Orbital Pulley Disorder

About Orbital Pulley Disorders (Heavy/Sagging Eyes)

A pulley is a system of ropes and wheels used to move equipment, to change its direction or to raise something. The muscles in the back of the eye work much the same way in a highly complex pulley system of its own.

These eye muscles pass through rings of other tissue made of collagen, elastin, and smooth muscle to increase and control motility. Orbital malformations, certain diseases, trauma, or procedures can interfere with any aspect of this integral eye pulley system and cause eye movement disorders. In the case of heavy or sagging eyes, there is a major problem with this pulley system. Some disorders can be mechanical or muscular or a problem with the nervous system. 

Conditions We Treat

Orbital pulley disorders may lead to strabismus. The strabismus specialists here at Columbia have extensive experience treating there conditions. Common orbital pulley disorders include:

  • Heavy eye syndrome
  • Sagging eye syndrome


Although orbital pulley disorders may be the cause of strabismus, since there are other causes of strabismus, our pediatric ophthalmologists/strabismologists can determine the cause and then make sure you or your child receives the appropriate course of treatment.


Symptoms of an orbital pulley disease can be prominent. Double vision and/or misalignment of the eyes (crossing or one eye higher than the other) are the most common symptoms. In these disorders, the symptoms are often variable and can range from being mild to quite severe.

Treatments We Offer

Our team of pediatric ophthalmologists/strabismologists can perform surgery or prescribe prism to help eliminate any visual problems caused by the orbital pulley disorder.

Why Choose Columbia?

At Columbia, our strabismus specialists have extensive experience in treating orbital pulley disorders such as heavy eye syndrome and sagging eye syndrome. We have the experience and most advanced technology and training to make sure that you or your child has a highly successful surgery and that you are thrilled with the outcome. From your first office visit and evaluation to recovery and follow-up care, Columbia pediatric ophthalmologists/strabismologists are right there with you every step of the way.