Duane’s Syndrome

G. Vike Vicente, MD

Duane’s SyndromeALL FORMS RETRACT IN ADDUCTION• Abda Dubba Deux• Type I: deficit in abduction and retraction in adduction

(due to co-contaction of MR and LR • Type II: deficit in adduction• Type III: both.

• Watch for strabismus, face turn: attitude• Usually sporadic, also think Goldenhars, Wildervanck

syndromes• OS more common than OD• Females > males• Watch also for vertical pull, leashing phenomenom.• Occasional abscent CN 6 nucleus.

G.Vicente

Duane’s Syndrome Type I: OSlimited abduction,

retraction in adduction

G.Vicente

Duane’s Syndrome Type Ilimited abduction,

retraction in adduction: superior viewnotice co-contraction of LMR & LLR

Dr. G.Vicente

OS OD

Duane’s Syndrome Type I retraction in adduction limited abduction, superior view

OS OD

G.Vicente

Duane’s Syndrome Type II: OSlimited adduction

retraction in adduction

G.Vicente

Duane’s Syndrome Type III: OSlimited adduction and abduction

retraction in adduction

G.Vicente

Funny Story…

• 15 yo wm

• Bad attitude…

• ortho…?Right gaze,Left face turn…

Funny Story…

• 15 yo wm • Bad attitude…• ortho…?• 30 PD LET actually,• But can fuse in right

gaze, left head turn

And I forgot to Check his ductions…

1ry gaze

Funny Story…

• 15 yo wm • Bad attitude…• ortho…?• 30 PD LET actually,• But can fuse in right

gaze, left head turn

• And, I forgot to notice the limited abduction and narrow fissure in adduction

Left gaze,Right face turn…

Duane’s Syndrome Type I: OSlimited abduction,

retraction in adduction

G.Vicente

Duane’s treatment

• If strabismus in 1ry position– ET>XT

• Or significant head turn: attitude.

• Never resect LR if no abduction.– This will worsen globe retraction and not

improve abduction.

G.Vicente