1. Duane’s Syndrome
G. Vike Vicente, MD

2. 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

3. Duane’s Syndrome Type I: OS limited abduction, retraction in adduction
G.Vicente

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

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

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

7. Duane’s Syndrome Type III: OS limited adduction and abduction retraction in adduction
G.Vicente

8. Funny Story… 15 yo wm Bad attitude… ortho…? Right gaze,
Left face turn…

9. 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…

10. 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…

11. Duane’s Syndrome Type I: OS limited abduction, retraction in adduction
G.Vicente

12. 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