Pseudo-Duane Retraction Syndrome from Intraorbital foreign body: Case report

1. Usa Thitiratsanont, MD¹
2 Juthathip Hiriotappa, MD¹
3.Patcharapim Masaya-anon, MD²
4. Rosana Pittayapongpat, MD¹
5.Yuthapong Imsuwan, MD³

¹Department of Ophthalmology, Queen Sirikit National Institute of Child Health, Bangkok,
Thailand
²Department of Ophthalmology, Prasat Neurological Institute, Bangkok, Thailand
³Department of Ophthalmology, Phramongkutklao Hospital, Bangkok, Thailand

Purpose: To report a case of Duane -like restrictive strabismus from retained intraorbital glass foreign body which was initially undetected one year after a car accident.

Methods: Case report

Results: Reviewed history of illness, past medical history, full ophthalmic examination with positive force duction test on her left eye revealed acquired restrictive strabismus. Orbital CT scan showed an abnormal tubular shape hyperdensity at lateral wall of the left orbit. Orbitotomy accessed through the wide conjuctival incision of left lower fornix were performed requiring the cooperation of strabismus and orbit specialists in order to lysis adhesion, remove intraorbital glass foreign bodies which adhered to the globe, and recess lateral rectus muscle.

Conclusions: A high degree of suspicious of an intrao rbital foreign body is need
when patients present with injuries to the eyelids and orbit. Careful history taking and full ophthalmic examination with force duction test are important to rule out restrictive strabismus from Duane syndrome.