There are six muscles in the eye socket that control the eye's movement up, down, to each side, and in rotation. These are the extraocular muscles. When there is a weakness or paralysis in one or more of these muscles, the eyes' movements are uncoordinated. Graves disease affects the eye muscles and causes vertical double vision, where one image appears to be on top of the other image. Strabismus, or misaligned eyes, is caused by a weakened or paralyzed eye muscle that does not allow the eyes to align properly.

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