|Title||A CASE OF CONGENITAL BILATERAL INVERSE DUANES RETRACTION SYNDROME|
|Author, Co-Author||Alison Hixenbaugh, Lynn Trieu|
|Abstract|| BACKGROUND: Duane’s retraction syndrome (DRS) is a congenital eye movement disorder involving a miswiring of the medial and lateral recti muscles. It is classified into three types characterized by globe retraction on adduction and either limited abduction, adduction, or both. Inverse DRS is very rare and is differentiated from classic DRS by globe retraction upon abduction. Most reported cases are actually acquired globe retraction syndromes. Here we present a case of congenital inverse bilateral DRS.
CASE REPORT(S): A 16 year old black female presented to the clinic for a routine eye exam with a previous diagnosis of DRS with no history of trauma or previous treatment. Upon questioning, the patient reported longstanding occasional diplopia in primary gaze at distance. The examination revealed esophoria and intermittent right hypertropia in primary gaze at distance and intermittent alternating hypertropia in primary gaze at near. Versions revealed abduction deficit OU with retraction and downshoot on attempted abduction. Base out prism was prescribed to alleviate symptoms of diplopia.
CONCLUSIONS: This is an extremely rare form of DRS. Most reports describe restrictive etiologies and are, therefore, not true DRS. However, abnormal innervation seems to be the cause of our patient’s disorder. There is only one other reported case of a true inverse DRS. Management strategies remain similar to conventional DRS and may include prism, vision therapy, surgery, and/or monitoring.
|Affiliation of Co-Authors||Pennsylvania College of Optometry at Salus University|