A Case of Duane's Retraction Syndrome Type I Showing an Exotropia

Jang, Jung Hyun; Park, Jung Min; Lee, Soo Jung

Case Report

Korean Journal of Optometry and Vision Science 2012;11(1):117-121.
Published online June 20, 2012.

외사시를 보이는 듀안안구후퇴증후군 I형 1예

장정현, 박정민, 이수정

¹Department of Ophthalmology, Maryknoll Medical Center, ²Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea

A Case of Duane's Retraction Syndrome Type I Showing an Exotropia

Jung Hyun Jang, Jung Min Park, Soo Jung Lee

Abstract

Purpose
To present a case of Duane's retraction syndrome type I showing an exotropia. Methods: A 8-year-old girl showed global retraction, palpebral fissure narrowing, upshoot (+4), downshoot (+3) on adduction, and limitation of abduction (－4) in the left eye. She had an exotropia of 15 PD at distance, 25 PD at near in the primary position. She was diagnosed with Duane's retraction syndrome type I of the left eye showing an exotropia. Because her mother had strong desire for correction of limitation of abduction as well as an exotropia, the Hummelsheim surgery was performed in the left eye to correct limitation of abduction. Results: She achieved improvement in abduction (-2) but exotropia was aggravated to 20 PD at distance, and 30 PD at near. Lateral rectus recession (10 mm) was done in the right eye for correction of exotropia. After 2nd surgery, lateral incomitance was improved but she had still exotropia of 10 PD at distance, 20 PD at near. Lateral rectus recession (7 mm) and posterior fixation of the left eye were performed to correct an exotropia, upshoot, and downshoot on adduction. After final surgery, she showed an orthotropia at distance, exotropia of 10 PD at near, and improvement in lateral incomitance, upshoot (+2) and downshoot (0). However, limitation of abduction was aggravated to －3 in the left eye. Conclusions: We recommend a focus of treatment in a case of Duane's retraction syndrome type I showing an exotropia should not be limitation of abduction but an exotropia. (Korean J Optom Vis Sci 2012; 11(1):117-121)

Key Words: Duane retraction syndrome, Exotropia, Hummelsheim, Oculomotor muscles