IOVS Antimicrobial Agents and Chemotherapy
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

(Investigative Ophthalmology and Visual Science. 2005;46:2258-2263.)
© 2005 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.04-1164
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (6)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Jaggi, G. P.
Right arrow Articles by Killer, H. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jaggi, G. P.
Right arrow Articles by Killer, H. E.

The Anatomy of the Muscle Insertion (Scleromuscular Junction) of the Lateral and Medial Rectus Muscle in Humans

Gregor P. Jaggi,1 Hubert R. Laeng,2 Markus Müntener,3,4 and Hanspeter E. Killer1,5

1From the Department of Ophthalmology, and the 2Institute of Pathology, Kantonsspital, Aarau, Switzerland; the 3Department of Anatomy, University of Zürich, Zürich, Switzerland; the 4Department of Chemistry and Applied Biosciences, Swiss Federal Institute of Technology (ETH), Zürich, Switzerland; and the 5Department of Ophthalmology, University of Basel, Basel, Switzerland.


   Abstract
Top
 Abstract
Material and Methods
 Results
 Discussion
 References
 
PURPOSE. To analyze the histologic features of the insertion of the medial and the lateral rectus muscles in humans.

METHODS. Postmortem study performed on 49 extraocular muscles from 21 subjects without known ocular disease. All muscles were obtained no longer than 8 hours after death, after consent for autopsy. Thirty-seven lateral recti muscles and 12 medial recti muscles were studied with light microscopy (hematoxylin-eosin and Goldner stains) as well as with enzyme histochemistry and immunohistochemistry, with monoclonal-human tenascin C antibody.

RESULTS. Light microscopic studies of muscle insertions of the lateral and the medial rectus muscle demonstrated muscle tissue connecting directly to the sclera without a tendon. These findings were confirmed immunohistochemically with tenascin C-antibody staining.

CONCLUSIONS. Based on the results of this postmortem study in humans the term "muscle tendon" should be used with caution for the insertional area (scleromuscular junction) of the lateral and medial extraocular muscles. Light microscopy, histochemistry, and immunohistochemistry demonstrate that the tissue at the scleromuscular junction contains striated muscle with minimal connective (tendinous) tissue connecting to the sclera. To the best of the authors’ knowledge, this is the first study in which enzyme histochemistry and immunohistochemistry have been used to investigate the anatomy of the insertional area (muscle-tendon-sclera junction) of the extraocular muscles in humans.

Knowledge of the anatomic characteristics of the extraocular muscles and their insertional area is of vital interest for understanding the physiology of eye movements.1 2 3 4 Most studies of the tendons of the extraocular muscles and the scleromuscular junction were performed macroscopically. Quantitative data concerning the length of the muscles and the tendons were obtained with calipers and were highly variable in the literature.5 6 7 8 9 10 11 12 13


   Material and Methods
Top
 Abstract
 Material and Methods
Results
 Discussion
 References
 
Forty-nine extraocular muscles (37 lateral rectus muscles and 12 medial rectus muscles) from 21 subjects (13 females and 8 males) without known ocular disease were obtained no later than 8 hours after death, after consent for autopsy according to the tenets of the Declaration of Helsinki. All muscles were dissected through transconjunctival access and removed with a small piece of adhering sclera. The specimens were embedded in optimal cutting temperature (OCT) compound (Tissue Tek; Miles, Elkhart, IN) and frozen in melting isopentane (–160°C) within 2 hours after excision. Some muscles were fixed in formaldehyde (4%) and embedded in paraffin (56–58°C, paraffin embedding system TBS88, Tissuewax; Medite Medizintechnik, Burgdorf, Germany).

Serial sections (8 µm) of the frozen muscles were cut at –20°C (Cryocut Jung CM 3000; Leica, Glattbrugg, Switzerland). The specimens embedded in paraffin were cut longitudinally (5 µm) with a rotation microtome (Microm HM 325; Carl Zeiss Meditec, Jena, Germany).

Some sections of each specimen were stained with hematoxylin-eosin (HE). For simultaneous demonstration of muscle fiber types and motor endplates, 20-µm-thick sections were processed according the method of Ashmore et al.14 For demonstration of the position of the endplates alone, acetylcholinesterase was shown in sections (14 µm), according to the method of Karnovsky and Roots.15

One lateral rectus muscle was completely sectioned longitudinally and all sections processed to demonstrate the distribution of motor endplates along the entire length of the muscle. For the demonstration of motor end plates together with the terminal axons, sections (40 µm) were processed according to the methods of Karnovsky and Roots15 and Pestronk and Drachman.16 Serial consecutive sections (14 µm) were stained for myofibrillar adenosine triphosphatase (mATPase), cytochrome c oxidase and {alpha}-glycerophosphate-dehydrogenase.17 18 19 20 21

The extracellular glycoprotein tenascin C (monoclonal anti-human-tenascin C antibodies (Clon: B28-13; donated by Ruth Chiquet-Ehrismann, Miescher Institut Basel, Switzerland) was detected in longitudinal cryosections (8 µm) immunohistochemically, as described by Chiquet and Fambrough.22

Tenascin C, an extracellular glycoprotein, is present in the tendons of skeletal muscle but absent in scleral tissue. In addition, tenascin C is found in the connective tissue of the walls of blood vessels and of peripheral nerves.22 23 24 25 26 27 28 In control experiments, biopsy specimens of human multifidus muscles were processed in the same way.

The sections were evaluated with a light microscope (Axioscop; Carl Zeiss Meditec) and photographed with the microscopic system (Progress 3012 mF; Jenoptik Laseroptik Systeme, Jena, Germany) and further processed on computer (Photoshop 7.0; Adobe Systems Inc., Mountain View, CA).


   Results
Top
 Abstract
 Material and Methods
 Results
Discussion
 References
 
All muscle insertions (scleromuscular junctions) of the medial and lateral rectus muscle were investigated, and in all muscles a global and an orbital portion was identified. (Fig. 1) . The two portions were separated by connective tissue that displayed multiple medium-sized blood vessels. The same type of arterioles was regularly demonstrated at the scleromuscular junction.



View larger version (126K):
[in this window]
[in a new window]
  		FIGURE 1. Horizontal section through human globe. (*) Insertion of medial rectus displaying global portion (GP) and orbital portion (OP). H E stain. MR, medial rectus muscle; LR, lateral rectus muscle.

 
In all muscles, short tendinous fibers were found between the muscle fibers and the sclera. For semiquantitative measurement of the length of these tendons, longitudinal sections (HE, anti-tenascin-C) were used. The length of the tendon was determined from the distance between the sclera and the first appearance of muscle tissue. The maximum length of tendon (HE staining) measured 3 mm in a lateral rectus muscle (Fig. 2) . In the specimens stained with anti-tenascin, neither medial nor lateral rectus muscles demonstrated a tendon length of more than 1 mm. In 75% of the specimens, muscle tissue was demonstrated connecting to the sclera (Fig. 3) . Direct contact between muscle and sclera was also demonstrated with hematoxylin-eosin stain. The global portion of the muscle inserted into the sclera more remotely in relation to the limbus (Fig. 4) .



View larger version (59K):
[in this window]
[in a new window]
  		FIGURE 2. Scleromuscular junction of lateral rectus muscle displaying a maximum of 3 mm of tendon. Some of the material appearing as tendon (arrow) may be due to inadvertent dissection of sclera during preparation of the specimen. Multiple blood vessels (arrowhead). H E stain.

 


View larger version (146K):
[in this window]
[in a new window]
  		FIGURE 3. Scleromuscular junction (dotted line). Blood vessels in the muscle (M) show staining of the connective tissue in their walls with anti-tenascin C. Inset: tendon tissue surrounded by striated muscle. ({cjs3656}) Musculotendinous junction. Only the connective tissue of the tendon was stained; the sclera remained unstained. Anti-tenascin C stain.

 


View larger version (103K):
[in this window]
[in a new window]
  		FIGURE 4. (A) Medial rectus muscle inserting into the sclera (Goldner staining). Note two-finger–type insertion (i.e., the global portion insertion is more remote from the limbus than the orbital portion). OP, orbital portion; GP global portion. (B) Higher magnification of the medial rectus insertion showing multiple layers of muscle connecting directly to the sclera (S).

 
In all specimens examined, immunohistochemical staining demonstrated small amounts of tendon embedded in muscle tissue, but not necessarily connecting to the sclera. In most of the immunohistochemical specimens, striation of the muscle tissue remained intact. In all sections examined, tenascin-containing connective tissue was demonstrated. There was a slight increase in the amount of tenascin-stained tendon tissue found immediately adjacent to the sclera. These tendon fibers run parallel to the direction of the muscle fibers (Fig. 5) . The multifidus muscle that was used as a control for the stain showed a strong reaction to the antibody (Fig. 6) .



View larger version (117K):
[in this window]
[in a new window]
  		FIGURE 5. Detail from lateral rectus muscle displaying striated muscle fibers (MF) and antitenascin-C–stained tendon tissue running parallel to muscle fibers. Note the intact striation of the muscle tissue. Tenascin-C free endomysium (arrow).

 


View larger version (142K):
[in this window]
[in a new window]
  		FIGURE 6. Human multifidus muscle demonstrating a global, strong anti-tenascin-C reaction.

 
The specimens stained for motor endplates14 15 and terminal axons15 16 were evaluated on a qualitative basis. Motor endplates and terminal axons were also found in the immediate vicinity of the sclera.


   Discussion
Top
 Abstract
 Material and Methods
 Results
 Discussion
References
 
This histologic investigation (light microscopy, immunohistochemistry, and enzymohistochemistry) of the insertion of the lateral and medial extraocular muscles in humans demonstrated large amounts of muscle tissue that contained only minimal islands of tendon and connected directly with the sclera. A distinct tendon was not demonstrated. These findings contrast with former studies6 7 11 29 that reported a proper muscle tendon connecting the muscle to the sclera. However, in only one of these former studies were histologic methods used for tissue identification. Histologic evidence of the presence of a tendon was only presented in one study of the superior oblique muscle.30 Whether the term "tendon" is appropriate for extraocular muscles has been questioned by Apt,7 who at the same time has raised doubt about the accuracy of the measurements of the length of the tendons reported in previous articles. He has suggested that the term "aponeurosis" would be more appropriate than the term tendon. Most of the literature dealing with eye movements has not fully explained eye muscle functions based on current anatomic knowledge.29 31 32 33 The recent discovery of the pulley system has delivered powerful functional and anatomic insight into the way eye movements take place.31 32 34 35 36 37

With classic histologic staining such as hematoxylin-eosin or Goldner, tendon and sclera cannot be distinguished. Therefore, splitting off of scleral fibers due to inadvertent dissection could be misinterpreted to represent tendon (Fig. 2) . We used anti-tenascin C antibodies as a reliable tissue marker for distinguishing among muscle, tendon, and sclera. Tenascin C has been demonstrated in the limbus region of the eye, conjunctiva, Descemet’s membrane, and the tunica interna of blood vessels. The high specificity of tenascin C for collagen-containing tendon tissue is reflected by the lack of reaction to the connective tissue in the endomysium and the positive reaction to the connective tissue in the walls of blood vessels and in the perineurium.22 23 24 25 26 27 28 The reaction of these tissues was used as a positive control.

In contrast to other publications examining the "tendons" of extraocular muscles, we were unable to demonstrate the presence of a true tendon connecting muscle directly with the sclera in neither the medial nor the lateral rectus muscles. In the region of the muscle insertion (scleromuscular junction), we found muscle tissue containing only small islands of tendon tissue in the vicinity of the sclera. Such a situation was proposed by De Gottrau and Gajisin,8 albeit without proper histologic or immunohistochemical evidence. The absence of Golgi-spindle organs in the distal portion of the extraocular muscles, as described by Blumer et al.,38 Bruenech and Ruskell,39 and Richmond et al.,40 correlates with our findings of the paucity of tendon tissue in that region. The presence of motor endplates is further evidence for muscle tissue in the scleromuscular junction.

Electromyographic (EMG) recordings demonstrating EMG potentials (Killer HE, personal experience) in the vicinity of the insertion of the lateral rectus and medial rectus muscle supplies clinical evidence for the presence of muscle endplates near the insertion of the muscle into the sclera. Innervated myotendinous cylinders (IMCs) were found abundantly in the proximal segments (insertional zone) of extraocular muscles.2 10 As functional structures, IMCs are highly important for the proprioceptive innervation of human extraocular muscles.41 Ophthalmologists performing eye muscle surgery should be aware that when they perform muscle resection they reduce the number of IMCs as well as the number of sarcomeres and motor endplates. In comparison with recession for surgical correction of strabismus, marginal myotomy was found to be more proprioceptively "deafferenting" than recession, probably due to a greater disruption of palisade endings.42 Our findings showing that the medial and lateral recti insert without a tendon directly into the sclera indicate that resection of muscle tissue containing proprioceptive elements may also be more "deafferenting" than recession. Eye muscles are neded to perform extremely rapid (saccades) and highly coordinated movements (versions). To perform these movements, it is desirable that the generator of force (muscle) and the object being rotated (eyeball) be in direct contact. The interposition of a tendon between muscle and eyeball would probably impair the efficiency of ocular muscle function.


   Acknowledgements
 
The authors thank Michael C. Brodsky, MD (Arkansas Children’s Hospital, Little Rock, AR), and Jody Stähelin, MD (Department of Pediatrics, Kantonsspital, Aarau, Switzerland), for helpful comments on the manuscript.


   Footnotes
 
Submitted for publication October 1, 2004; revised January 21, 2005; accepted March 11, 2005.

Disclosure: G.P. Jaggi, None; H.R. Laeng, None; M. Müntener, None; H.E. Killer, None

The publication costs of this article were defrayed in part by page charge payment. This article must therefore be marked "advertisement" in accordance with 18 U.S.C. §1734 solely to indicate this fact.

Corresponding author: Hanspeter E. Killer, Augenklinik, Kantonsspital Aarau, Aarau, 5001 Switzerland; killer{at}ksa.ch.


   References
Top
 Abstract
 Material and Methods
 Results
 Discussion
 References
 

  1. Baker RS, Porter JD. Development adaptations in the extraocular muscles of Macaca nemestrina may reflect a predisposition to strabismus. Strabismus. 1993;1:173–180.
  2. Hertle RW, Chan CC, Galita DA, Maybodi M, Crawford MA. Neuroanatomy of the extraoxular muscle tendon enthesis in macaque, normal human, and patients with congenital nystagmus. J AAPOS. 2002;6:319–327.
  3. Porter JD, Baker RS, Ragusa RJ, Brueckner JK. Extraocular muscles: basic and clinical aspects of structure and function. Surv Ophthalmol. 1995;39:451–484.[Web of Science][Medline][Order article via Infotrieve]
  4. Porter JD, Poukens V, Baker RS, Demer JL. Structure-function correlations in the human medial rectus extraocular muscle pulleys. Invest Ophthalmol Vis Sci. 1996;37:468–472.[Abstract/Free Full Text]
  5. Adachi B. Anatomische Untersuchungen an Japanern. Z Morphol Anthropol. 1900;2:198–222.
  6. Lang J, Horn T, von den Eichen U. Über die äusseren Augenmuskeln und ihre Ansatzzonen. Kirsche W Kadanoff D Mayersbach Het al eds. Gegenbaurs morphologisches Jahrbuch. 1979;817–840. Akademische Verlagsgemeinschaft Geest und Portig Leipzig.
  7. Apt L, Call NB. An anatomical reevaluation of rectus muscle insertions. Ophthalmic Surg. 1982;13:108–112.[Web of Science][Medline][Order article via Infotrieve]
  8. De Gottrau P, Gajisin S. Données anatomiques, histologiques, et morphométriques des muscles droits oculaires et de leurs rapports avec le globe et la capsule de Tenon. Klin Monatsbl Augenheilkd. 1992;200:515–516.[Medline][Order article via Infotrieve]
  9. Hesser C. Der Bindegewebeapparat und die glatt Muskulatur der Orbita beim Menschen in normalem Zustand. Anatomische Hefte. 1913;1:1–302.[CrossRef]
  10. Lukas JR, Blumer R, Denk M, Baumgartner I, Neuhuber W, Mayr R. Innervated myotendinous cylinders in human extraocular muscles. Invest Ophthalmol Vis Sci. 2000;41:2422–2431.[Abstract/Free Full Text]
  11. Merkel I. Handbuch der gesamten Augenheilkunde: makroskopische Anatomie. Graefe AS eds. Anatomie und Physiologie. 1874;1:50–60. Wilhelm Engelmann Verlag Leipzig, Germany.
  12. Von Noorden GK. Binocular vision and ocular motility: summary of the gross anatomy of the extraocular muscles. Binocular Vision and Ocular Motility. 1990; 4th ed. 41–52. CV Mosby St. Louis.
  13. Bron AJ, Tripathi RC, Tripathi BJ. The anatomy of the eye and orbit: the extraocular muscles and ocular movements. Wolff EB eds. Wolff’s Anatomy of the Eye and Orbit. 1997; 8th ed. 107–176. Chapman and Hall Medical London.
  14. Ashmore CR, Vigneron P, Marger L, Doerr L. Simultaneous cytochemical demonstration of muscle fiber types and acetylcholinesterase in muscle fibers of dystrophic chickens. Exp Neurol. 1978;60:68–82.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  15. Karnovsky MJ, Roots L. A "direct-coloring" thiocholine method for cholinesterases. J Histochem Cytochem. 1964;12:219–221.[Web of Science][Medline][Order article via Infotrieve]
  16. Pestronk A, Drachman DB. A new stain for quantitative measurement of sprouting at neuromuscular junctions. Muscle Nerve. 1978;1:70–74.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  17. Guth L, Samaha FJ. Procedure for the histochemical demonstration of actomyosin ATPase. Exp Neurol. 1970;28:365–367.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  18. Müntener M. Variable pH dependence of the myosin-ATPase in different muscle of the rat. Histochemistry. 1979;62:299–304.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  19. Müntener M. A rapid and reversible muscle fiber transformation in the rat. Exp Neurol. 1982;77:668–678.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  20. Käser L, Mannion AF, Rhyner A, Weber E, Dvorak J, Müntener M. Active therapy for chronic low back pain: Part 2. Effects on paraspinal muscle cross-sectional area, fiber type size, and distribution. Spine. 2001;26:909–919.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  21. Dubowitz V. Muscle Biopsy. 1985; 2nd ed. Baillère Tindall London.
  22. Chiquet M, Fambrough D. Chick myotendinous antigen. I: a monoclonal antibody as a marker for tendon and muscle morphogenesis. J Cell Biol. 1984;98:1926–1936.[Abstract/Free Full Text]
  23. Chiquet M, Fambrough DM. Chick myotendinous antigen. II. A novel extracellular glycoprotein complex consisting of large disulfide-linked subunits. J Cell Biol. 1984;98:1937–1946.[Abstract/Free Full Text]
  24. Chiquet-Ehrismann R, Mackie EJ, Pearson CA, Sakakura T. Tenascin: an extracellular matrix protein involved in tissue interactions during fetal development and oncogenesis. Cell. 1986;47:131–139.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  25. Matsumoto K, Saga Y, Ikemura T, Sakakura T, Chiquet-Ehrismann R. The distribution of tenascin-X is distinct and often reciprocal to that of tenascin-C. J Cell Biol. 1994;125:483–493.[Abstract/Free Full Text]
  26. Nicolo M, Piccolino FC, Zardi L, Giovannini A, Mariotti C. Detection of tenascin-C in surgically excised choroidal neovascular membranes. Graefes Arch Clin Exp Ophthalmol. 2000;238:107–111.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  27. Ringelmann B, Roder C, Hallmann R, et al. Expression of laminin alpha 1, alpha2, alpha4 and alpha5 chains, fibronectin, and tenascin-C in skeletal muscle of dystrophic 129ReJ dy/dy mice. Exp Cell Res. 1999;246:165–182.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  28. Tuori A, Uusitalo H, Thornell LE, Yoshida T, Virtanen I. The expression of tenascin-X in developing and adult rat and human eye. Histochem J. 1999;31:245–252.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  29. Fuchs E. Beiträge zur normalen Anatomie des Augapfels. Arch Ophthalmol. 1884;30:1–60.
  30. Helveston EM, Oberlander M, et al. Ultrastructure of the superior oblique tendon. J Pediatr Ophthalmol Strabismus. 1995;32:315–316.[Web of Science][Medline][Order article via Infotrieve]
  31. Kapoula Z, Bernotas M, Haslwanter T. Listing’s plane rotation with convergence: role of disparity, accommodation, and depth perception. Exp Brain Res. 1999;126:175–186.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  32. Miller JM. Functional anatomy of normal human rectus muscles. Vision Res. 1989;29:223–240.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  33. Misslisch H, Hess BJ. Three-dimensional vestibuloocular reflex of the monkey: optimal retinal image stabilization versus listing’s law. J Neurophysiol. 2000;83:3264–3276.[Abstract/Free Full Text]
  34. Demer JL. The orbital pulley system: a revolution in concepts of orbital anatomy. Ann N Y Acad Sci. 2002;956:17–32.[Web of Science][Medline][Order article via Infotrieve]
  35. Demer JL, Miller JM, Poukens V, Vinters HV, Glasgow BJ. Evidence for fibromuscular pulleys of the recti extraocular muscles. Invest Ophthalmol Vis Sci. 1995;36:1125–1136.[Abstract/Free Full Text]
  36. Oh SY, Poukens V, Demer JL. Quantitative analysis of rectus extraocular muscle layers in monkey and humans. Invest Ophthalmol Vis Sci. 2001;42:10–16.[Abstract/Free Full Text]
  37. Miller JM, Demer JL, Rosenbaum AL. Effect of transposition surgery on rectus muscle paths by magnetic resonance imaging. Ophthalmology. 1993;100:475–487.[Web of Science][Medline][Order article via Infotrieve]
  38. Blumer R, Lukas JR, Wasicky R, Mayr R. Presence and morphological variability of Golgi tendon organs in the distal portion of sheep extraocular muscle. Anat Rec. 2000;258:359–368.[CrossRef][Medline][Order article via Infotrieve]
  39. Bruenech R, Ruskell GL. Myotendinous nerve endings in human infant and adult extraocular muscles. Anat Rec. 2000;260:132–140.[CrossRef][Medline][Order article via Infotrieve]
  40. Richmond FJ, Johnston WS, Baker RS, Steinbach MJ. Palisade endings in human extraocular muscles. Invest Ophthalmol Vis Sci. 1984;25:471–476.[Abstract/Free Full Text]
  41. Ruskell GL. The fine structure of innervated myotendinous cylinders in extraocular muscles of rhesus monkeys. J Neurocytol. 1978;7:693–708.[CrossRef][Web of Science][Medline][Order article via Infotrieve]
  42. Steinbach MJ, Kirshner EL, Arstikaitis MJ. Recession vs marginal myotomy surgery for strabismus: effects on spatial localization. Invest Ophthalmol Vis Sci. 1987;28:1870–1872.[Abstract/Free Full Text]



This article has been cited by other articles:


Home page
 IOVSHome page
M. Fesharaki, P. Karagiannis, D. Tweed, J. A. Sharpe, and A. M. F. Wong
Adaptive Neural Mechanism for Listing's Law Revealed in Patients with Skew Deviation Caused by Brainstem or Cerebellar Lesion
Invest. Ophthalmol. Vis. Sci., January 1, 2008; 49(1): 204 - 214.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
K.-M. Lee, A. P. Lai, J. Brodale, and A. Jampolsky
Sideslip of the Medial Rectus Muscle during Vertical Eye Rotation
Invest. Ophthalmol. Vis. Sci., October 1, 2007; 48(10): 4527 - 4533.
[Abstract] [Full Text] [PDF]

Home page
 IOVSHome page
J. R. McClung, B. L. Allman, D. M. Dimitrova, and S. J. Goldberg
Extraocular Connective Tissues: A Role in Human Eye Movements?
Invest. Ophthalmol. Vis. Sci., January 1, 2006; 47(1): 202 - 205.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (6)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Jaggi, G. P.
Right arrow Articles by Killer, H. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jaggi, G. P.
Right arrow Articles by Killer, H. E.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS