Successful management of Duane Retraction Syndrome type III with significant upshoot and concurrent superior rectus contracture.

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Rupini Yogesvaran
Fiona Lee Min Chew


Background: Duane Retraction Syndrome (DRS) Type III is an uncommon condition, which remains surgically challenging.

Objective: To report a rare case of DRS Type III with superior rectus (SR) contracture and its successful surgical management.

Method: Case - report

Results: A 31- year old gentleman presented to our clinic with abnormal head posture and double vision. On examination, he had right face turn. Left exotropia and hypertropia were noted. Adduction of the left eye revealed severe upshoot of the left eye and narrowing of the palpebral aperture. Limitation of left eye adduction, abduction and depression was noted. The patient was diagnosed with DRS type III with SR contracture which is very rare. He later underwent left eye Y-split lateral rectus recession with superior rectus recession for his condition

Results: Post-operatively, there was resolution of head posture and diplopia. The procedure improved patient’s ocular deviation, cosmetic appearance and functional ability.



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1. Ahluwalia BK, Gupta NC, Goel SR, Khurana AK. Study of Duane's retraction syndrome. Acta Ophthalmologica. 1988;66(6):728-30.

2. DeRespinis PA, Caputo AR, Wagner RS, Guo S. Duane's retraction syndrome. NEW YORK: Elsevier Inc; 1993. p. 257-88.

3. Rosenbaum AL, Santiago AP. Clinical strabismus management: principles and surgical techniques. Philadelphia: Saunders; 1999.

4. Rao VB, Helveston EM, Sahare P. Treatment of upshoot and downshoot in Duane syndrome by recession and y-splitting of the lateral rectus muscle. Journal of AAPOS. 2003;7(6):389-95.

5. Rogers GL, Bremer DL. Surgical treatment of the upshoot and downshoot in Duanes' retraction syndrome. Ophthalmology. 1984;91(11):1380-3.

6. Von Noorden GK. Recession of both horizontal recti muscles in Duane's retraction syndrome with elevation and depression of the adducted eye. American Journal of Ophthalmology. 1992;114(3):311-3.

7. Kekunnaya R, Kraft S, Rao VB, Velez FG, Sachdeva V, Hunter DG. Surgical management of strabismus in Duane retraction syndrome. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus. 2015;19(1):63-9.

8. Arora P, Ganesh S, Shanker V. Duane's retraction syndrome with severe upshoot and ipsilateral superior rectus contracture: A rare presentation. Journal of Clinical Ophthalmology and Research. 2014;2(2):108.