Abnormal saccades in paralytic strabismus

Saccadic eye movements were measured in ten patients with unilateral limitation of function of an extraocular muscle. With the paretic eye fixating, there were a series of saccades when refixating in the direction opposite to the paralysis. Between each saccade, the eye drifted back toward the starting position; the drift rate decreased as the eye moved into the field of action of the strong agonist muscle. In one patient, the normal (covered) eye was immobilized during attempted refixations. In this case, the abnormal pattern of saccades made by the paretic eye persisted. Thus, the central nervous system uses innervation or efference to calculate the position of the eye in the orbit for saccadic eye movements.