Familial duane's syndrome

To describe a family suffering from Duane's Syndrome. Case series studies. Diagnosis and Research department of Ophthalmology, Allied Hospital, PMC, Faisalabad Oct 2009 [One month]. A Gentle man, 65 years old, shopkeeper, resident of Jaranwala, Faisalabad, presented with his four children two male and two female with complaint of asymmetry of their unilateral eyes, since birth. There was no history of maternal intake of drugs, or smoking during pregnancy. There was no history of trauma or surgery. On examination the unaided vision of all the study cases was 6/6, 6/6. The cornea, conjunctiva, lens, iris, pupil, vitreous and retina of all the subjects was normal. The IOP of the all was also with in normal range. The ocular motility and lid fissure narrowing was noted in different ocular gazes. The lymph nodes and thyroid gland examination was done. The Hiss screen test was done to quantify individual muscle action. The levator function test, cover tests, papillary reactions, slit lamp examination, fundus examination were performed. The lids fatigue ability tests and strength of hands grip was estimated at the last. All cranial nerves were examined. Urine, blood and thyroid tests were requested and documented. The all the cases had lid fissure narrowing in one of their horizontal gazes. The all of them had under action of one of their horizontal muscles. So all the children had been proved to be suffering from unilateral Familial Duane's Syndrome. In our clinical practice the Familial DS is rarely found. None of the study patients showed amblyopia, diplopia, upshots or down shoots phenomenon. Similarly no associated systemic anomalies were seen

Management of Duane's syndrome with botulinum toxin injection

Recession is the main surgical procedure in correction of eye deviation in Duane's syndrome. We evaluate the efficacy of botulinum toxin injection in the treatment of this type of strabismus instead of surgery or before it. Three patients with Duane's syndrome type I and one patient with Type II were selected at Poostchi eye clinic from patients who diagnosed primarily and had not any eye surgery before. Botulinum toxin [Dysport[TM], 10 IU] was injected into medial or lateral rectus muscles under general [2 patients] or local [2 others] anesthesia. Amount of deviation, leash phenomenon and limitation of movements were measured pre injection and 72 hours, 1, 4, 12 and 24 weeks postinjections and the results were compared. The amount of deviation was decreased between 8-35 PD at 24 weeks postinjection. No significant change was observed in limitation of movement but leash phenomenon improved in 3 patients. Injection of botulinum toxin in Duane's syndrome will decrease the amount of deviation and leash phenomenon; however, surgical intervention maybe necessary for residual deviation or globe retraction

Experiencias quirúrgicas en síndrome de Duane / Surgical experiencies in Duane's syndrome

Se revisaron 14.564 historias clínicas de las consultas asistencial y privada de uno de los autores, comprendiendo un período de tiempo de 9 años. El 19.3 porciento de los casos presentaba un diagnóstico de estrabismo y de éstos, el síndrome de Duane representó el 1.6 porciento (45 pacientes). De éstos, 18 fueron sometidos a cirugía, obteniéndose 7 casos con resultados excelentes, 7 buenos y 4 regulares