Dear ann21-ga;
Thank you for allowing me an opportunity to answer your interesting
question.
I assume that you already have at least some working knowledge of this
syndrome, which is basically a significant congenital misalignment of
the eye(s). In the event that you do not, you might want to read these
articles first and familiarize yourself with the condition before
moving on:
HANDBOOK OF OCCULAR DISEASE MANAGEMENT
“Duane's Retraction Syndrome”
http://www.revoptom.com/handbook/oct02_sec6_1.htm
THE ENGLE LABORATORY
“Research: Duane syndrome”
http://web1.tch.harvard.edu/research/engle/duane.html
Here are some interesting facts about Duane’s syndrome:
“DRS more frequently occurs in the left eye than in the right, and in
females more than in males. Bilateral involvement is less frequent
than unilateral occurrence. In several large series, the ratio of
right eye to left eye involvement was 1:3, the prevalence of
bilaterality was 20 per cent, and there was a slight preponderance of
females over males (54 per cent versus 46 per cent). This condition is
found in approximately 1 per cent of individuals with strabismus.
Clinical Manifestations The most characteristic clinical findings in
DRS include an absence of abduction of an eye with slight limitation
of adduction, retraction of the globe in attempted adduction, and up-
and downshooting, or both in adduction. Huber, with the support of
electromyography, provided a useful classification of DRS into three
types: Type I. Marked limitation or complete absence of abduction,
normal or only slightly restrict adduction, narrowing of the palpebral
fissure and retraction of the globe on adduction, and widening of the
palpebral fissure on attempted abduction. Electromyography shows
absence of electrical activity in the lateral rectus muscle on
abduction, but paradoxic electrical activity on adduction.”
GEOMETRY.NET: HEALTH CONDITIONS – DUANE’S RETRACTION SYNDROME
http://www.geometry.net/health_conditions/duane_retraction_syndrome.php
In this study, 124 cases in which surgery was used to correct the
misalignment(s), were examined in order to provide a reliable success
rate for the treatments used:
“MEDLINE/HealthSTAR 1995 - 2001
Author: Kubota, N, Takahashi, H, Hayashi, T, Sakaue, T, Maruo, T
Affiliation: Department of Ophthalmology, Teikyo University School of
Medicine, Tokyo, Japan.
Title: Outcome of surgery in 124 cases of Duane's Retraction Syndrome
(DRS) treated by intraoperatively graduated recession of the medial
rectus for esotropic DRS, and of the lateral rectus for exotropic DRS.
Source: Binocular Vision and Strabismus Quarterly, 2001 Spring,
16(1):15-22.
Abstract:
RESULTS: Both the primary eye position and the abnormal head posture
were satisfactorily improved in 119 cases (89%) after surgery with a
result rated "excellent" or "good" by a residual deviation of 7
degrees or less and a definitely improved abnormal head posture, for
all types of DRS deviations.
CONCLUSION: Recession of the appropriate horizontal rectus muscle is a
safe and effective primary procedure for both the primary deviation
and abnormal head posture in all types of DRS.”
“Current Citations from 5/12/2001 Strabismus”
http://med-aapos.bu.edu/Melvyl/51201s.html
By all accounts surgery an acceptable and relatively reliable
treatment for this condition in most cases, provided the condition is
not compounded by other complicating diseases (thyroid problems,
deformities, etc). Most all studies agree that surgery also does not
eliminate the fundamental abnormality of innervation and while
treatment may provide aesthetic, cosmetic and even corrective results,
no surgical technique has been completely successful in eliminating
the abnormal eye movements entirely. “Simple horizontal muscle
recession procedures, vertical rectus muscle transposition procedures,
or combinations of the two may be successful in improving or
eliminating head turns and misalignment of the eyes. The choice of
procedure must be individualized.”
Obviously, I cannot recommend a particular surgeon to you and even if
I could, most directories do not specify which of the many types of
syndrome each physician treats (Duane Syndrome Type IA, 1B, 1C; Type
2A, 2B, 2C; Type 3A, 3B, 3C). However, I can try to help you with a
strategy to narrow your seach for a specialist in this field. Here I
have found some known specialists in the field of ophthalmic surgery
(specifically with regard to Duane’s Retractive Syndrome) and a number
of other sources who are well versed in this area of expertise. I
recommend you contact them and see if they can give you a referral to
someone in your area that can provide the services you need:
Rudolph S. Wagner, MD
Clinical Associate Professor
Bd. Certified: Ophthalmology
Training: Ed: UMDNJ-New Jersey Medical School (1978). Res: Thomas
Jefferson University Hospital, PA.; UMDNJ-New Jersey Medical School.
Fel:Wills Eye Hospital, PA.
Clinical Interests: Botulinum toxin in the treatment of strabismus,
cranial nerve palsies, ocular genetics, Duane's retraction syndrome,
and spina bifida and ocular disease.
For appointments, call (973) 972-2065
UNIVERISTY HOSPITAL – NEWARK, NEW JERSEY
http://www.theuniversityhospital.com/physservdirectory/html/ophthalmology.htm
Suqin Guo, MD
Assistant Professor
Training: Ed: Beijing Medical University, China (1981). Res: UMDNJ-New
Jersey Medical School. Fel: Emory University, GA; Wills Eye Hospital,
PA; Children's Hospital of New Jersey, NJ.
Clinical Interests: Medical and surgical management of adult and
pediatric cataracts, vertical strabismus, and Duane's Retraction
Syndrome
Other Languages Spoken: Chinese
For appointments, call (973) 972-2065
UNIVERISTY HOSPITAL – NEWARK, NEW JERSEY
http://www.theuniversityhospital.com/physservdirectory/html/ophthalmology.htm
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
Tel: (914)428-7100
Fax: (914)997-4763
Tel: (888)663-4637
TDD: (914)997-4764
Email: resourcecenter@modimes.org
Internet: http://www.modimes.org
Schepens Eye Research Institute
20 Staniford Street
Boston, MA 02114-2500
Tel: (617)912-0100
Fax: (617)523-3463
Email: geninfo@vision.eri.harvard.edu
Internet: http://www.eri.harvard.edu
NIH/National Eye Institute
Building 31 Rm 6A32
31 Center Dr MSC 2510
Bethesda, MD 20892-2510
United States
Tel: 3014965248
Fax: 3014021065
Email: 2020@nei.nih.gov
Internet: http://www.nei.nih.gov/
NIH/Office of Rare Diseases
Steve Groft, Pharm.D.
31 Center Drive,Rm 1B19, MSC 2084
Bethesda, MD 20892-
Tel: (301)402-4336
Fax: (301)480-9655
Email: hh70f@nih.gov
Internet: http://rarediseases.info.nih.gov/ord/
Genetic Alliance
4301 Connecticut Avenue NW
Suite 404
Washington, DC 20008-2304
Tel: (202)966-5557
Fax: (202)966-8553
Tel: (800)336-4363
Email: info@geneticalliance.org
Internet: http://www.geneticalliance.org
National Organization for Rare Disorders
P.O. Box 8923
New Fairfield, CT
06812-8923;
Phone (203) 746-6518
Web site http://www.rarediseases.org
Email orphan@rarediseases.org
In the meantime, here you will find others who are discussing the
condition and you may find that many of them have already researched
the information you are seeking:
YAHOO GROUPS
http://groups.yahoo.com/group/duanes/messages/4140
YAHOO GROUPS – DUANE LINKS
http://groups.yahoo.com/group/duanes/links
SUPPORT GROUPS
http://med-aapos.bu.edu/AAPOS/support.html
SUCCESSFUL GOOGLE SEARCH FOR SUPPORT GROUPS
://www.google.com/search?hl=en&lr=&ie=UTF-8&oe=UTF-8&safe=off&q=%22Duane%27s+retraction+syndrome%22+%22SUPPORT+GROUPS%22
I hope you find that that my research exceeds your expectations. If
you have any questions about my research please post a clarification
request prior to rating the answer. I welcome your rating and your
final comments and I look forward to working with you again in the
near future. Thank you for bringing your question to us.
Best regards;
Tutuzdad-ga
INFORMATION SOURCES
HANDBOOK OF OCCULAR DISEASE MANAGEMENT
“Duane's Retraction Syndrome”
http://www.revoptom.com/handbook/oct02_sec6_1.htm
THE ENGLE LABORATORY
“Research: Duane syndrome”
http://web1.tch.harvard.edu/research/engle/duane.html
YAHOO GROUPS
http://groups.yahoo.com/group/duanes/messages/4140
HEALTH LIBRARY – DUANE’S SYNDROME
http://www.bromenn.org/library/healthguide/IllnessConditions/topic.asp?hwid=nord224
YAHOO GROUPS – DUANE LINKS
http://groups.yahoo.com/group/duanes/links
SUPPORT GROUPS
http://med-aapos.bu.edu/AAPOS/support.html
SUCCESSFUL GOOGLE SEARCH FOR SUPPORT GROUPS
://www.google.com/search?hl=en&lr=&ie=UTF-8&oe=UTF-8&safe=off&q=%22Duane%27s+retraction+syndrome%22+%22SUPPORT+GROUPS%22
SEARCH STRATEGY
SEARCH ENGINE USED:
Google ://www.google.com
SEARCH TERMS USED:
SURGERY DUANE'S RETRACTION SYNDROME "TYPE 1"
SUCCESS RATE SURGERY DUANE'S RETRACTION SYNDROME "TYPE 1"
“DUANE'S RETRACTION SYNDROME” “SUPPORT GROUPS”
“DUANE'S RETRACTION SYNDROME” “MESSAGE BOARDS”
DUANE'S RETRACTION SYNDROME |
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