Duane Syndrome

Abnormal innervation from 3rd cranial nerve

Most sporadic, 5% autosomal dominant inheritance

More common in females than males.

OS affected more often than OD.

80% of cases are unilateral, when bilateral it is usually asymmetric.

Gender and Laterality:

Gender and Laterality in 835 cases of Duane Syndrome. DeRespinis PA, Wagner RS, Guo S; Duane’s Retraction Syndrome. Surv Ophthalmol 38:257, 1993

Narrowing of the palpebral fissure and retraction of the globe of the involved eye on attempted adduction.

The amount of limitation depends on the amount of co-contraction of the medial rectus and lateral rectus.

Abnormal firing of the lateral rectus is found with EMG testing.

Angle of deviation almost always less than 30D , usually less than 15D .

Face turn toward the side of limited movement- permits fusion.

Anisometropic Ambylopia 10-30%

Ipsilateral congenital hearing loss 5%

Most cases are isolated

Goldenhar syndrome (hemifacial microsomia, ocular dermoids, ear abnormalities, preauricular skin tags, eyelid colobomas)

Wildervanck syndrome (sensorineural hearing loss, Klippel-Feil anomaly- shortness of neck with fused or missing vertebrae)

Treat Refractive Error

Consider treating Hyperopia > +2.50 if ET

Treat Amblyopia