Figure 4. Conceptual diagram showing a change in the center of rotation as a result of a reduction in the diameter of the eyeball.

This is an original figure created by the authors. Small axial length = small arc of contact  Small axial length = center of rotation differs from normal axial length. Strabismus surgery changes the position of the muscle attachment on the globe. For example, a 5mm recession produces a different reaction on the small eyeball compared to an eyeball of normal size.