Table Of ContentNeuro-Ophthalmology
Developments in
Ophthalmology
Vol. 40
Series Editor
W. Behrens-Baumann,Magdeburg
Neuro-
Ophthalmology
Neuronal Control of Eye Movements
Volume Editors
Andreas Straube,Munich
Ulrich Büttner,Munich
39 figures, and 3 tables, 2007
Basel·Freiburg·Paris·London·New York·
Bangalore·Bangkok·Singapore·Tokyo·Sydney
Andreas Straube Ulrich Büttner
Department of Neurology Department of Neurology
Klinikum Grosshadern Klinikum Grosshadern
Marchioninistrasse 15 Marchioninistrasse 15
DE–81377 Munich DE–81377 Munich
Library of Congress Cataloging-in-Publication Data
Neuro-ophthalmology / volume editors, Andreas Straube, Ulrich Büttner.
p. ; cm. – (Developments in ophthalmology, ISSN 0250-3751 ; v. 40)
Includes bibliographical references and indexes.
ISBN 978-3-8055-8251-3 (hardcover : alk. paper)
1. Neuroophthalmology. I. Straube, Andreas. II. Büttner, U. III. Series.
[DNLM: 1. Eye Movements–physiology. 2. Ocular Motility Disorders. 3.
Oculomotor Muscles–physiology. 4. Oculomotor Nerve-physiology. W1
DE998NG v.40 2007 / WW 400 N4946 2007]
RE725.N45685 2007
617.7(cid:1)32–dc22 2006039568
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© Copyright 2007 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland)
www.karger.com
Printed in Switzerland on acid-free paper by Reinhardt Druck, Basel
ISSN 0250–3751
ISBN: 978–3–8055–8251–3
Contents
VII List of Contributors
IX Preface
Büttner, U.; Straube, A. (Munich)
1 Anatomy of the Oculomotor System
Büttner-Ennever, J.A. (Munich)
15 Eye Movement Recordings: Methods
Eggert, T. (Munich)
35 Vestibulo-Ocular Reflex
Fetter, M. (Karlsbad)
52 Neural Control of Saccadic Eye Movements
Catz, N.; Thier, P. (Tübingen)
76 Smooth Pursuit Eye Movements and Optokinetic Nystagmus
Büttner, U.; Kremmyda, O. (Munich)
90 Disconjugate Eye Movements
Straumann, D. (Zurich)
110 The Eyelid and Its Contribution to Eye Movements
Helmchen, C.; Rambold, H. (Lübeck)
132 Mechanics of the Orbita
Demer, J.L. (Los Angeles, Calif.)
V
158 Current Models of the Ocular Motor System
Glasauer, S. (Munich)
175 Therapeutic Considerations for Eye Movement Disorders
Straube, A. (Munich)
193 Subject Index
Contents VI
List of Contributors
Prof.Dr.med.U.Büttner Prof.Dr.med.J.L.Demer
Department of Neurology Jules Stein Eye Institute
Klinikum Grosshadern 100 Stein Plaza
Marchioninistrasee 15 David Geffen School of Medicine at
DE–81377 Munich (Germany) UCLA
Los Angeles, CA 90095-7002,
Prof.Dr.med.Jean Büttner-Ennever Calif. (USA)
Institute of Anatomy
Ludwig-Maximilian University Dr.Ing.T.Eggert
Pettenkoferstrasse 11 Department of Neurology
DE–80336 Munich (Germany) Klinikum Grosshadern
Marchioninistrasee 15
Dr.N.Catz DE–81377 Munich (Germany)
Department of Cognitive Neurology
Hertie Institute for Clinical Brain Prof.M.Fetter
Research SRH Clinic Karlsbad-Langensteinbach
Hoppe-Seyler Strasse 3 Department of Neurology
DE–72076 Tübingen (Germany) Guttmannstrasse 1
DE–76307 Karlsbad (Germany)
VII
PD Dr.Ing.S.Glasauer Prof.Dr.med.A.Straube
Department of Neurology Department of Neurology
Klinikum Grosshadern Klinikum Grosshadern
Marchioninistrasse 15 Marchioninistrasse 15
DE–81377 Munich (Germany) DE–81377 Munich (Germany)
Prof.Dr.med.Ch.Helmchen Prof.Dr.med.D.Straumann
Department of Neurology Neurology Department
University Hospitals Zurich University Hospital
Schleswig-Holstein Frauenklinikstrasse 26
Campus Lübeck CH–8091 Zurich (Switzerland)
Ratzeburger Allee 160
DE–23538 Lübeck (Germany) Prof.Dr.med.P.Thier
Department of Cognitive Neurology
Dr.O.Kremmyda Hertie Institute for Clinical Brain
Department of Neurology Research
Klinikum Grosshadern Hoppe-Seyler Strasse 3
Marchioninistrasse 15 DE–72076 Tübingen (Germany)
DE–81377 Munich (Germany)
PD Dr.H.Rambold
Department of Neurology
University Hospitals
Schleswig-Holstein
Campus Lübeck
Ratzeburger Allee 160
DE–23538 Lübeck (Germany)
List of Contributors VIII
Preface
Each of us performs thousands of eye movements every day without being
aware of how the brain controls them. The oculomotor system is one of the best
understood motor systems not only with regard to premotor centers in the central
nervous system, but also with regard to the peripheral muscles moving the eye.
This has been made possible by intensive multidisciplinary research, including
ophthalmologists, neurologists and basic scientists, and is reflected in compre-
hensive textbooks [i.e. Leigh RJ, Zee DS: The Neurology of Eye Movements.
New York, Oxford University Press, 2006]. Based on these studies, some basic
features of the oculomotor system were formulated and put to use in clinical prac-
tice: (1) All extraocular motoneurons are involved in all eye movements and
innervate basically functionally similar muscles. (2) The pulling directions of the
muscles are determined by central commands. (3) There are at least 5 different
types of eye movements, i.e. saccades, smooth pursuit eye movements, vestibulo-
ocular reflex (VOR), vergence and optokinetic nystagmus. Furthermore, there are
special neuronal circuits involved in fixation of an object. The premotor centers
for these eye movements have different locations in the central nervous system.
However, experimental evidence gathered over recent years strongly sug-
gests that none of these basic rules are correct and they have to be modified. (1)
Twitch and nontwitch motor fibers of eye muscles have different distributions in
the eye muscle. They are innervated by different motoneurons with distinct loca-
tions in the oculomotor nuclei, and furthermore they receive different inputs from
premotor structures in the brainstem [see the chapter by Büttner-Ennever]. Thus,
there are different classes of motoneurons, which serve different functions. (2) It
also becomes increasingly clear that mechanical properties of the connective tis-
sues (pulleys including Tenon’s capsule) in the orbit are important, particularly for
IX
