Table 1 Clinical manifestations of patients with type 3 Duane retraction syndrome were compared between patients with a present abducens nerve (present group) and absent/hypoplastic abducens nerve (absent or hypoplastic group). [ncbi.nlm.nih.gov]

Age at presentation is variable and has been found to be younger in type I DRS, possibly due to earlier presentation to the pediatrician or pediatric ophthalmologist. [dovepress.com]

The study was presented to the Institutional Review Board and was approved by the Ministry of Health and the hospital director. [nature.com]

Amblyopia is uncommon and, where present, rarely dense. This can be treated with occlusion, and any refractive error can also be corrected. [en.wikipedia.org]

• Collapse

  To evaluate the impact on collapse of the angles of head turn and horizontal distance and near deviations, the mean postoperative measurements were deducted from the preoperative measurements divided by the lateral rectus muscle recession. [nature.com]

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 Treatment Options: Extraocular muscle surgery may improve ocular motility. Monitoring for amblyopia is important with appropriate treatment as indicated. Assistive hearing devices may be beneficial. [disorders.eyes.arizona.edu]

Unilateral rectus muscle recession in the treatment of Duane syndrome. J AAPOS 2012; 16: 145–149. Article PubMed Google Scholar Pressman SH, Scott WE. Surgical treatment of Duane’s syndrome. Ophthalmology 1986; 93: 29–38. [nature.com]

Management and Treatment How is Duane syndrome treated? Treatment will depend on age, severity and other illnesses you might have. Some people with Duane syndrome won’t need treatment. [my.clevelandclinic.org]

The treatment options and realistic expectations should be discussed with the patient and the family in detail. [webeye.ophth.uiowa.edu]

For the majority of patients, Duane syndrome does not require surgical treatment. [aapos.org]

With careful follow-up, the long-term prognosis for good vision is usually excellent. [aapos.org]

Outlook / Prognosis What can I expect if I have Duane syndrome? Some people with Duane syndrome can manage the condition by moving their heads slightly to improve their vision. In some cases, you may need surgery. [my.clevelandclinic.org]

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]

Also, bilateral type I DRS has been found to be the most common type of presentation.50–52,69 Zanin et al70 have classified bilateral DRS into three types in agreement with Jampolsky,71 based on the functional prognosis: Bilateral DRS with fusion – usually [dovepress.com]

[…] of Ophthalmology and Neurology, Director of Neuro-Ophthalmology, Moran Eye Center, University of Utah School of Medicine Date: 03/03/2015 Secondary CORE Categories: Neuro-ophthalmology/Evaluation of Diplopia/Differentiating Paretic From Restrictive Etiologies [morancore.utah.edu]

Etiology of DRS Various theories were proposed to explain the etiology of DRS. [dovepress.com]

The evidence from neuropathological, neuroradiological and neurophysiological studies suggests that the etiology of Duane syndrome is a neurogenic brainstem ocular motor dysfunction resulting from faulty embryogenesis. [webeye.ophth.uiowa.edu]

Etiology Most cases of Duane syndrome are sporadic. Some of these are clearly teratogenic, associated with intrauterine exposure to drugs such as thalidomide. Other cases have well- characterized genetic causes. [entokey.com]

The ability to adduct in this type is absent to restricted as compared to normal to mildly restricted in types 1 and 2.[7] Etiology Isolated Cases 90% occur sporadically and are commonly unilateral[5] Remaining 10% are inherited and these are commonly [eyewiki.aao.org]

"[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 Dec;12(6):576-80. doi: 10.1016/j.jaapos.2008.04.015. Epub 2008 Aug 23. Citation on PubMed [medlineplus.gov]

Diagnosis: Duane Retraction Syndrome, Type III (Duane's Syndrome, The Duane Syndrome, Congenital retraction syndrome) EPIDEMIOLOGY 1-5% among population of patients with strabismus Unilateral in 80% with left eye involvement in 60% Female: Male (3:2) [webeye.ophth.uiowa.edu]

[…] adduction (induced ptosis)[2] Partial deficiency of adduction[4] Oblique movement with attempts at adduction[4] Upshoot or downshoot of globe with adduction (Leash Phenomenon)[2] Widening of palpebral aperture with abduction[2] Deficiency of convergence[4] Epidemiology [eyewiki.aao.org]

Epidemiology Frequency United States The frequency of Duane syndrome in the general population of individuals with eye movement disorders (strabismus) is approximately 1%-5%. [emedicine.medscape.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. [ncbi.nlm.nih.gov]

Pathophysiology Imaging evidence of dysinnervation High-resolution MRI enables direct demonstration of the size and contractility of extraocular muscles, as well as their peripheral and subarachnoid motor innervation ( Figure 57.5A ). [entokey.com]

[…] manner with incomplete penetrance and variable expressivity[2] General Pathology Duane Retraction Syndrome results from an absent or dysplastic abducens motor neurons with aberrant innervations of the lateral rectus muscle by the oculomotor nerve.[7] Pathophysiology [eyewiki.aao.org]

Pathophysiology Neuropathologic, neuroradiologic, and neurophysiologic data Findings from neuropathologic, neuroradiologic, and neurophysiologic studies support the hypothesis that Duane syndrome results from an absence of cranial nerve VI (abducens nerve [emedicine.medscape.com]

Prevention How can I prevent Duane syndrome? At this time, there’s no way to prevent Duane syndrome from happening. Thalidomide, the medication that can cause Duane syndrome (in addition to many other congenital conditions), is no longer available. [my.clevelandclinic.org]

To eliminate disfiguring abnormal eyelid position The goal of treatment is to restore satisfactory eye alignment in the straight-ahead position, eliminate an abnormal head posture and to prevent amblyopia. Eye muscle surgery is not always required. [aapos.org]

Primary Prevention Duane Retraction Syndrome occurs sporadically or is inherited. No means of primary prevention has been identified for this syndrome. Diagnosis The diagnosis of Duane Retraction Syndrome is primarily clinical. [eyewiki.aao.org]

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. [medlineplus.gov]

Lastly, bilateral MR recession may also help prevent contracture of the MR on the affected side by creating “fixation duress” in the contralateral eye. [dovepress.com]