, the image of objects is recorded in the central part of the visual organs. Next, the image from each eye is transmitted to the brain. There, this data is combined, which provides full binocular vision.
With strabismus, the brain is unable to connect the information it receives from the right and left eyes. To protect a person from splitting, nervous system simply ignores the signal from the damaged visual organ. This causes a decrease in the functional activity of the squinting eye.
The following reasons can provoke the development of pathology:
- corneal thorn;
- cataract;
- degenerative changes of the macula;
- traumatic brain injuries;
- severe fear;
- visual fatigue;
- brain diseases;
- infectious processes of ENT organs;
- retinal detachment.
Strabismus causes restrictions in the mobility of the eyeball. The patient is deprived of the opportunity to see a three-dimensional image. Objects appear double. Patients complain of dizziness. There is a characteristic tilt of the head towards the damaged organ and squinting.
Vision can be corrected using specially selected glasses or contact lenses. Prismatic devices help relieve muscle tension and restore quality of vision.
The orthopedic treatment method involves applying a special bandage to the healthy eye. This will be a good stimulation for the damaged visual organ. In more severe cases, surgery is indicated.
The photo shows another pathology of the extraocular muscles - strabismus.
Strengthening exercises
Why do my eyes hurt? The causes of pain may be associated with the development of ophthalmological diseases or problems with the muscular system. Pain when moving the eyeballs indicates overstrain of the visual muscles. Simple eye exercises will help relieve spasm.
At first glance, the very idea of training muscle fibers may seem absurd, because they are already in constant dynamics. Indeed, the eye muscles work actively throughout the day, but such movements are most often of the same type.
ATTENTION! Gymnastics for the eyes is of a general strengthening nature and can be performed at any convenient time.
First, let's talk about how to strengthen the external muscles:
- Take a sitting position and keep your back straight. Look from the ceiling to the floor ten times. Then repeat the movement in the opposite direction.
- In the same position, move your eyeballs from the left side to the right and back. You will need to do ten such approaches.
- Imagine a clock face in front of you and move your eyes in a clockwise direction. Do five reps and then change direction.
- Finally, blink intensely for thirty seconds.
To train the internal muscles, you will need to make a black circle with a diameter of five millimeters in advance. It should be glued to the window, at eye level. Stand at a distance of thirty centimeters from the window. First, fix your gaze on the black circle, and then look at some medium-sized object outside the window.
The main condition is that the image must be still. It could be a tree, a car or some kind of structure. You should hold your gaze on nearby and distant objects for fifteen seconds. Five such cycles will be required.
Weak eye muscles can be strengthened by palming. First, rub the palms of both hands together until you get a pleasant warmth. Place your hands on your closed eyelids and sit in this position for several minutes. Try to relax completely, without thinking about anything. After this procedure, you will immediately notice clarity in your vision of objects.
The results of visual gymnastics directly depend on the correctness of the exercises and regularity. If you do exercises twice a day every day, then within two weeks you will feel an improvement in your vision.
Preventing muscle fatigue
As you know, we are what we eat. Diet is directly related to the functional activity of the visual system. One of the mandatory foods that should be in the diet of a person who cares about their eyesight should be carrots. This vegetable is a source of vitamin A, which improves visual acuity and twilight vision. Cottage cheese contains vitamin B, which ensures normal blood circulation and metabolic processes in the visual apparatus.
Blueberries are a “friend” for the eyes. This berry contains B vitamins, as well as retinol and ascorbic acid. Constant consumption of blueberries helps restore impaired metabolic processes and the activity of various eye structures.
Alternative medicine also gives many tips for relaxing the muscular system. Pour half a glass of fresh cucumber peel with one hundred grams of cool water, and also add a little salt. After fifteen minutes, the peel will give juice. It should be used in the form of compresses.
You can forget about muscle pain by following simple medical recommendations:
- Don't read lying down. Due to the unnatural arrangement of muscle fibers, they are stretched. This causes pain and deterioration of visual function.
- Provide good lighting when performing work that requires visual concentration.
- If your eyes begin to get tired quickly when working at a computer, use special glasses.
- Treat ophthalmological diseases in a timely manner. Untreated pathologies negatively affect the condition of the muscular system.
The eye muscles play a huge role in ensuring high-quality vision of objects. Disturbances in their work are fraught with the development of such serious pathologies as strabismus, myositis, spasm of accommodation, myasthenia gravis. Prevention is the best treatment. Experts advise training muscle fibers. Regular execution simple exercises will help strengthen the muscle system.
