Duane's retraction syndrome: a retrospective review from Kathmandu, Nepal

Abstract

Purpose:  The aim was to study the clinical characteristics of Duane's retraction syndrome (DRS) in Nepalese patients.

Method:  Medical records from 52 cases of DRS from May 2003 to April 2010 were retrospectively reviewed for age, gender, laterality and clinical characteristics. Forty‐one case records (78.8 per cent) that had complete clinical findings were considered for further evaluation. Examination included visual acuity by Snellen chart, refraction, associated horizontal and vertical strabismus in primary gaze, upshoot and downshoot on attempted adduction, binocular vision assessed with the Worth four‐dot test on adopted gaze and stereopsis examined with the Titmus stereo test.

Results:  DRS type I was the most common type observed in 73.2 per cent of cases, followed by DRS type II (14.6 per cent) and DRS type III (12.2 per cent). It was more common in female patients (58.5 per cent) than male patients (χ²= 4.6, df = 1, p = 0.03). DRS was more common in the left eye (68.3 per cent) than the right eye and unilaterally present in 95.1 per cent of subjects. In primary gaze, orthotropia (41.5 per cent) was more common than exotropia (34.1 per cent) and esotropia (24.4 per cent) and vertical strabismus was present in 24.4 per cent of subjects. Upshoot and downshoot on attempted adduction was seen in 14.6 and 9.8 per cent, respectively. Binocular single vision was present in 68.3 per cent of subjects by Worth four‐dot test at near. Stereopsis of 3,000 seconds of arc was present in 9.8 per cent, 100 to 200 seconds of arc in 14.6 per cent and 40 to 60 seconds of arc in 43.9 per cent with the Titmus stereo test.

Conclusion:  DRS is more common in female patients and the left eye. DRS type I is the most common type.

Key words:

• amblyopia
• clinical features
• Duane's retraction syndrome
• Nepal
• prevalence
• strabismus

ACKNOWLEDGEMENTS

The authors thank Mr Suraj Shrestha and the Medical Records Unit for providing data on the patients, without whom the study could not have been conducted. We also appreciate the assistance of Mr Himal Kandel and Mr Pratik Chettry, BOptom students, for collecting literature and searching patients' profiles. We also thank Mr Mike Hollenback for help with editing the article and Mr Suresh Sharma for providing the photographs.