Duane Syndrome
Last reviewed: 23.04.2024
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The sign of Duane syndrome is the retraction of the eyeball when an adduction attempt is made, caused by a simultaneous contraction of the inner and outer rectus muscles. The condition is basically bilateral, although often the symptomatology on one eye is so minimal that it goes unnoticed. In some cases it is combined with congenital developmental anomalies; most often - with sensorineural hearing loss and speech disorders.
[Symptoms of Duane Syndrome
Symptoms that can occur in each of the three types:
- When trying to bring about a retraction of the eyeball occurs, caused by a simultaneous contraction of the inner and outer rectus muscles, accompanied by narrowing of the eye gap. The degree of retraction of the eyeball varies from slight to severe. When you try to abduct the eye gap opens, and the eyeball acquires a normal position.
- Deviation upward and downward in adduction occurs in some patients. It is suggested that this phenomenon of "bridle" (or "leash") is associated with a short external rectus muscle that slips over or under the eyeball and is the cause of its pathological vertical deflection. However, recent MRI studies have shown that this is not always the case.
The external rectus muscle on the side of the lesion is subject to resection, which increases the retraction.
Classification of Duane syndrome according to Huber
I type, most common:
- Limited or absent abduction.
- Normal or somewhat limited adduction.
- In the primary position - the correct position of the eyes or insignificant esotropia.
II type, the rarest:
- Limited adduction.
- Normal or slightly limited abduction.
- In the primary position - the correct position of the eyes or a small exotrophy.
III type:
- Limitation of adduction and abduction.
- In the primary position - the correct position of the eyes or mild esotropia.
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Treatment of Duane Syndrome
In most cases, the position of the eyes is correct, so amblyopia does not arise. Surgical intervention is indicated in the deviation of eyeballs in the primary position and the forced position of the head, taken to maintain fusions. It can also be shown with cosmetically unsatisfactory deviations up, down, or pronounced retraction of the eyeball. Amblyopia, as a rule, develops due to anisometropia, rather than strabismus.