Sensory Adaptations In Duanes Retraction Syndrome

1. Dr. Savleen Kaur¹
2. Dr. Kamlesh¹
3. Dr. Anju Rastogi¹
4. Dr. Prem Vardhan¹
5. Dr. Shilpa Goel¹
6. Dr. Ashray Nayaka¹

¹Guru Nanak eye centre, New Delhi, India

Aim: There is limited knowledge of the sensory status of patients with Duane's retraction syndrome (DRS). The patients least likely to suffer sensory symptoms are patients with dense suppression on lateral versions. The fact that diplopia is usually absent in unilateral Duanes is understandable, because the syndrome is present from birth. The cases reported below presented an unusual feature of diplopia in DRS.

Case: We are reporting the case of a 20 year male with visual acuity 20/20 and 20/50 in the right and left eye respectively and a 10 year old female child with visual acuity 20/50 BE. In both the cases, the eyes were straight in the primary position with narrowing of the palpebral fissure on adduction along with a marked limitation of movement of the left lateral rectus, and a large face turn to the left. Unexpectedly, the patient complained of diplopia if the head was forcibly straightened. There was also over-action of the right medial rectus on laevoversion, as expected.

Conclusion: If diplopia is present in patients with an abduction deficit, some physicians and surgeons might mistake it for a sixth nerve palsy and inadvertently resect the paretic lateral rectus. We describe such variant of DRS in an attempt to overcome problems in diagnosis and treatment.