It is associated with a number of medical conditions, and may be weak, paralysed, overreactive, or even congenitally absent in some people.

The superior rectus muscle originates from the annulus of Zinn.

Each superior rectus muscle is innervated by contralateral oculomotor nucleus in the mesencephalon.

[9] This may be congenital, often with a familial genetic link, or acquired, most often caused by head injuries.

[9] Local anaesthetics used in cataract surgery may weaken the inferior rectus muscle, despite efforts to use minimal anaesthetic and to avoid placing the needle into the muscle.

[10] Treatment may involve eye surgery that weakens or repositions the superior rectus muscle, which generally has good outcomes.