Duane's syndrome

In the examination, this condition may be easily misdiagnosed as sixth nerve palsy. In Duane's syndrome, the main 
feature being narrowing of the palpebral fissure on adduction and globe retraction.

In classical Duane's syndrome (type I). The affected eye has limited abduction but normal adduction. There is narrowing 
of the palpebral fissure on adduction. The affected globe retracts on adduction (you need to examine from the side to see 
this well). Other features commonly seen include up-shooting or down-shooting when the eye is adducted. Both A and V 
pattern may be seen on vertical eye movement.

Other features:

  • Remember that 20% of cases are bilateral
  • Type II Duane's syndrome: reduced adduction but normal abduction
  • Type III Duane's syndrome: reduced abduction and adduction
Associated features:
  • Goldenharg's syndrome
  • Deafness
  • Klipper-Fleil's syndrome (in which there is failure of the scapula to descend)


1. What is the proposed pathogenesis of Duane's retraction syndrome?

2. The mother of a child with Type I Duane's syndrome wants you to correct the ocular appearance of her child
    because 'he looks odd on looking to the side'. How would you manage the request?


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