TNOA Journal of Ophthalmic Science and Research (Jan 2019)
Duane retraction syndrome: Clinical presentation and management strategy
Abstract
Duane retraction syndrome (DRS) is a special strabismus with variable presentation. It has been best classified by Huber based on electromyography in 1974 into three types. Huber type I is the most common form of DRS with an earlier presentation and also has satisfactory surgical outcomes. Huber type II is the least common presentation. Ahluwalia et al. in 1988 have further divided it into subgroups A, B, and C based on the alignment in primary position, indicating esotropia, exotropia, and orthophoria. Type I has esotropia, type II has exotropia, and type III has esotropia and exotropia equally common. DRS can be associated with other ocular abnormalities and systemic issues when present in syndromes. Hence, these patients need a more detailed evaluation. Management strategy aims at alignment in primary position, correcting anomalous head posture, improving palpebral fissure size, and alleviating upshoots and downshoots. It is challenging to address these patients and they need to be counseled before surgery regarding the outcome that is expected of the surgery.
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