To the Editor.
—I read with great interest the article entitled "Central Ocular Motor Abnormalities in Duane's Retraction Syndrome" by Gourdeau et al in the Archives (1981;99:1809-1810). These authors suggest that Duane's retraction syndrome is produced by a primary brainstem abnormality involving premotor structures. This conclusion is based on eye movement studies on five patients with type 1 Duane's retraction syndrome.When only a limited number of patients are studied, it would seem that each case should be typical of the syndrome. One patient had a large amount of esotropia (30 PD), and one patient was exotropic (16 PD). Wong et al1 reported only 12% of all their esotropic patients with Duane's retraction syndrome had a deviation as large as 30 PD (6% of their entire series). The esotropia averaged 16 PD. Danis2 found only 15% of his patients with Duane's retraction syndrome were exotropic.In the article