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Schwartz, Around the Eye in 365 Days

  This continuing medical education activity is sponsored by Vindico Medical Education.


Original Articles
Management of Duane Retraction Syndrome
Journal of Pediatric Ophthalmology and Strabismus   Vol. 42   No. 1   January/February 2005
Brian Chua, BSc, MBBS, MPH; Kim Johnson, BAppSc, (Orthoptics); Craig Donaldson, MBBS, FRANZCO, FRACS and Frank Martin, MBBS, FRANZCO, FRACS
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BACKGROUND

Duane retraction syndrome is the most common cause of congenital aberrant ocular innervation. We report referral practices, clinical characteristics and complications, prevalence of congenital and familial anomalies, and management outcomes from a clinic-based series.

METHODS

Retrospective clinic-based study of 65 patients with Duane retraction syndrome seen between January 1994 and March 2004.

RESULTS

The majority of patients were girls with type I Duane retraction syndrome associated with esotropia in primary gaze. Twenty percent of cases were complicated by absent binocular stereoacuity and 16.9% had amblyopia. Family history of any ocular disorder was reported in 38.5% of cases, while an associated congenital abnormality was found in 46% of patients. There was a significant delay between the age when ocular abnormalities were first noticed and the age when patients presented at our tertiary referral center (P < .001). Twenty-two percent of patients underwent surgical correction at a mean age of 6 years. Most procedures were unilateral or bilateral medial or lateral rectus recessions. Postoperative ocular alignment < 15 prism diopters (PD) was achieved in 86% of cases, with 50% of cases having < 5 PD.

CONCLUSIONS

Amblyopia and absent binocular stereo vision affected one in five patients with Duane retraction syndrome. There was significant delay between identification of an abnormality and presentation at the eye clinic.

J Pediatr Ophthalmol Strabismus 2005;42:13-17.

AUTHORS

Mr. Chua, Donaldson, and Martin are from the Department of Ophthalmology, and Ms. Johnson is from the Department of Orthoptics, Children’s Hospital at Westmead, New South Wales, Australia.

Address reprint requests to Kim Johnson, BAppSc (Orthoptics), Department of Orthoptics, Children’s Hospital at Westmead, Hawkesbury Road, Westmead, NSW, Australia, 2145.

Originally submitted August 17, 2004.

Accepted for publication September 15, 2004.

The authors have no industry relationships to disclose.

In accordance with ACCME policies, the audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage.

The material presented at or in any SLACK Incorporated continuing medical education activities does not necessarily reflect the views and opinions of SLACK Incorporated. Neither SLACK Incorporated nor the faculty endorse or recommend any techniques, commercial products, or manufacturers. The faculty/authors may discuss the use of materials and/or products that have not yet been approved by the U.S. Food and Drug Administration. All readers and continuing education participants should verify all information before treating patients or utilizing any product.