Duanes Syndrome

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Duanes Syndrome

• G. Vike Vicente, MD

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Duanes 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 gt males
• Watch also for vertical pull, leashing
  phenomenom.
• Occasional abscent CN 6 nucleus.

G.Vicente
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Duanes Syndrome Type I OSlimited abduction,
retraction in adduction
G.Vicente
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Duanes Syndrome Type Ilimited abduction,
retraction in adduction superior viewnotice
co-contraction of LMR LLR
OD
OS
Dr. G.Vicente
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Duanes Syndrome Type I retraction in adduction
limited abduction, superior view
OS
OD
G.Vicente
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Duanes Syndrome Type II OSlimited adduction
retraction in adduction
G.Vicente
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Duanes Syndrome Type III OSlimited adduction
and abduction retraction in adduction
G.Vicente
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Funny Story

• 15 yo wm
• Bad attitude
• ortho?

Right gaze, Left face turn
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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
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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
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Duanes Syndrome Type I OSlimited abduction,
retraction in adduction
G.Vicente
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Duanes treatment

• If strabismus in 1ry position
• ETgtXT
• Or significant head turn attitude.
• Never resect LR if no abduction.
• This will worsen globe retraction and not improve
  abduction.

G.Vicente