Duane retraction syndrome is a rare congenital abnormality that is characterized by the inability to move the affected eye outwards, hence leading to strabismus. It sometimes also includes various problems with accessory parts of the eye, such as ptosis, or leads to refractive errors, such as anisometropia, and finally convergence insufficiency, poor binocular vision.
The good majority of cases of Duane syndrome are sporadic and unilateral, although certain genetic and syndromic forms also exist. It is generally accepted that it arises due to incorrect innervation of lateral rectus muscle during early embryologic development – the innervation abnormality disables the outward movement of the affected eye.
Duane syndrome and amblyopia
Whilst around two thirds of patients with Duane syndrome have frank strabismus in primary gaze, it is only logical that many of them would also develop amblyopia. That said, the incidence is somewhat low as it is estimated that only about 10 percent of people affected will ever develop amblyopia.
Management of DRS – is there room for vision training?
The goal of management of Duane syndrome is to achieve good alignment of the two eyes in the primary position (i.e. when looking straight forward) with no double vision or compensatory head tilt and good binocular function. Those are usually achieved with correctly prescribed spectacles, specialized prism glasses, or surgical treatment. If, however, there is accompanying amblyopia, it should be addressed with standard treatment options such as are patching, penalization, or vision training. Vision training can nonetheless be beneficial if there is accompanying poor binocular vision.
The Duane syndrome is a disorder that is primarily characterized by strabismus and does, therefore, benefit most from a surgical treatment that resolves eye misalignment. Nonetheless, it is sometimes also accompanied by amblyopia and poor binocular vision – in these cases, it can also benefit from standardized amblyopia treatment as well as vision training such as AmblyoPlay.
