An anomalous muscular band between the superior and inferior rectus muscles in a patient with recurrent painful ophthalmoplegic neuropathy: A case report

The extraocular muscles are integral to voluntary and reflexive eye movements, enabling precise gaze control through the coordinated action of six muscles. Variants in extraocular muscle anatomy, though rare, may contribute to disorders of ocular movement. We report a case of a 20-year-old female presenting with recurrent painful ophthalmoplegic neuropathy found to possess a rare anomalous muscular band between the superior and inferior rectus muscles identified on magnetic resonance imaging of the orbits. This report seeks to expand the limited literature on anomalous bands of the orbit by presenting the first radiological imaging-based characterization of this variant, highlighting the need for radiologists and clinicians interpreting orbital magnetic resonance imaging to remain vigilant in identifying atypical orbital soft tissue anatomy and its potential role in visual or eye movement pathologies.