Author Response: Letter to the Editor of IOVS From Joseph L. Demer and Robert A. Clark Regarding Joel M. Miller EOM Pulleys and Sequelae: A Critical Review

摘要

The Active Pulley Hypothesis, as I use the term, and as Demer and colleagues normally do, was described in their article, “Evidence for Active Control of Rectus Extraocular Muscle Pulleys,” which proposed that each rectus muscle was functionally two independent muscles, one of which (the global layer [GL]) was inserted in the sclera to rotate the globe, and the other (the orbital layer [OL]) was inserted in and translated the pulley to alter the oculorotary action of the GL passing through it. The diagrammatic representation from that paper (top half of Fig. 10), which has appeared in many versions since, is reproduced here ( ). The APH is a hypothesis, not merely a statement about anatomy, and it proposes both mechanical and innervational independence of OL and GL. To claim otherwise, as Demer and Clark do in the main argument of their letter, is to mislead.