A 51-year-old woman with consecutive exotropia after surgery for esotropia underwent magnetic resonance imaging (MRI) of her orbits by orbital surface coil. Imaging demonstrated an 8.0 mm segment of very thin tissue that spanned the distance from a normal-looking medial rectus muscle proximally to the sclera distally. Surgical treatment revealed anatomic pathology of the medial rectus muscle consistent with spatial relationships of stretched scar and muscle that were predicted by MRI.