To the Editor.
—The Photo Essay by Ziavras et al1 in the July 1990 issue of the Archives about an infant with features of Goldenhar's syndrome—facial asymmetry, epibulbar dermoid, and ear and cervical spine defects—was interesting and the photographs were superb. The case, however, is somewhat atypical. The authors describe the infant as having an esotropia of 10 prism diopters with limitation of abduction in the left eye. Although a congenitally paretic left lateral rectus is possible, it is uncommon in a newborn. A more likely explanation is Duane's syndrome since the child is female and the left eye is involved.It is unusual for Duane's syndrome to be associated with Goldenhar's syndrome. Although Treacher Collins syndrome was briefly discussed, it looks little like this, but another syndrome, Wildervanck's, does.2 This condition is seen almost exclusively in female patients and is associated with Duane's syndrome; features include severe
Coyle JT. Goldenhar's Syndrome. Arch Ophthalmol. 1991;109(7):916. doi:10.1001/archopht.1991.01080070026010