The Clinical Features and Management of Duane’s Retraction Syndrome Type 2 in Pediatric Patients

INTRODUCTION: The aim of this study was to describe the demographic details, features, and clinical management of pediatric patients with Duane retraction syndrome (DRS) type 2.
METHODS: A total of 632 charts from patients who were diagnosed with DRS between January 1998 and January 2016 were retrospectively reviewed. DRS type 2 patients who were <18 years old were identified. Demographic data and clinical findings from pediatric patients with a follow-up time >1 year were collected. Orthotropia or ±10 prism diopters (PD) at near and distance fixation in primary position with available optical correction at the last visit was considered a satisfactory outcome.
RESULTS: There were 5 girls (62.5%) and 3 boys (37.5%). The average age at the first visit was 8.87±6.70 years (range: 2-18 years). The left eye was affected in 4 patients, the right eye in 3 patients, and 1 patient had bilateral involvement. Amblyopia was detected in 4 patients. Four patients had abnormal head posture (AHP). All of the patients had exotropia (XT). The near deviation angle was 24.75±16.45 PD (range: 4-60 PD), and the distance deviation angle was 29±23.12 PD (range: 10-80 PD). Orthotropia/<10 PD XT was seen in 5 patients with refractive correction. Three patients underwent surgery to correct deviation. In the final examination, 2 patients had AHP and orthophoria/<10 PD XT was observed in 6 patients.
DISCUSSION AND CONCLUSION: Amblyopia and deviation in primary position was common in children with DRS type 2 in our small group; therefore, detailed patient examinations are very important. Surgery would be appropriate for patients with strabismus and/or AHP.