الفهرس 
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Abstract
Duane syndrome (DS) is a congenital group of extra ocular muscle disorders that have the following characters: Difficult abduction or adduction, abnormal head position to keep the eyes straight, ocular deviation leading to misalignment of the two eyes, palpebral fissure narrowing, globe retraction and upshoot or downshoot may occasionally occur on attempted adduction.
In DS, the sixth cranial nerve that controls the lateral rectus muscle does not develop properly. There is also irregular innervation from a branch of the third cranial nerve, which controls the medial rectus muscle. On this basis, DS is classified into four different types.
DS affects girls more often than boys and the left eye is more affected than the right. Around 20% of DS patients have both eyes affected with no particular race. Only 10% of patients with DS may have an affected family member. Those tend to have both eyes affected.
Many strabismus disorders may be confused with Duane syndrome as sixth nerve palsy, Brown syndrome, monocular elevation deficiency, congenital fibrosis and Mobius syndrome.
The following evaluations are recommended in DS: family history, determination of primary gaze position, head position with eyes in primary position, horizontal and vertical gaze restrictions, Photographic documentation for future comparison, general physical examination because of association with systemic anomalies and forced duction testing to confirm tightness of the horizontal rectus muscles.
Surgery in DS is indicated for one of four reasons: to reduce strabismus, eliminate a socially unacceptable head position, significant upshoot or downshoot and disfiguring enophthalmos.
Surgical treatment options for DS: MR recession or tendon transfer of the SR and IR to the LR in the mildest cases for esotropic Duane, recession of both LR with larger amount on the involved side for exotropic Duane, LR and MR recession for severe cases of globe retraction, Y” splitting of LR or posterior fixation suture to reduce upshoot and downshoot.