What is eye muscle inflammation?

Each eye in the human body has several muscles that are needed to move the eyeball.
There are a total of four eye muscles that can move the eye up, down, laterally (sideways) and medially (towards the nose). There are also two other muscles that cause combined movement. Other muscles in the eye are, for example, in the eyelids. Various muscles and fibers are also involved in the changes in the size of the pupils and the curvature of the lens.

If one or more of these eye muscles are inflamed, one speaks of eye muscle inflammation. The inflammation is characterized by swelling, overheating, pain and possibly a functional impairment.

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The causes of eye muscle inflammation can be varied.
For example, inflammation of the eye muscles from pathogens is possible. These pathogens can spread further from the eye and thus also affect the eye muscles. Typically, eye infections are caused by viruses or bacteria as pathogens, whereby bacteria migrate more frequently and can occasionally attack the eye muscles. Severe injuries to the eyeball with an infection that can also affect the eye muscles are rare.

Often, however, eye muscle inflammation is caused by inflammation of the brain or meninges. Bacteria and viruses can settle in the meninges and in the nerve water (Liquor) and move from there towards the eye. There they can attack the muscles of the eye, causing inflammation of the eye muscles. Common pathogens for this are, for example, Borrelia. But other bacteria that like to cause meningitis such as pneumococci or meningococci can also be the trigger.

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Viral diseases that migrate from the brain to the eye muscles are, for example, the TBE viruses or herpes viruses, which can also establish themselves in the eye. Inflammation of the eye muscles can also be caused by autoimmune diseases. This leads to a reaction of the immune system against its own body. Immune cells attack the body's own cells and trigger immune reactions and inflammation in the affected area.

Read more on the subject at:

  • Meningitis
  • Vaccination against meningococci

Lyme disease

Borreliosis is a disease that is triggered by bacteria (Borrelia). These pathogens are typically transmitted via ticks. '
At first, the Borrelia infection only spreads on the skin and leads to erythema migrans (the so-called wandering redness) in about half of the cases. Occasionally, the Borrelia spread further and reach the central nervous system (brain and spinal cord). There they trigger inflammation of the meninges and occasionally the brain. From there, the pathogens can migrate and also establish themselves in the eye muscles. This leads to the typical symptoms of inflammation in the eye: swelling, pain (especially when moving the eyes), overheating and functional restrictions.

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Read more on the subject at:

  • Lyme disease symptoms
  • Treatment of borreliosis


The diagnosis of ocular muscle inflammation consists of a medical history and an examination of the eye. Above all, restrictions in the mobility of the eyeball should be tested. Then the focus of the diagnosis should be to identify the cause of the eye muscle inflammation.

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Infections of the eye can spread to the eye muscles. There is a risk of the inflammation spreading further into the brain, which should be prevented. If, on the other hand, there is already an inflammation in the brain or on the meninges, this in turn can be the trigger for the eye muscle inflammation. To diagnose meningitis, a sample of the cerebrospinal fluid (liquor) usually has to be taken from the lower lumbar vertebrae.

You may also be interested in this topic: CSF puncture

What are the symptoms of eye muscle inflammation?

Inflammation of the eye muscles is mainly characterized by pain when moving the eyeball. The inflammation of the eye muscle leads to swelling, overheating and reduced functionality of the affected eye muscle. If the muscle is needed to move the eyeball, it can cause pain. The symptoms typically always occur when the person concerned is looking in a certain direction. If multiple eye muscles are affected by the inflammation, movement in different directions can be painfully restricted.

Extensive eye muscle inflammation can also cause swelling and reddening of the skin surrounding the eye in the affected area. If the ocular muscle inflammation is so pronounced that the affected eye can no longer be moved completely in all directions, phenomena such as double vision also occur. These come about because the healthy eye moves normally, but the sick eye cannot fully follow the movement and so both eyes look in slightly different directions. These double vision can also trigger headaches and other complaints such as dizziness and malaise up to nausea and vomiting.

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If other structures are also inflamed, this can also cause additional symptoms. Inflammation of the meninges is particularly feared. This leads to severe headaches, nausea, vomiting, dizziness, and neck pain. A fever can also occur.

If the eye muscle inflammation is caused by autoimmune processes, it is usually only part of an autoimmune disease that affects several organs. For example, the eye can also be particularly dry. Reduced saliva production with dry mouth and mucous membranes can also be a side effect. It can also lead to inflammation of other muscles (for example in the trunk, arms and legs). Or vasculitis - an inflammation of the vessels - also occurs.

Read more on the subject at: Meningitis symptoms


The therapy for eye muscle inflammation is very dependent on the underlying cause.
The pure inflammation of the eye muscle can often be treated symptomatically. Cooling compresses can be used for this. Eye drops with anti-inflammatory agents can also help reduce eye muscle inflammation.

However, if there is suspicion or confirmation of an infectious cause of the eye muscle inflammation, the pathogen must be eliminated as soon as possible. The rush of therapy is mainly caused by the possibility of infection of the meninges or the brain itself, which can have serious consequences. A bacterial infection should therefore be treated with antibiotics (usually systemically with tablets or even via the vein). Antivirals (antivirals) may be used for viral infections (which are less common).

If the ocular muscle inflammation leads to the formation of a pus cavity (abscess), surgical treatment of the ocular muscle inflammation may also have to be carried out. If, on the other hand, the inflammation of the eye muscles is only triggered by meningitis, then the meningitis (meningitis) be treated. This is also mainly done through antibiotics via the vein, which at the same time treats the inflammation in the eye muscles.

If, on the other hand, there is an autoimmune disease, this should be treated. Typically, drugs are used that downregulate the body's immune system. As a rule, one starts with cortisone therapy, which can usually be carried out using tablets (in more severe cases also via the vein). Afterwards, the medication is usually switched to other immunosuppressive agents, as cortisone therapy is not recommended over a longer period due to some side effects.

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You may also be interested in this topic: Therapy of purulent meningitis

When does cortisone help?

Cortisone can be used in the therapy of eye muscle inflammation, especially if the inflammation has an autoimmune component.
This is the case, for example, with autoimmune diseases that affect the entire body. The immune reaction is downregulated by the cortisone, the immune cells no longer attack the body's own cells and the inflammation of the eye muscles can heal.


The duration of eye muscle inflammation depends heavily on its cause. In the case of infectious causes, a successful treatment can be achieved within a few weeks with well-controlled antibiotic or antiviral therapy. However, if complications such as meningitis occur, the healing process can be significantly delayed.

Autoimmune diseases, on the other hand, are often chronic. An acute flare-up with ocular muscle inflammation caused by cortisone can be treated well within a few days to weeks, but the underlying disease remains, so that the ocular muscle inflammation can recur.

Also read our topic: Eye socket infection

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