Logan Steele
Our eyes are controlled by six muscles that work in pairs, allowing us to direct our gaze in various directions. These muscles are essential for our vision and eye movement, and their proper functioning is crucial for our overall eye health. Eye muscle conditions or disorders can significantly impact our vision and eye movement, leading to issues such as double vision or strabismus (crossed eyes). To maintain eye health and potentially improve certain vision problems, eye exercises, also known as vision therapy, have been proposed. While there is limited scientific evidence supporting the effectiveness of eye exercises, they may still offer some benefits, such as improved eye comfort and reduced eye strain.
| Characteristics | Values |
|---|---|
| Number of eye muscles controlling movement | 6 |
| Type of eye muscles controlling movement | External or extrinsic |
| Type of eye muscles | Rectus muscles, oblique muscles |
| Number of rectus muscles per eye | 4 |
| Number of oblique muscles per eye | 2 |
| Names of rectus muscles | Superior rectus, inferior rectus, medial rectus, lateral rectus |
| Names of oblique muscles | Superior oblique, inferior oblique |
| Cranial nerve controlling superior, inferior, and medial rectus muscles, and inferior oblique muscle | Cranial nerve III (oculomotor nerve) |
| Cranial nerve controlling lateral rectus muscle | Cranial nerve VI (abducens nerve) |
| Eye muscle conditions | Muscle disorders, nervous system-related disorders |
| Vision therapy techniques | Eye exercises, special lenses, prisms, patches, electronic targets, balance boards |
| Eye exercises | Pencil push-ups, tracing an imaginary figure eight, palming, blinking exercises, focus exercises |
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What You'll Learn
Eye muscle exercises
20-20-20 Rule
Every 20 minutes, look at something 20 feet away for 20 seconds. This helps to reduce eye strain, especially during screen use.
Blinking
Blinking exercises can help to keep your eyes fresh and focused for longer. Blinking improves symptoms of digital eye strain, dry eye, and can help improve blinking habits. Try taking a blinking break every 20 minutes, especially when looking at screens.
Figure Eight
Imagine a large number 8 about 8-10 feet in front of you. Slowly trace the shape with your eyes, maintaining smooth movements, for 30 seconds. Then, switch directions. This is an excellent exercise to strengthen eyesight and improve tracking ability.
Focus Change
Hold your finger a few inches away from your eyes and focus your gaze on it. Then, slowly move your finger further away, holding your focus. Look away for a moment, into the distance, then bring your finger back towards your face, focusing on it the whole time. Repeat this process three times.
Eye Rolling
Look right and left several times without moving your head, then look up and down several times. This exercise keeps the muscles flexible and is an essential part of any treatment for weak eye muscles.
Pencil Pushups
Hold a pencil at arm's length, between your eyes. Focus on the pencil and slowly move it towards your nose, until it is no longer a single image. Move the pencil back to the closest point where you can see a single image. Repeat this process 20 times. This exercise can help with convergence insufficiency.
Brock String
The Brock String was developed by Frederick Brock of Switzerland and can be used for a variety of exercises to train the visual system. To set up the Brock String, tie a loop on each end of a long string, then attach one loop to a doorknob. Place three beads on the string, with the distance bead closest to the doorknob, and the middle bead 2-5 feet from you. Hold the other end of the string just below your nose and look straight at the bead with both eyes open. This exercise helps improve eye coordination.
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Eye muscle conditions
Muscle Disorders
Muscle disorders that affect eye movement include myotonic dystrophy and oculopharyngeal muscular dystrophy (OPMD). Kearns-Sayre syndrome, thyroid eye disease, and Graves' disease can also be categorized as muscle disorders.
Nervous System-Related Disorders
Cranial nerve palsies are a specific type of nervous system-related disorder that affects eye movement. The sixth nerve palsy (abducens) is the most common form, but it can also affect the third nerve (oculomotor nerve) and the fourth nerve (trochlear nerve). Nervous system-related disorders that can affect eye movement include myasthenia gravis, multiple sclerosis, stroke and transient ischemic attacks (TIAs), brain tumors and cancers, nerve or brain lesions, and Lyme disease. Parkinson's disease and Parkinsonism can also impact eye movement.
Eye Movement Disorders
Eye movement disorders are crucial clues to many conditions, including dangerous ones. Two common eye movement disorders are strabismus and nystagmus. Strabismus is a disorder in which the two eyes do not line up in the same direction, resulting in "crossed eyes" or "walleye." Nystagmus is characterized by fast, uncontrollable movements of the eyes, sometimes called "dancing eyes." Some eye movement disorders are present at birth, while others develop over time and may be associated with injuries or other problems. Treatments for eye movement disorders include glasses, patches, eye muscle exercises, and surgery. However, some types of nystagmus have no cure.
Diagnosis and Treatment
Neurological exams and lab tests, such as blood tests, can help diagnose eye muscle disorders. Treatments for eye muscle disorders vary, and sometimes the condition will resolve on its own. Treating the underlying condition may also improve the eye movement issue.
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Cranial nerves and eye muscles
The eyes have six muscles that control their movement and allow them to point in different directions. These muscles are attached to the outside of the eyeball and are referred to as "external" or "extrinsic" muscles. The eyes also have two types of muscles: rectus muscles and oblique muscles. Each eye has four rectus muscles and two oblique muscles.
The movement of the eyes is controlled by three cranial nerves: cranial nerve III (CN III), also known as the oculomotor nerve; cranial nerve IV (CN IV), also known as the trochlear nerve; and cranial nerve VI (CN VI), also known as the abducens nerve.
CN III controls the movements of the superior, inferior, and medial rectus muscles, as well as the inferior oblique muscle. A lesion of CN III will affect most of the extraocular muscles, causing the affected eye to be displaced laterally and inferiorly, resulting in a "down and out" position.
CN IV controls the superior oblique muscle. A lesion of CN IV will paralyse the superior oblique muscle, resulting in double vision or diplopia, and the patient may develop a head tilt away from the site of the lesion.
CN VI controls the lateral rectus muscle. Palsy of the abducens nerve will affect the lateral rectus, causing the eye to be addicted by the medial rectus.
In addition to these three main cranial nerves, the cavernous sinus in the cranium contains five cranial nerves, four of which are involved in the innervation of the eyes: CN III, CN IV, CN V1, CN V2, and CN VI.
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Eye muscle movement
The extraocular muscles, innervated by three cranial nerves, execute eye movements. These cranial nerves are:
- Cranial nerve III (oculomotor nerve): Controls the superior, inferior, and medial rectus muscles, as well as the inferior oblique muscle.
- Cranial nerve VI (abducens nerve): Controls the lateral rectus muscle.
The coordination of eye movements is essential for proper visual perception. The two eyes must work together and move in synchrony to enable depth perception and three-dimensional (3D) vision. This coordination is achieved through the gaze system, which ensures that the images on the two retinas correspond to the binocular field.
While there is limited scientific evidence that eye exercises can significantly improve vision, they can still provide several benefits. Eye exercises are often recommended as part of vision therapy to enhance visual skills, comfort, and eye tracking. They can be particularly effective in treating conditions such as strabismus (crossed eyes) and amblyopia (lazy eye). Additionally, eye exercises can help alleviate eye strain, especially for those who experience eye irritation or fatigue due to digital device usage.
- Figure-of-eight exercise: Trace an imaginary figure eight with your eyes, focusing on a point about 8-10 feet away, for 30 seconds, and then switch directions.
- Pencil push-up: Hold a pencil at arm's length and focus on the tip or a letter on the eraser. Slowly move the pencil towards your nose, keeping it in focus. Once it becomes blurry, draw it away from your eyes again.
- Thumb focus: Hold your thumb about 10 inches from your face and focus on it for 15 seconds. Then, shift your gaze to a target 20 feet away and focus on it for another 15 seconds.
- Palming: Rub your hands together to warm them, close your eyes, and place your palms over your corresponding cheekbones. Cup your hands over your eyes and breathe deeply for five minutes to relax the muscles around the eyes.
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Eye muscle anatomy
The human eye has six muscles that control movement. These muscles are responsible for directing eye movement side-to-side, up and down, or at diagonal angles. These muscles are called "external" or "extrinsic" muscles because they attach to the outside of the eyeball.
There are two types of eye muscles: rectus muscles and oblique muscles. Each eye has four rectus muscles and two oblique muscles. The four rectus muscles are:
- Superior rectus: This muscle is located at the top of the eye.
- Inferior rectus: This muscle is located at the bottom of the eye.
- Medial rectus: This muscle is located on the side closest to the nose.
- Lateral rectus: This muscle is located on the side farthest from the nose.
The two oblique muscles are:
- Superior oblique: This muscle works like a pulley, starting at the upper back of the eye and extending forward, then threading through a small, bony opening on the upper-inner side of the eye socket.
- Inferior oblique: This muscle attaches to the lower-inner side of the eye socket, extends laterally (away from the nose), wraps around the bottom of the eye, and attaches just behind the lateral rectus on the far side.
The six external muscles of the eyes work in pairs. When one muscle moves, its partner in the same eye helps control and balance that movement. This is why the eyes can only turn so far. There is also a type of paired movement involving both eyes, called "yoking," where the eyes turn in unison, like a pair of yoked horses or oxen.
The extraocular muscles are located within the orbit but are extrinsic and separate from the eyeball itself. They control the movements of the eyeball and the superior eyelid. The levator palpebrae superioris (LPS) is the only muscle involved in raising the superior eyelid.
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Frequently asked questions
The eye has three layers, the outermost of which is a fibrous layer consisting of the cornea and the sclera. The sclera is white and covers most of the eye. The second layer is a vascular layer consisting of the choroid, the iris, and the ciliary body. The inner layer contains the retina. The extraocular muscles are seven muscles supplied by cranial nerves that are responsible for eye movement.
The extraocular muscles execute eye movements and are innervated by three cranial nerves. The six external muscles of the eyes work in pairs. When one muscle moves, its partner in the same eye helps control and balance that movement.
Some eye exercises to improve eye muscle strength include:
- Pencil push-ups: Hold a pencil at arm's length and focus on the tip of the eraser. Slowly move the pencil towards your nose, and once the eraser goes out of focus, move it back to its original position.
- Focus shift: Hold your thumb about 10 inches from your face and focus on it for 15 seconds. Then, shift your focus to a target 20 feet away for 15 seconds. Repeat this several times.
- Figure eight: Trace an imaginary figure eight with your eyes by focusing on a point on the floor about 10 feet away from you. Continue for 30 seconds, then switch directions.
Some common symptoms that may indicate that eye strengthening exercises are useful include skipping lines or words while reading, closing one eye, eyestrain, and headaches.
Eye exercises can help treat certain eye conditions, such as strabismus (crossed eyes) and lazy eye (amblyopia). However, they are not effective for conditions such as myopia (nearsightedness), hyperopia (farsightedness), astigmatism, age-related macular degeneration, cataracts, or glaucoma.
