Presentation
In unilateral DRS, Type I was present in 72 (78.26 %), Type II was present in 2 (2.17%), Type III was present in 18 (19.57%) patients. [djo.org.in]
We have previously reported that the abducens nerve on the affected side was present in all of DRS type 2, absent in all of DRS type 1, and either present or absent in DRS type 3.[3] This was the only study to show a sensitivity of 100% in normal controls [journals.plos.org]
It presents during childhood and it accounts for less than 5% of cases of strabismus 1. [radiopaedia.org]
Unilateral lateral rectus cysticercosis presenting as Duane retraction syndrome type IIb 1 Department of Neurology, Dr. S.N. [neurologyindia.com]
Workup
Duane's Syndrome (type I) It may be confused with a paralysis of the muscle which causes the eye to turn outwards (lateral rectus) resulting in an unnecessary neurological workup. [strabismus.org]
A complete strabismus workup with emphasis on deviation in primary gaze and presence and direction of anomalous head posture was done. [jcor.in]
Approach to the patient: an overview The above review emphasizes the need to extend patient evaluation in cases of DRS beyond the routine clinical examination by a strabismologist to genetic analysis, systemic workup and neuroimaging. [dovepress.com]
Treatment
Orthoptic vision therapy is a treatment alternative in DRS patients. [dovepress.com]
Treatment Treatment Options: Various treatments can be useful, ranging from prisms for mild cases to muscle surgery for a severe head turn or vertical deviations. [disorders.eyes.arizona.edu]
References Rao VB, Helveston EM, Sahare P (2003) Treatment of upshoot and downshoot in Duane syndrome by recession and Y-splitting of the lateral rectus muscle. J AAPOS 7: 389-395. Pressman SH, Scott WE (1986) Surgical treatment of Duane's syndrome. [omicsonline.org]
[…] if necessary as px can maintain AHP and avoid amblyopia - Differential diagnosis - Moebius syndrome (VI and VII CN) - Sixth nerve palsy - Generally conservative treatment as: - Symptom free - Slight abnormal head posture - Well compensated deviation [brainscape.com]
Prognosis
Prognosis Isolated DRS is a benign disorder which, if managed appropriately, results in excellent long term prognosis for vision. In some cases, amblyopia or loss of binocular single vision might develop. [orpha.net]
With careful follow-up, the long-term prognosis for good vision is usually excellent. [aapos.org]
The patient was prescribed glasses, surgical prognosis explained and we are awaiting a follow-up from her. [sjopthal.net]
The prognosis of surgery is not good; therefore, it is best to avoid surgery if patients have some form of binocular vision. [emedicine.medscape.com]
Etiology
The underlying etiology of DRS is a defect in some of the eye muscles (specifically the lateral and medial rectus muscles) receiving proper signal from the cranial nerves that innervate them. [cags.org.ae]
Furthermore, forced duction testing revealed a neurological etiology rather than muscular. Cover test revealed constant left exotropia greater than 45 prism diopters. Distance acuity was correctable to 20/20 OD and 20/25 OS. [aaopt.org]
Neurologia i Neurochirurgia Polska 37(2): 429-435, 2003 Duane's syndrome; observations on the pathogenesis and etiology of different forms of the Stilling-Duane-Turk retraction syndrome. Documenta Ophthalmologica. [eurekamag.com]
Get a balanced view of etiology, diagnosis, and management, and access unique guidance on the practical problems encountered in real-life clinical cases. Impresses the importance of systemic disease in diagnosis and management. [books.google.com]
Etiology DRS results from failure of normal development of the pontine abducens nucleus or nerve resulting in failure of the normal innervation of the lateral rectus muscle on the affected side. [orpha.net]
Epidemiology
[…] retraction in adduction 6 Duane’s Syndrome Type III: OS -limited adduction and abduction -retraction in adduction/abduction 7 History Squinting Head tilt Loss of binocular vision Reduced ocular movement Facial asymmetry Picture of paralytic squint 8 Epidemiology [slideplayer.com]
Summary Epidemiology The prevalence of DRS is about 1/10, 000, representing about 1-5% of all strabismus cases. Females are more affected than males. [orpha.net]
"[Epidemiological and clinical aspects of Stilling-Turk-Duane syndrome]". J. Fr. Ophtalmol. (in French). 19 (8–9): 533–42. PMID 8944136. Further reading[edit] Andrews, Caroline V.; Hunter, David G.; Engle, Elizabeth C. (1993). "Duane Syndrome". [en.wikipedia.org]
Differences in epidemiological and clinical characteristics between various types of Duane retraction syndrome in 331 patients. J AAPOS 2008; 12:576-80. Kekunnaya R, Gupta A, Sachdeva V, Krishnaiah S, Rao BV, Vashist U, Ray D. [djo.org.in]
Differences in epidemiological and clinical characteristics between various types of Duane retraction syndrome in 331 patients. J AAPOS. 2008 Dec;12(6):576-80. doi: 10.1016/j.jaapos.2008.04.015. Epub 2008 Aug 23. Citation on PubMed [medlineplus.gov]
Pathophysiology
Considerations on pathophysiology and aetiology. Transactions of the Fifth International Orthoptic Congress, Cannes., pp.119-125. Journal Kim, J. H. and Hwang, J. [citethisforme.com]
[…] movement Stilling and Turk : described it first Duane popularised it Classic features Limitation of abduction Slight limitation of adduction Retraction of globe on adduction Adduction narrowing of palpebral fissure Upshoot / downshoot of eye in adduction 3 Pathophysiology [slideplayer.com]
As DRS type 3 partly share the same pathophysiology with type 1 and 2 DRS, the classification of DRS may have to be revised according to MRI findings. [journals.plos.org]
Huber A (1984) Duane’s Retraction Syndrome: Consideration of Pathophysiology and Etiology. In: Grune & Stratton Orlando (Eds.), Florida, USA, pp. 345-361. [medcraveonline.com]
Prevention
How do you Prevent Duane’s Syndrome? Sporadic Duane’s syndrome cannot be prevented as they occur spontaneously in offspring of normal parents. [medindia.net]
The goal of treatment is to restore satisfactory eye alignment in the straight-ahead position, eliminate abnormal head posture, and prevent amblyopia. [eyehealthweb.com]
This condition prevents outward movement of the eye (toward the ear), and in some cases may also limit inward eye movement (toward the nose). As the eye moves inward, the eyelids partially close and the eyeball pulls back (retracts) into its socket. [diseaseinfosearch.org]
Surveillance is necessary to prevent or detect amblyopia. Vision therapy is advised for secondary convergence insufficiency. [orpha.net]