Whereas skeletal muscles generally perform specific limited roles, extraocular muscles (EOMs) have to be responsive over a wider dynamic range. As a result, EOMs have fundamentally distinct structural, functional, biochemical, and immunological properties as compared to other skeletal muscles.
At birth, the extraocular muscles are at approximately 50 % to 60 % of their final dimension. Their relative growth within the enlarging orbit and their angular relations with the globe remain nearly constant from infancy to adulthood. The adult rectus muscles are approximately the same length (40 mm) but differ in thickness and in the length of their tendons. There are six extrinsic, or extraocular, muscles of the eye: four recti and two obliques. Only the horizontal and vertical recti insert on the eyeball in front of its equator. Both obliques have their insertions behind the equator of the globe. All six muscles consist of striated muscle fibers with abundant elastic fibers. The EOMs have muscle fibers and innervations that differ from those of skeletal muscle. There are three distinct types of muscle fibers (fine, granular, and coarse) that contribute to the action of the EOMs. The fine fibers are thought to be responsible for slow twitch movements, the granular fibers for fast twitch movements, and the coarse fibers for slow tonic movements. The EOMs are more richly innervated than other voluntary muscles of the body and have three types of nerve terminals: single endplate (driving eye movements), multiple endplates (tonic tension), and palisade endings (can be sensory receptors). In addition, there are both singly and multiply innervated nerve fibers present. EOMs are able to vary their contractile force by small increments. The maximum firing frequency of ocular motor units is about four times greater than those of limb muscle motor units. To allow them to operate at a higher frequency, EOMs also have faster contractile properties, with their time to peak tension and their one-half relaxation time being at least half of those in limb muscles.