What is Duane's Syndrome
Duane syndrome (DS) is a rare, congenital (present from birth) eye movement disorder. Most patients are diagnosed by the age of 10 years and DS is more common in girls (60 percent of the cases) than boys (40 percent of the cases).
DS is a miswiring of the eye muscles, causing some eye muscles to contract when they shouldn't and other eye muscles not to contract when they should. People with DS have a limited (and sometimes absent) ability to move the eye outward toward the ear (abduction) and, in most cases, a limited ability to move the eye inward toward the nose (adduction).
Often, when the eye moves toward the nose, the eyeball also pulls into the socket (retraction), the eye opening narrows and, in some cases, the eye will move upward or downward. Many patients with DS develop a face turn to maintain binocular vision and compensate for improper turning of the eyes.
In about 80 percent of cases of DS, only one eye is affected, most often the left. However, in some cases, both eyes are affected, with one eye usually more affected than the other.
Other names for this condition include: Duane's Retraction Syndrome (or DR syndrome), Eye Retraction Syndrome, Retraction Syndrome, Congenital retraction syndrome and Stilling-Turk-Duane Syndrome.
In 70 percent of DS cases, this is the only disorder the individual has. However, other conditions and syndromes have been found in association with DS. These include malformation of the skeleton, ears, eyes, kidneys and nervous system, as well as:
- Okihiro's syndrome, an association of DS with forearm malformation and hearing loss
- Wildervanck syndrome, fusion of neck vertebrae and hearing loss
- Holt-Oram syndrome, abnormalities of the upper limbs and heart
- Morning Glory syndrome, abnormalities of the optic disc or "blind spot"
- Goldenhar syndrome, malformation of the jaw, cheek and ear, usually on one side of the face
What are the symptoms
Clinically, Duane syndrome is often subdivided into three types, each with associated symptoms.
Type 1: The affected eye, or eyes, has limited ability to move outward toward the ear, but the ability to move inward toward the nose is normal or nearly so. The eye opening narrows and the eyeball pulls in when looking inward toward the nose, however the reverse occurs when looking outward toward the ear. About 78 percent of all DS cases are Type 1.
Type 2: The affected eye, or eyes, has limited ability to move inward toward the nose, but the ability to move outward toward the ear is normal or nearly so. The eye opening narrows and the eyeball pulls in when looking inward toward the nose. About 7 percent of all DS cases are Type 2.
Type 3: The affected eye, or eyes, has limited ability to move both inward toward the nose and outward toward the ears. The eye opening narrows and the eyeball pulls in when looking inward toward the nose. About 15 percent of all DS cases are Type 3.
Each of these three types can be further classified into three subgroups, depending on where the eyes are when the individual looks straight (the primary gaze):
Subgroup A: The affected eye is turned inward toward the nose (esotropia).
Subgroup B: The affected eye is turned outward toward the ear (exotropia).
Subgroup C: The eyes are in a straight, primary position.
What causes Duane's Syndrome
Common thought is that Duane syndrome (DS) is a miswiring of the medial and the lateral rectus muscles, the muscles that move the eyes. Also, patients with DS lack the abducens nerve, the sixth cranial nerve, which is involved in eye movement. However, the etiology or origin of these malfunctions is, at present, a mystery.
Many researchers believe that DS results from a disturbance - either by genetic or environmental factors - during embryonic development. Since the cranial nerves and ocular muscles are developing between the third and eighth week of pregnancy, this is most likely when the disturbance happens.
Presently, it appears that several factors may be involved in causing DS. Therefore it is doubtful that a single mechanism is responsible for this condition.
How is Duane's Syndrome diagnosed
A thorough family history and ocular (eye) examination is conducted, with special attention to the presence of other ocular or systemic malformations. Measurements of vision (visual acuity), the ocular misalignment, ocular range of motion, head turn, globe (eyeball) retraction, palpebral fissure (eye opening) size, and up- and downshoots are indicated. In addition, an examination of the cervical (neck) and thoracic (chest) spine, palate (roof of mouth), vertebrae, hands, and a hearing test is recommended to rule out disorders associated with DS3.
How can Duane's Syndrome be treated
The goal of surgery is the elimination or improvement of an unacceptable head turn, the elimination or reduction of significant misalignment of the eyes, the reduction of severe retraction and the improvement of upshoots and downshoots. Surgery does not eliminate the fundamental abnormality of innervation and no surgical technique has been completely successful in eliminating the abnormal eye movements. Surgery should not be performed unless there is a cosmetic problem when looking straight ahead. A simpler solution than surgery is special glasses with prism to eliminate the head turn. Some of these patients have secondary convergence problems, which are effectively treated by a natural vision therapy like Eyerobics.
How can Eyerobics help
The Eyerobics program is a program of eye exercises based on the Bates Method. This is a well known method developed by Dr William Bates in the 20's.
The eye exercises are designed to address most eye disorders including by improving the function of your eye muscles and at the same time relaxing them. The focus on improving your eye muscles enables your eyes to adjust to the symptoms caused by Duanes Syndrome and corrects the misalignment. Eyerobics exercises addresses all eye muscles. This is especially important in the case of Duanes Syndrom as the difference in strength and flexibility of various eye muscles causes the eyes to misalign. Exercises can help you to retrain your brain to use your eye muscles in a different way, to accommodate to the disorder. Because you are consciously controlling your eye muscles while doing the exercises they are a great way to address particular muscles that you find are more difficult to control. Remember that the body is very capable of adjusting to different circumstances and physical differences. Our Full Year Money Back Guarantee makes trying the Eyerobics program an affordable and logic choice for anyone wanting to address this disorder in a natural and affordable way.
"After four eye operations, 25 years in glasses and contact lenses, and still having problems I discovered Eyerobics.
In 2 weeks I started getting results and such clear vision that I removed my contact lenses and have never used them since. I made a visit to my eye specialist in Melbourne. I wanted an unbiased opinion so I didn't mention what I had been doing.
After he examined me, he told me my eyes were great and I wouldn't need glasses or contacts again. I couldn't be happier with the results, so simple and yet noticing each day the major improvements."
Tracey McIvor - Euroa, Victoria.