Duane′s retraction syndrome with severe upshoot and ipsilateral superior rectus contracture: A rare presentation

Abstract

Type III Duane's retraction syndrome (DRS) is a rare condition and represents only 1% of all cases of Duane's syndrome. It consists of limited/absent abduction as well as adduction of the affected eye. A characteristic upshoot/downshoot/both, in adduction, and globe retraction may occur in DRS patients. Secondary muscle changes like medial rectus contracture or superior rectus contracture (SRC) may rarely be associated with DRS. SRC has been reported in patients with unilateral superior oblique palsy and dissociated vertical deviation. However, no case report of association of SRC with DRS has been reported. We report a rare case of type III DRS with severe upshoot, globe retraction and ipsilateral SRC. It is hypothesized that a long standing severe upshoot could be the reason for development of secondary SRC. The condition was treated with Y-split of lateral rectus and superior rectus recession.