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April 1987

Adduction Deficiency Following Medial Recti Recession in Duane's Retraction Syndrome

Arch Ophthalmol. 1987;105(4):465. doi:10.1001/archopht.1987.01060040035018

To the Editor.  —With a mounting sense of déjà vu, we read Dr Nelson's article1 about severe adduction deficiency following medial rectus recession in patients with Duane's retraction syndrome (DRS). We have also read the dialogue between Drs Metz2 and Nelson3 concerning the diagnosis of DRS in these patients. We wish to report a similar experience in treating a case of bilateral type 1 DRS in which a large exotropia resulted from a 5.0-mm recession of both medial recti.

Report of a Case.  —The parents of a 7-month-old girl had noted a large esotropia from her first month of life. Visual acuity was central, steady, and maintained in both eyes with good cross fixation. The esotropia measured 35 prism diopters, according to Krimsky's prism test, and was characterized by marked limitation of abduction bilaterally, with the left eye just reaching the midline and the right eye abducting

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