Posterior Inflection of Weakened Lateral Rectus Path: Connective Tissue Factors Reduce Response to Lateral Rectus Recession

The LR muscle pulley suspension contributes to LR muscle tension, tightening the muscle belly by stretching it temporally when LR muscle tone is reduced. The increase in LR muscle path length resulting from temporal inflection offsets the effect of recession by up to 4 mm. Connective tissue action explains some response variability after LR muscle recession.