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Duane retraction syndrome
Strabismus
Key Points
- •Duane retraction syndrome is a congenital cranial dysinnervation disorder caused by absent VI nerve + anomalous III nerve innervation of the lateral rectus → co-contraction on adduction.
- •The diagnostic triad is: limited horizontal movement + globe retraction on adduction + palpebral fissure narrowing on adduction.
- •Type I (limited abduction, esotropia) is the most common type (70–80%); affects the left eye (60%), females (60%), and is usually unilateral (80%).
- •Upshoot/downshoot on adduction is caused by the lateral rectus leash effect (mechanical), NOT inferior oblique overaction - do NOT perform IO weakening.
- •Most patients do NOT need surgery - compensatory head turn preserves binocular vision; surgery is indicated for significant strabismus, head posture >15–20 degrees, or problematic upshoot/downshoot.
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations