Face turns in Type 1 Duane's retraction syndrome – Right? Left? or none?

Abstract

Purpose: The purpose of this study is to create awareness about the face turns in Type 1 Duane's retraction syndrome (DRS). Subjects and Methods: This was a retrospective analysis of 27 cases of Type 1 DRS seen in a teaching hospital. A complete strabismus workup with emphasis on deviation in primary gaze and presence and direction of anomalous head posture was done. Results: Of 27 patients, 9 patients (33.33%) had esotropia, 8 (29.63%) had exotropia, whereas 10 (37.03%) were orthotropic in primary gaze; 17 (62.96%) had a face turn, 9 (33.33%) patients had a face turn toward the affected side, 8 (29.63%) toward the sound side, while 10 (37.03%) did not have a face turn. Conclusions: It is important to be aware that patients with Type 1 DRS may have an associated face turn; the direction of which is variable depending on the deviation present in the primary position. Awareness of this interesting observation of the variations in face turn prevents a misdiagnosis of sixth nerve palsy which has more serious clinical implications.

Keywords

• anomalous head posture
• duane's retraction syndrome
• face turn
• primary gaze
• strabismus