Duane syndrome is characterized by limitation of
abduction ( class I ) ,adduction ( class II ),
or both ( class III ), narrowing of the fissure
with enophthalmos on adduction and face
turn which varies according to the class of
Duane.
It is easier to keep
the different types of Duane syndrome in mind by
simply describing the primary position
alignment. Patients with Duane
syndrome I have an esotropia of the involved eye
when the head is straightened. When the patient
is allowed to assume the most comfortable head
posture, the face invariable turns toward the
involved side. In most cases, these patients are able to
recognize normal or near-normal stereopsis and
rarely have amblyopia.
Patients with Duane syndrome II
are
either
orthotropic
( orthotropic Duane )or have an exotropia in the primary position.
the face invariable turns toward the uninvolved
side.
Patients with Duane syndrome III have
straight or nearly straight eyes in
the primary position and often with upshoot or
downshoot. There is usually no face turn.
Indications for surgery for Duane syndrome
are strabismus in the primary position,
unacceptable head posture, severe up- and
downshoot of the affected eye in adduction,
and disfiguring enophthalmos.
This girl with Duane Syndrome II, is
orthotropic in the primary position (
orthotropic Duane ), she has an accepted
face turn, there is no up or down shoot on
adduction and the narrowing during adduction
is minimal. For me, this girl has no need
for surgery.
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