A High Prevalence Of Exotropia In Duane Retraction Syndrome (DRS) Patients – Data From A Tertiary Referral Centre

1. Manju Bhate¹
2. Amit Gupta¹
3. Debajit Ray¹
4. Virender Sachdeva²
6. Ramesh Kekunnaya¹

¹Department of Pediatric Ophthalmology LV Prasad Eye Institute Hyderabad India
²Department of Pediatric Ophthalmology LV Prasad Eye Institute Vizag India

Purpose : To determine prevalence and clinical characteristics of patients with DRS presenting with Exotropia

Methods : Medical records of 140 exotropic DRS out of the 441 DRS (31.74%) patients from 2000 to 2009 were reviewed. Characteristics studied included age at presentation, sex, laterality, manifest primary position, abnormal head posture, ocular motility & overshoots. Associated ocular & systemic abnormalitites and amblyopia if present were also assessed.

Results : The mean age of the patients was 15.96 + 15.06 (range 1-65) years. 59 (42.1%) were male subjects out of the 140 exotropic DRS patients studied. Type I accounted for 122 (87.1%),Type II for 6 (4.3%) and Type III were 12 (2.2%).Left eye was involved in 97 (69.3%) , 37 (26.4%) had right DRS and 6 were bilaterally involved. Exotropia ranged from 10 – 60 PD. An AHP was noted in 72 patients and upshoot in 26.
Associated ocular and systemic abnormalities in these patients were looked for which showed cataract in 6, aniridia in1, NLD block in 1 and retinal breaks in 1 patient.

Conclusion : Almost a third of DRS patients who presented over the 10 year period were exotropic, of which majority were adults with Type I DRS. An exact cause cannot be ascertained for the primary position exotropia in these cases. It could have possibly been due to long standing nature of the disease for such a finding.