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[Clinical features of 31 cases with bilateral Duane's retraction syndrome].

OBJECTIVES: To summarize the clinical features of 31 cases with bilateral Duane's retraction syndrome (DRS) and discuss its differential diagnosis. METHODS: We retrospectively summarized 31 cases with bilateral DRS from 1979 to 1996. Its clinical features including chief complaints, age and sex distribution, types of presentation, defects in abduction and adduction, retraction of the globe, upshots and downshots in abduction, etc. were analyzed. RESULTS: There were 14 males and 17 females with a female-to-male ratio 1 : 0.8. The chief complaints comprised 14 cases (45%) with ocular motility disorders and 10 cases (32%) with ocular deviations. The most common form of the syndrome was type 1 (29 cases, 94%), the remaining 2 cases (6%) with type III. Its clinical features consisted of retraction of the globe with narrowing of the palpebral fissure in attempted adduction, limitation in abduction with variable extent also in adduction, and upshot and/or downshot of the affected eye during adduction. CONCLUSIONS: In atypical cases, the retraction of the globe in adduction was not obvious and the diagnosis of DRS must be differentiated from the following ocular motility disorders, namely, abducens nerve palsy, Möebius syndrome, congenital oculomotor apraxia and congenital or infantile esotropia.

Adolescent↗

[Value of the stereoscopic tests in the detection of sensorimotor anomalies in children].

Limitations and advantages of the stereotests are briefly discussed. In this trial, two stereotests (TNO and Frisby) have been tested in 3 groups of patients: group 1 was composed of 180 cases with normal binocular vision; group 2 of 312 patients with known ocular motility disorders: group 3 of 186 patients with unknown sensorimotor status. The utility of the two stereotests in detecting ocular motility disorders and/or amblyopia is uncertain when used alone. Because of a high number of false positives and false negatives the tests are best used in conjunction with other clinical tests of ocular sensorimotor function.

Adolescent↗

Abnormal ocular motility with brainstem and cerebellar disorders.

The disorders of ocular motility seen in association with brainstem or cerebellar disorders may point to rather specific anatomical or pathological correlations. Pontine gaze palsy reflects involvement of the pontine paramedian reticular formation. Internuclear ophthalmoplegia signifies a lesion in the medial longitudinal fasciculus. Skew deviation may result from a lesion anywhere in the posterior fossa. Ocular bobbing typically results from a pontine lesion. The Sylvian aqueduct syndrome is characteristic of involvement in the upper midbrain-pretectal region, usually a pinealoma. Cerebellar lesions may be manifested by gaze paresis, skew deviation, disturbances of saccadic or smooth pursuit movements, ocular myoclonus, or several characteristic forms of nystagmus. Familiarity with these disorders may be of great help to the physician dealing with a patient with a possible posterior fossa lesion.

Adult↗

[Injection of botulinum toxin into the oculomotor muscles in disorders of ocular motility].

Injections of botulinum toxin into the oculomotor muscles was used in incorrectible diplopia, ocular torticollis, Duane's syndrome and congenital nystagmus. Favourable results were obtained and the sole complications which could be observed were a transitory ptosis and subconjunctival haemorrhages. Frequently 2 to 3 injections were sufficient for a permanent effect.

Adolescent↗

[Severe myopia and restrictive disorders of ocular motility].

High myopia may produce a masquerade syndrome, exhibiting clinical findings similar to those found in endocrine ophthalmopathy. Several hypotheses have been proposed as an explanation: sixth nerve paresis, structural changes in oculomotor muscles, contact between elongated globes and the bones of the orbital apices. These hypotheses are discussed after the presentation of a case with electroneuro-oculographic and tomodensitometric findings.

Aged↗