Duane syndrome is an eye condition that you’re born with that affects how far your eyes can move from left to right. Your eye opening may get smaller when you look in a certain direction. Severe cases may need surgery.
Duane syndrome is a type of strabismus, an eye misalignment that’s congenital (something you’re born with). If you have Duane syndrome, you’ll have difficulties moving your eyes from side to side. You may have trouble with one or both eyes looking inward toward your nose or outward toward your ear.
You may also have trouble looking upward or downward. Along with your eyes crossing, or being out of alignment with each other, your eyelids might move when you try to move your eyes. This is because the nerves that control the muscles in your eyes don’t work correctly.
About 80% to 90% of Duane syndrome cases are unilateral, which means they affect only one eye. The left eye is more commonly affected.
Are there other names for Duane syndrome?
Yes, there are several names for Duane syndrome. They include:
Yes, there are different types of Duane syndrome: type 1, type 2 and type 3.
Duane syndrome type 1 is the most common form. It accounts for about 78% of all cases.
If you have type 1, you’ll have trouble moving your eye outward toward your ear. Your eye will be able to cross inward toward your nose, but your eye opening typically becomes smaller and the eyeball retracts. Your eye may look crossed in toward your nose (esotropia).
Duane syndrome type 2 is the least common form. It accounts for about 7% of people with the condition.
If you have type 2, you have a limited ability to move your eyes inward toward your nose. You will be able to turn your eye outward toward your ear but your eye opening typically becomes smaller and the eyeball retracts. Your eye may look turned out toward your ear (exotropia).
Duane syndrome type 3 accounts for about 15% of total cases.
If you have type 3, your ability to move your eyes in either direction is limited. Also, your eye opening may become smaller and your eyeball retracts with certain gazes.
It’s estimated that 4% of the population of the U.S., or some 13 million people, have strabismus. It’s further estimated that about 1% to 5% of the total number of people with strabismus have Duane syndrome.
Duane syndrome is slightly more common in people assigned female at birth (AFAB) than people assigned male at birth (AMAB).
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Signs and symptoms of Duane syndrome, some of which may be seen in infants, may include:
Duane syndrome doesn’t always happen with other conditions, but it sometimes does. These conditions may include:
There may also be other eye-related conditions that happen along with Duane syndrome, including:
Duane syndrome is genetic, but not typically inherited. The movement issues are due to problems with your cranial nerves, or the nerves that control the way your eyes move.
Duane syndrome may happen more frequently in people who’ve been exposed to thalidomide in utero.
Only about 10% of people with Duane syndrome have other family members with the condition. In cases that run in the family, Duane syndrome is usually bilateral (it affects both eyes).
If you inherit Duane syndrome, it happens because a variant of CHN1, MAFB, or SALL4 is passed down. The pattern for inheritance in Duane syndrome, called “autosomal dominant,” means that it occurs equally in people AMAB and people AFAB, and it can be inherited if just one parent has Duane syndrome.
No, Duane syndrome isn’t contagious. You can’t pass it on to someone like you can with an infection.
Your healthcare provider will take a complete medical history and will do a thorough eye exam. They’ll measure how much misalignment is present and test how far your eyes, or your child’s eyes, can move from side to side.
Your provider may also want to order tests for other conditions that might be linked to Duane syndrome.
There’s another condition called sixth cranial nerve palsy that’s very similar to Duane syndrome but is much less common than Duane syndrome.
Treatment will depend on age, severity and other illnesses you might have.
Some people with Duane syndrome won’t need treatment. They’ll just need to keep a regular appointment schedule with their eye care providers.
People who also have amblyopia may benefit from patching their good eye so the weaker one becomes stronger.
If you have a severe case of Duane syndrome, you may need surgery on your eye muscles. The surgery can’t fix the nerve problem but it can change the position of eye muscles to relieve an abnormal head posture, straighten eyes when looking straight ahead, and improve up-shoots/down-shoots.
At this time, there’s no way to prevent Duane syndrome from happening. Thalidomide, the medication that can cause Duane syndrome (in addition to many other congenital conditions), is no longer available.
Some people with Duane syndrome can manage the condition by moving their heads slightly to improve their vision. In some cases, you may need surgery.
If you have another condition along with Duane syndrome, your provider will treat that condition also.
You may need glasses to improve vision and/or alignment.
You may want to ask your healthcare provider questions like these:
A note from Cleveland Clinic
A provider will probably diagnose Duane syndrome within the first 10 years of your child’s life if your child has the condition. Contact your healthcare provider if you have any questions about your sight or your child’s sight. Your healthcare provider can work with you to determine the best treatment for Duane syndrome and can help to treat amblyopia if it’s present.
Last reviewed by a Cleveland Clinic medical professional on 10/18/2022.
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