In normal vision, lateral movement of one eye ( lateral rectus muscle ) is precisely coupled to medial movement of the other eye ( medial rectus muscle ), so that both eyes remain fixed on the same object.
22.
The main muscle for abduction is the lateral rectus, so although superior oblique contributes to a downwards and lateral eye movement, testing this motion would not be specific enough as inferior and lateral recti muscles would also be tested.
23.
MRI may be helpful in the diagnosis, in one study volumes of medial rectus, lateral rectus, and inferior rectus muscles in CPEO were not smaller than normal ( in contrast to the profound atrophy typical of neurogenic paralysis ).
24.
The central anatomy of the sixth nerve predicts ( correctly ) that infarcts affecting the dorsal pons at the level of the abducens nucleus can also affect the facial nerve, producing an ipsilateral facial palsy together with a lateral rectus palsy.
25.
But children are certainly going to be put off by the rampant medical jargon, as in " the abducens nerve is the sixth cranial nerve and extends from the dorsal part of the pons to the lateral rectus muscle of the eye ."
26.
The abducens nucleus contains two types of cells : motor neurons that control the lateral rectus muscle on the same side, and interneurons that cross the midline and connect to the contralateral oculomotor nucleus ( which controls the medial rectus muscle of the opposite eye ).
27.
The sixth nerve, the abducens nerve, which innervates the lateral rectus muscle of the eye ( moves the eye laterally ), is also commonly affected but fourth nerve, the trochlear nerve, ( innervates the superior oblique muscle, which moves the eye downward ) involvement is unusual.
28.
The concept of reciprocal innervation is also applicable to the eye ( Sherrington's law ), wherein increased innervation to an extraocular muscle is accompanied by a simultaneous decrease in innervation to its specific antagonist, such as the medial rectus and the lateral rectus in the case of an eye looking to one side of the midline.
29.
Secondly, by reducing the size of the deviation temporarily it might allow prismatic correction to be used where this was not previously possible, and, thirdly, by removing the pull of the medial rectus it may serve to reveal whether the palsy is partial or complete by allowing any residual movement capability of the lateral rectus to operate.
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