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KMID : 1191420120110010117
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Korean Journal of Optometry and Vision Science
2012 Volume.11 No. 1 p.117 ~ p.121
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A Case of Duane’s Retraction Syndrome Type I Showing an Exotropia
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Jang Jung-Hyun
Park Jung-Min
Lee Soo-Jung
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Abstract
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Purpose: To present a case of Duane’s retraction syndrome type I showing an exotropia.
Methods: A 8-year-old girl showed global retraction, palpebral fissure narrowing, upshoot (+4), downshoot (+3) on adduction, and limitation of abduction (－4) in the left eye. She had an exotropia of 15 PD at distance, 25 PD at near in the primary position. She was diagnosed with Duane’s retraction syndrome type I of the left eye showing an exotropia. Because her mother had strong desire for correction of limitation of abduction as well as an exotropia, the Hummelsheim surgery was performed in the left eye to correct limitation of abduction.
Results: She achieved improvement in abduction (-2) but exotropia was aggravated to 20 PD at distance, and 30 PD at near. Lateral rectus recession (10 mm) was done in the right eye for correction of exotropia. After 2nd surgery, lateral incomitance was improved but she had still exotropia of 10 PD at distance, 20 PD at near. Lateral rectus recession (7 mm) and posterior fixation of the left eye were performed to correct an exotropia, upshoot, and downshoot on adduction. After final surgery, she showed an orthotropia at distance, exotropia of 10 PD at near, and improvement in lateral incomitance, upshoot (+2) and downshoot (0). However, limitation of abduction was aggravated to －3 in the left eye.
Conclusions: We recommend a focus of treatment in a case of Duane’s retraction syndrome type I showing an exotropia should not be limitation of abduction but an exotropia.
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KEYWORD
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Duane retraction syndrome, Exotropia, Hummelsheim, Oculomotor muscles
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