Duane Syndrome

What is Duane syndrome?

Duane syndrome — which is also known as Duane’s syndrome or Duane retraction syndrome — is a rare form of strabismus, or misalignment of the eye. Where most forms of strabismus leave side-to-side eye movements intact, in Duane syndrome the “wiring” of the eye muscles gets jumbled, and movement of eye(s) is limited in certain directions. There are three types of Duane syndrome, but the most common is Type I, which interferes with the eye’s ability to move outward (away from the nose). Duane syndrome can usually affects just one eye, but it can sometimes involve both.  The left eye is more likely to be affected than the right, although doctors still don’t know exactly why.

To better understand Duane syndrome, it’s helpful to understand the basic anatomy of the eye

  • Three of the nerves extending from the brain to the eye muscles, called cranial nerves, control the movements of the eye by transmitting electrical signals.
  • The sixth cranial nerve is in charge of the lateral rectus muscle, the muscle that moves the eye outward.
  • The third cranial nerve controls the medial rectus muscle, the muscle that pulls the eye inward, as well as other muscles.

What are the different types of Duane syndrome?

There are three types of Duane syndrome. In all three types, the opening of the eye narrows and the eyeball retracts when the eye moves inward

By far the most common is Type I, in which, in addition to the retraction of the eye:

  • there is limited or no ability to move the eye outward
  • the eye has little to no difficulty moving inward
  • the opening of the eye and widens when the person tries to move the eye outward

In Type II Duane syndrome:

  • there is limited or no ability to move the eye inward
  • the eye has little to no difficulty moving outward

In Type III Duane syndrome:

  • there limited or no ability to move the eye either inward or outward

Because the affected sixth cranial nerve cannot be repaired or replaced, there is no cure for Duane syndrome. However, for people whose lives are significantly disrupted by the condition, surgery can be very helpful in:

  • reducing or stopping the abnormal head posture many develop in an attempt to see better
  • reducing the angle of strabismus (misalignment of the eyes) 

How we care for Duane syndrome

Boston Children's Hospital is known nationwide for handling the most complex cases of Duane syndrome and related disorders. Our ophthalmologic surgeons specialize in the delicate eye muscle operations that are required to treat the syndrome, including adjustable suture surgery and vertical transposition surgery. 

Children’s ophthalmologists are actively involved in research that is shaping the way eye disorders like Duane syndrome are detected and treated around the world. And, since Children’s is Harvard Medical School’s primary teaching hospital for pediatrics and pediatric ophthalmology, our doctors are also training the next generation of clinicians and clinical scientists. 

Our team treats each person with Duane syndrome with a patient-focused, family-centered approach, drawing from the extensive multidisciplinary expertise within our Department of Ophthalmology and across the hospital.

Although we are known for our science-driven approach to medicine, we always remember that every patient is, first and foremost, an individual. Our team of professionals will create a customized treatment plan for specific symptoms and circumstances — and we’ll include you and your family at every step of the way.