Duane Retraction Syndrome
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This 5-year-old boy has 20/20 vision in each eye with mild nearsightedness. He has limited eye movement, especially up and down movements of the right eye. He can fuse images when tilting his head to the left. This appears to be asymmetric bilateral exotropic Duane syndrome, more pronounced in the right eye. The doctor would recommend weakening the right lateral rectus muscle through a Y-splitting procedure to reduce exotropia and improve eye movements and head posture. Treatment of the left eye is not needed currently.
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Duane retraction syndrome
This document discusses Duane retraction syndrome, an ocular motility disorder characterized by defective horizontal eye movement and narrowing of the eyelid when the eye adducts. It is usually unilateral and sporadic, though some familial cases are due to mutations in the CHN1 gene. There are four types described based on limitations of adduction and abduction. Duane syndrome can occur with other syndromes and limb abnormalities. Clinical features and differential diagnosis are provided. Surgical treatment depends on the type of strabismus and may include recession or resection of extraocular muscles.
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This document discusses congenital infantile esotropia. It defines esotropia as eyes turning inward and provides background on types. Congenital infantile esotropia is characterized by a large-angle esotropia present before 6 months of age. It may be associated with cerebral palsy or low birth weight. Treatment involves correcting refractive errors, amblyopia therapy, and bilateral medial rectus recession surgery between 6 months to 2 years of age. Post-surgical outcomes include orthophoria, small residual deviations managed with observation, or large residual deviations requiring repeat surgery.
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Duane retraction syndrome (DRS) is a congenital cranial dysinnervation syndrome caused by agenesis of the sixth nerve nucleus. It results in limited eye abduction and co-contraction of the medial and lateral recti muscles on adduction, causing globe retraction on eye movement inward. There are three types based on the pattern of limited eye movement: type 1 has poor abduction, type 2 has poor adduction, and type 3 has poor abduction and adduction. Treatment aims to address face turning from strabismus, globe retraction, and vertical slippage of the lateral rectus muscle.
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Case presentation 2 : Duane's Syndrome
This document summarizes the key information about Duane's syndrome including:
1) It is a congenital eye movement disorder caused by misdirection of eye muscle nerves, leading to abnormal eye muscle contraction.
2) It affects eye abduction and retraction and can cause strabismus. Proper diagnosis and treatment are needed to prevent amblyopia.
3) The case study describes a young male patient with left eye Duane's syndrome type 1 who was properly managed with glasses and vision therapy to maintain good vision outcomes.
Duanes retraction syndrome ..
Duane's retraction syndrome involves congenital miswiring of the medial and lateral rectus muscles, causing limited eye movement. There are typically four types based on the pattern of limited adduction and/or abduction. Treatment may involve glasses, prisms, botulinum toxin injections, or surgery such as recession of the medial or lateral rectus muscles to improve eye alignment and positioning. Brown syndrome similarly involves a congenital or acquired restriction of eye elevation in adduction, believed to be caused by an abnormality of the superior oblique tendon. It is characterized by limited elevation in adduction and downshoot, and may cause a vertical eye misalignment.
Duane's Retraction Syndrome.pptx
Duane syndrome, also called Duane retraction syndrome (DRS), is a congenital and non-progressive type of strabismus due to abnormal development of the 6th cranial nerve.
It is characterized by difficulty rotating one or both eyes outward (abduction) or inward (adduction).
On the other hands Duane Retraction Syndrome is a congenital strabismus syndrome occurring in isolated or syndromic forms. It presents with a variety of clinical features including diplopia, anisometropia, and amblyopia.
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Duane retraction syndrome
Duane retraction syndrome (DRS) is a congenital cranial dysinnervation syndrome caused by agenesis of the sixth nerve nucleus. It results in limited eye abduction and co-contraction of the medial and lateral recti muscles on adduction, causing globe retraction on eye movement inward. There are three types based on the pattern of limited eye movement: type 1 has poor abduction, type 2 has poor adduction, and type 3 has poor abduction and adduction. Treatment aims to address face turning from strabismus, globe retraction, and vertical slippage of the lateral rectus muscle.
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Superior oblique palsy
The document discusses Fourth Nerve Palsy (SOP), which causes weakness of the superior oblique muscle. It describes the anatomy of the fourth cranial nerve and the effects of SOP, including ipsilateral hypertropia that increases in opposite gaze. Common causes are trauma, vascular issues like hypertension, and diabetes. Clinical findings are outlined, along with classification systems. Management involves investigating for underlying causes, using prisms for small deviations, and surgery like weakening overacting muscles for large deviations. Surgical techniques are provided to address specific muscle weaknesses or torsion.
Case presentation 2 : Duane's Syndrome
This document summarizes the key information about Duane's syndrome including:
1) It is a congenital eye movement disorder caused by misdirection of eye muscle nerves, leading to abnormal eye muscle contraction.
2) It affects eye abduction and retraction and can cause strabismus. Proper diagnosis and treatment are needed to prevent amblyopia.
3) The case study describes a young male patient with left eye Duane's syndrome type 1 who was properly managed with glasses and vision therapy to maintain good vision outcomes.
Duanes retraction syndrome ..
Duane's retraction syndrome involves congenital miswiring of the medial and lateral rectus muscles, causing limited eye movement. There are typically four types based on the pattern of limited adduction and/or abduction. Treatment may involve glasses, prisms, botulinum toxin injections, or surgery such as recession of the medial or lateral rectus muscles to improve eye alignment and positioning. Brown syndrome similarly involves a congenital or acquired restriction of eye elevation in adduction, believed to be caused by an abnormality of the superior oblique tendon. It is characterized by limited elevation in adduction and downshoot, and may cause a vertical eye misalignment.
Duane's Retraction Syndrome.pptx
Duane syndrome, also called Duane retraction syndrome (DRS), is a congenital and non-progressive type of strabismus due to abnormal development of the 6th cranial nerve.
It is characterized by difficulty rotating one or both eyes outward (abduction) or inward (adduction).
On the other hands Duane Retraction Syndrome is a congenital strabismus syndrome occurring in isolated or syndromic forms. It presents with a variety of clinical features including diplopia, anisometropia, and amblyopia.
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1. Monocular elevation deficiency (MED), also known as double elevator palsy, is characterized by an inability to elevate one eye in all fields of gaze, resulting in hypotropia of the affected eye.
2. The condition can be congenital or acquired, with causes including superior rectus palsy, inferior rectus restriction, and supranuclear lesions.
3. Surgical management of MED depends on forced duction testing and may include inferior rectus recession, superior rectus resection, or Knapp's procedure to improve eye alignment and increase binocular vision.
Double elevator palsy
1. Monocular elevation deficiency (MED), also known as double elevator palsy, is characterized by an inability to elevate one eye in all fields of gaze, resulting in hypotropia of the affected eye.
2. The condition can be congenital or acquired, with causes including superior rectus palsy, inferior rectus restriction, and supranuclear lesions.
3. Surgical management of MED depends on forced duction test results and may include inferior rectus recession, superior rectus resection, or Knapp's procedure to transpose the horizontal rectus muscles. The goal is to improve eye position and increase binocular vision.
Squint
This document summarizes key concepts related to strabismus and eye movement examination. It defines terms like strabismus, visual axis, anatomical axis, orthophoria and describes tests to evaluate eye alignment and movement including:
- Hirschberg test to measure strabismus angle
- Cover-uncover test and alternate cover test to detect heterotropia and heterophoria
- Prism bar cover test for measuring strabismus angle
- Synoptophore for grading binocular vision
- Maddox rod test for detecting horizontal and vertical phorias
- Extraocular muscle actions and innervations are also summarized.
Eye movements
This document summarizes the anatomy and physiology of eye movements. It describes the six extraocular muscles that control eye movement and their innervation by three cranial nerves. It discusses the different types of eye movements including saccades, smooth pursuit, optokinetic nystagmus, vergence, and vestibulo-ocular movements. It also outlines the brain structures involved in motor control of eye movements, including the frontal eye fields, superior colliculus, brainstem gaze centers, and their connections.
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Superior Oblique Palsy
Superior oblique palsy is a weakness or paralysis of the superior oblique muscle, which functions to depress, intort, and abduct the eye. It causes double vision that is worse when looking in certain directions and may be accompanied by a compensatory head tilt. Diagnosis involves identifying which eye is higher in primary gaze, which eye shows worse deviation in right or left gaze, and which head tilt reduces the double vision. Causes can include trauma, congenital issues, ischemia, aneurysms, and tumors. Treatment may involve observation to see if it resolves on its own or use of prisms to reduce double vision.
Similar to Duane Retraction Syndrome (20)
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About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
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Duane Retraction Syndrome
- 1. This 5-year-old boy has 20/20 vision in each eye and his refraction is OD and OS +.50 sphere. Head posture is as shown below with head tilt to the left. Adduction is limited in both eyes, but enophthalmos and up and down shoot are seen mostly in the right eye. When assuming the head posture shown, this boy fuses the Titmus stereo fly (4,000 seconds). How would you classify this Duane syndrome? What treatment would you recommend?
- 4. Expert Commentary Comments of Arthur L. Rosenbaum, M.D. This child appears to have asymmetric bilateral exotropic Duane syndrome. The pictures clearly substantiate this diagnosis in the right eye and to a lesser extent in the left eye. I do not actually see globe retraction or narrowing of the palpebral fissure in the left eye on attempted adduction. However, there is an unequivocal inability to fully adduct the left globe. I have never seen a compensatory head posture using a large head tilt, as shown in the
- 5. photos. I assume that he is adopting this posture to somehow neutralize the upshoot and/or downshoot of the right globe in adduction. At any rate, he seems to be a fusing patient with an anomalous head posture and therefore a surgical candidate. I would recommend a right lateral rectus Y-splitting procedure with larger recession of each half of the split right lateral rectus and transposition of the superior half superiorly and the inferior half inferiorly. This should reduce the exotropia in the primary position and improve the upshoot and downshoot as well as his head posture. I would not recommend treatment of the left eye at this time.
- 6. In such patients, we are beginning to perform disinsertion of the right lateral rectus muscle with attachment to the lateral orbital wall accompanied by a partial transposition of the lateral halves of the superior and inferior rectus muscles to the lateral rectus insertional stump, with posterior fixation. The first few cases that we have performed have done extremely well, although some have required subsequent medial rectus recession, since the patient no longer has any lateral rectus function. However, I think it is too early to recommend this type of treatment at the present time. The time honored option is to weaken the right lateral rectus muscle, as described in the first part of this discussion.