Bilateral Exotropic Duane Syndrome

A healthy 5-year-old male presented with an outward deviation of both eyes since approximately 4 months of age. Motility testing was notable for significant limitation to adduction in both eyes, significant downshoot in the right eye and downshoot and upshoot in the left eye in attempted adduction. Narrowing of the palpebral fissure in attempted adduction was present in both eyes. Cover and alternate cover test demonstrated a 60 prism diopters (PD) exotropia with alternate fixation. The patient was diagnosed with bilateral exotropia Duane and a bilateral lateral rectus recession of 12.0 mm was performed. One week post operatively the patient had 6 PD of exotropia at distance and 8 PD of exotropia at near.

Large exotropia associated to bilateral exotropia Duane syndrome can be corrected with bilateral supramaximal lateral rectus recession. 

Presentation Date: 01/14/2021

Issue Date: 04/01/2022