Duanes Syndrome G Vike Vicente MD Duanes Syndrome

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 phenom. • 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 OS OD 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 And I forgot to Check his ductions… 1 ry 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: OS limited abduction, retraction in adduction G. Vicente

Duane’s treatment • If strabismus in 1 ry 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