3D modeling for visualization of the orbital pulley system.

Purpose: To facilitate visual appreciation of the anatomical relationships among the extraocular muscles and the orbital suspensory system, these tissues were realistically rendered using Blender, a three-dimensional (3D) modeling software. Methods: Information on the size and position of the globe and extraocular muscles (EOMs) in healthy adult participants was obtained from published studies and was used to create a detailed, realistic 3D model of the orbital pulley system. Results: The 3D model successfully rendered realistic anatomical structures and illustrated the relationship among the orbital pulleys, globe, Tenon's fascia, and EOMs. Key features of the model include a) a pulley sleeve for each rectus EOM, with a central pulley ring; b) pulley array, interconnecting bands linking the rectus pulley rings to the oblique muscles; and c) pulley slings attached anteriorly to the lateral and nasal orbital walls, and posteriorly to Tenon's fascia forming a continuous enclosure around the globe. Conclusions: This educational model provides an anatomically accurate visualization accessible to strabismus specialists, ophthalmologists, and extraocular surgeons. The model also holds potential for adaptation to depict pathological anatomy in strabismus caused by orbital pulleys disorders.