Disorders of Eye Movement
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Try one of these related symptoms.
Eyes not tracking together
Have problems moving my eyes
Difficulty moving right eye
Difficulty moving left eye
Right eye does not move
Left eye does not move
Eyeball not moving
Abnormal eye movements
Eyes don’t line up with one another
Eye misalignment
Eye points inward
Double vision
About the Symptom
Eye movement disorder is characterized by intact alignment but in which the eyes either have restricted motility, move too slowly, or are misdirected. This can be due to muscle or nerve disorders.
When to See a Doctor
Seek professional care if you experience any of the following symptoms
- Cannot move eyes
Possible Causes
Generally, Disorders of eye movement can be related to:
- Tolosa Hunt Syndrome
Tolosa-Hunt Syndrome is a rare condition characterized by severe headaches behind the eyes, decreased and painful eye movements typically in just one eye. The exact cause is unknown, but it may be related to inflammation in certain areas behind the eye.
- MELAS Syndrome
MELAS is a rare genetic disorder that starts in childhood and mainly affects the nervous system and muscles. The disorder is transmitted through the affected person's mother. Typical MELAS symptoms include weak muscles, sudden ("stroke-like") neurological symptoms such as paralysis of the right or left side of the body, blindness, or numbness, in addition to seizures and migraine-like headaches. People who have MELAS are also typically short in size, and have difficulty hearing.
Related Serious Diseases
Sometimes, Disorders of eye movement may be related to these serious diseases:
- Orbital Blowout Fracture
An injury where the bones around the eye are fractured, usually caused by a severe impact to the front of the eye, such as a golf ball.
- Wernicke Encephalopathy
- Vertebral Artery Dissection
- Optic Neuritis (Optic Neuromyelitis, Ischemic Optic Neuropathy)
- Cerebral Hemorrhage
- Cerebral Infarction
- Cerebral Venous Sinus Thrombosis (CVT)
- Subarachnoid Hemorrhage
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Do you have difficulty moving your eyes in a specific direction?
- How long have you had difficulty moving or unable to move your eye(s) in a certain direction?
Reviewed By:
Ami Shah Vira, MD (Ophthalmology)
Dr. Shah Vira grew up in Arizona. She moved to Chicago to complete a combined engineering and medical program at the Illinois Institute of Technology (IIT) and Chicago Medical School. She completed a highly competitive two year dual fellowship in Neuro-ophthalmology and Oculoplastic at the highly regarded Ohio State University in Columbus, Ohio. Dr. Shah Vira specializes in surgical correction of the eyelids and eyebrows, eyelid malposition and tumors, excessive tearing, and conditions involving the orbit.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Feb 6, 2025
Following the Medical Content Editorial Policy
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FAQs
Q.
One Pupil Larger Than the Other? When This Is a Medical Emergency
A.
Unequal pupils can be benign, but a sudden change is an emergency if it comes with severe headache, head injury, confusion, vision loss or double vision, drooping eyelid, weakness or numbness, slurred speech, seizures, or neck stiffness; these can signal stroke, aneurysm, brain bleeding, high intracranial pressure, or acute angle-closure glaucoma and need immediate ER care. There are several factors to consider, including long-standing harmless anisocoria, medication effects, migraine, and nerve problems like third nerve palsy or Horner’s syndrome, which change the next steps for care; see below for specific red flags, what to do right now, and when monitoring is reasonable.
References:
* Patel D, Patel S, Lim LL, et al. Anisocoria: What the Clinician Needs to Know. Clin Ophthalmol. 2018;12:2075-2081. doi:10.2147/OPTH.S178657. PMID: 30464407.
* Geyer HL, Chhabra N, Rhee K. Anisocoria in the Emergency Department. J Emerg Med. 2017 Mar;52(3):530-534. doi: 10.1016/j.jemermed.2016.10.021. PMID: 27876211.
* Kuchtey J, Kuchtey RW. Acute anisocoria: a clinical algorithm for diagnosis and management. J Neuroophthalmol. 2011 Sep;31(3):272-8. doi: 10.1097/WNO.0b013e3182236d39. PMID: 21772138.
* Lee MS, Smith SJ, Galetta SL, et al. The Anisocoria Workup: A Step-by-Step Approach. J Neuroophthalmol. 2014 Dec;34(4):427-31. doi: 10.1097/WNO.0000000000000185. PMID: 25310688.
* Nemet AY, Nemet AA. Anisocoria. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. PMID: 30422538.
Q.
Is Your Eye Drifting? Why Your Lazy Eye is Failing & Medically Approved Next Steps
A.
There are several factors to consider; a drifting or worsening lazy eye is most often related to muscle imbalance, uncorrected vision differences, or untreated childhood amblyopia, and fatigue can make it more noticeable, while a sudden new drift or double vision in adults can point to nerve or neurologic issues that need urgent care. Medically approved next steps include a comprehensive eye exam, updated glasses or prisms, vision therapy or selective patching, possible strabismus surgery, and treating underlying conditions, with important nuances that could change your plan explained below.
References:
* Polat U, Kılıç-Toprak A. Amblyopia treatment: An overview of the past, present, and future. Taiwan J Ophthalmol. 2020 May 29;10(2):69-76. doi: 10.4103/tjo.tjo_10_20. PMID: 32483864; PMCID: PMC7292265.
* Holmes JM, Lazar EL, Kraker RT, Wallace DK, Anderson JS, Birch EE, Cole SR, Cotter SA, Donahue SP, Everett DF, Kasturi S, Kulp MT, Mazow ML, McDonald MA, Miller AM, Mitchell GL, Quinn GE, Repka MX, Scheiman MM, Silverman SE, Pediatric Eye Disease Investigator Group. Current treatment options for amblyopia. Ophthalmology. 2016 Apr;123(4):898-904. doi: 10.1016/j.ophtha.2015.12.002. Epub 2016 Jan 23. PMID: 27040409; PMCID: PMC4819448.
* D'Andrea D, Magli A, Magli G. Treating amblyopia in adults: a review. J Ophthalmol. 2020 Feb 3;2020:6451694. doi: 10.1155/2020/6451694. PMID: 32047585; PMCID: PMC7017726.
* Alabduljalil A. Amblyopia: definition, classification, diagnosis, and treatment. J Ophthalmic Vis Res. 2019 Apr-Jun;14(2):220-221. doi: 10.4103/jovr.jovr_18_19. PMID: 31191060; PMCID: PMC6547055.
* Hess RF, Thompson B. Amblyopia in adults: recent advances and future directions. Optom Vis Sci. 2015 Jan;92(1):34-40. doi: 10.1097/OPX.0000000000000490. PMID: 25555461.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Types of Strabismus- American Academy of Ophthalmology
https://www.aao.org/education/basic-skills/type-of-strabismus-introduction