Clinical Analysis, Management and Outcome of Duane's Retraction Syndrome at a Tertiary Eye Care Centre in South India

Aim: To study clinical features, management & outcome of Duane's retraction syndrome (DRS). Materials & Methods: This prospective, interventional, non randomised study of 102 patients diagnosed with DRS was done from September 2009 to August 2011. Various characteristics studied include...

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Main Authors: Meenakshi Ravindran, Neelam Pawar, Radhika P Karkera, Rajagopal Kunnatur
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2013-10-01
Series:Delhi Journal of Ophthalmology
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Online Access:https://journals.lww.com/10.7869/djo.2013.21
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author Meenakshi Ravindran
Neelam Pawar
Radhika P Karkera
Rajagopal Kunnatur
author_facet Meenakshi Ravindran
Neelam Pawar
Radhika P Karkera
Rajagopal Kunnatur
author_sort Meenakshi Ravindran
collection DOAJ
description Aim: To study clinical features, management & outcome of Duane's retraction syndrome (DRS). Materials & Methods: This prospective, interventional, non randomised study of 102 patients diagnosed with DRS was done from September 2009 to August 2011. Various characteristics studied included sex, age at presentation, laterality, manifest primary position horizontal deviation, upshoot and downshoot, amblyopia, and associated ocular and systemic abnormalities. Follow up for non surgical patients was for minimum period of 6 months. Surgery was advised in patients with anomalous head posture of more than 15 degrees, cosmetically unacceptable upshoot or downshoot, significant deviation in primary position and globe retraction. Post operative follow up of surgical cases was done at 1 month and were followed up for a minimum period of 6 months. Results: Of the total 102 patients, 92 (90.2%) had unilateral and 10 (9.8%) had bilateral DRS. Type I (78.57 %) was the most common while Type II (2.68%) was the least common among unilateral as well as bilateral cases. Preponderance for the female gender was seen in unilateral and bilateral cases. Left eye preponderance was seen in unilateral cases. A significant association was found between type of unilateral DRS and type of ocular deviation in primary gaze, direction of face turn, presence of upshoot/downshoot. Exotropia (41.2%) was the most common ocular deviation in primary position in our study. Exotropia was more common in unilateral cases and esotropia more in bilateral cases. Surgical correction was done in 20 patients (22 eyes). Patients with both esotropia and exotropia who underwent surgical correction showed a significant improvement after surgery (p=0.0368 and 0.0011 respectively). There was a significant improvement of abnormal head posture (AHP) and globe retraction post operatively (p =0.014 and p =0.005 respectively). Conclusion: Unilateral types I, II, and III Duane syndrome and bilateral cases differs in the primary position horizontal deviation, upshoot and downshoot, and associated ocular abnormalities. Surgical intervention is recommended in patients with abnormal head posture (AHP), overshoot, globe retraction and significant deviation in primary position.
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spelling doaj-art-da6415e61e31487e8b78a9b5496fa64a2025-08-20T01:48:33ZengWolters Kluwer Medknow PublicationsDelhi Journal of Ophthalmology0972-02002454-27842013-10-012429710110.7869/djo.2013.21Clinical Analysis, Management and Outcome of Duane's Retraction Syndrome at a Tertiary Eye Care Centre in South IndiaMeenakshi RavindranNeelam PawarRadhika P KarkeraRajagopal KunnaturAim: To study clinical features, management & outcome of Duane's retraction syndrome (DRS). Materials & Methods: This prospective, interventional, non randomised study of 102 patients diagnosed with DRS was done from September 2009 to August 2011. Various characteristics studied included sex, age at presentation, laterality, manifest primary position horizontal deviation, upshoot and downshoot, amblyopia, and associated ocular and systemic abnormalities. Follow up for non surgical patients was for minimum period of 6 months. Surgery was advised in patients with anomalous head posture of more than 15 degrees, cosmetically unacceptable upshoot or downshoot, significant deviation in primary position and globe retraction. Post operative follow up of surgical cases was done at 1 month and were followed up for a minimum period of 6 months. Results: Of the total 102 patients, 92 (90.2%) had unilateral and 10 (9.8%) had bilateral DRS. Type I (78.57 %) was the most common while Type II (2.68%) was the least common among unilateral as well as bilateral cases. Preponderance for the female gender was seen in unilateral and bilateral cases. Left eye preponderance was seen in unilateral cases. A significant association was found between type of unilateral DRS and type of ocular deviation in primary gaze, direction of face turn, presence of upshoot/downshoot. Exotropia (41.2%) was the most common ocular deviation in primary position in our study. Exotropia was more common in unilateral cases and esotropia more in bilateral cases. Surgical correction was done in 20 patients (22 eyes). Patients with both esotropia and exotropia who underwent surgical correction showed a significant improvement after surgery (p=0.0368 and 0.0011 respectively). There was a significant improvement of abnormal head posture (AHP) and globe retraction post operatively (p =0.014 and p =0.005 respectively). Conclusion: Unilateral types I, II, and III Duane syndrome and bilateral cases differs in the primary position horizontal deviation, upshoot and downshoot, and associated ocular abnormalities. Surgical intervention is recommended in patients with abnormal head posture (AHP), overshoot, globe retraction and significant deviation in primary position.https://journals.lww.com/10.7869/djo.2013.21duane's retraction syndromeabnormal head posturemuscle recession
spellingShingle Meenakshi Ravindran
Neelam Pawar
Radhika P Karkera
Rajagopal Kunnatur
Clinical Analysis, Management and Outcome of Duane's Retraction Syndrome at a Tertiary Eye Care Centre in South India
Delhi Journal of Ophthalmology
duane's retraction syndrome
abnormal head posture
muscle recession
title Clinical Analysis, Management and Outcome of Duane's Retraction Syndrome at a Tertiary Eye Care Centre in South India
title_full Clinical Analysis, Management and Outcome of Duane's Retraction Syndrome at a Tertiary Eye Care Centre in South India
title_fullStr Clinical Analysis, Management and Outcome of Duane's Retraction Syndrome at a Tertiary Eye Care Centre in South India
title_full_unstemmed Clinical Analysis, Management and Outcome of Duane's Retraction Syndrome at a Tertiary Eye Care Centre in South India
title_short Clinical Analysis, Management and Outcome of Duane's Retraction Syndrome at a Tertiary Eye Care Centre in South India
title_sort clinical analysis management and outcome of duane s retraction syndrome at a tertiary eye care centre in south india
topic duane's retraction syndrome
abnormal head posture
muscle recession
url https://journals.lww.com/10.7869/djo.2013.21
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