Duane’s Syndrome G. Vike Vicente, MD

Duane’s Syndrome ALL 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: OS limited abduction, retraction in adduction G.Vicente

Duane’s Syndrome Type I limited abduction, retraction in adduction: superior view notice co-contraction of LMR & LLR OD OS Dr. G.Vicente

Duane’s Syndrome Type I retraction in adduction limited abduction, superior view OS OD G.Vicente

Duane’s Syndrome Type II: OS limited adduction retraction in adduction G.Vicente

Duane’s Syndrome Type III: OS limited 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 1ry gaze And I forgot to Check his ductions…

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: OS limited 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