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Aisha Elghadi
: The pat. has restriction on abd. , narrowing of
palpepral fissure on add. LE , this IS duane
syndrome , type one , LE , there is no up or down
shoot , on primary position there is mild esotropia
, so better to not touch the pat. ,or do mild
recessionn MR of the LE . |
I definitely agree with Dr Aisha
: This is an example of Duane syndrome type I. There
is limited abduction in the left eye, and narrowing
of the left palpebral fissure on Rt gaze. The girl
assumes very minimal left face turn and very
minimal right gaze to achieve aligned eyes
presumably with fusion.
In a case like this, it is always necessary to rule
out a left sixth nerve palsy since there is limited
abduction and left face turn but the narrowing of
the left palpebral fissure with enophthalmos helps
confirm Duane. This would not occur in a sixth nerve
palsy.
I think this patient doesn't fulfill any of the
indications of surgical interference in Duane
syndrome which are :
* tropia in the primary position
* unacceptable face turn
* disfiguring narrowing
* up/down shooting
However , what bothers the patient is the esotropia
that appears on looking left because of the limited
extrusion of the Lt eye , this could be treated
surgically by faden operation for the Rt MR ( the
sound eye ) , this will limit the extrusion of the
Rt eye on looking left , I adopt this surgery many
times before and it works excellent .
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