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Type II Duane's syndrome斜视 -> Ophthalmoplegic SyndromesThis is the rarest form of Duane’s syndrome, characterized by poor adduction and good abduction. The abducens nerve is intact and functioning, however the lateral rectus is also partially innervated by the third cranial nerve. Thus, on adduction, both medial and lateral rectus muscles are activated and the eye is unable to adduct well. The globe also retracts, causing lid fissure narrowing.
This patient has Duane’s syndrome in the right eye and has had unknown prior strabismus surgery (which improved his adduction) and has a small residual XT, seen in primary position. He exhibits decreased abduction on both right and left gaze (some of this is likely a sequelae of the prior surgery). Most prominently, he has an upshoot of the adducting right eye as well as lid fissure narrowing.
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