Duane Syndrome

Dr. Russel Lazarus, September 5, 2021

Approximately 1 in 10,000 people worldwide have Duane syndrome.

Duane syndrome (DS) is a rare, non-progressive eye movement disorder, which is usually detected by doctors at childbirth.

How does Duane Syndrome impact the eyes?

This condition affects the functioning of the nerves controlling the eye’s muscles. 

Due to the miswiring of the eye’s nerves, this condition can cause some eye muscles to contract when they are not supposed to and other eye muscles not to contract when they should.

The ability to shift the eye outward toward the ear (abduction) is limited or absent in people with DS. In most cases, they have limited ability to move the eye inward toward the nose (adduction).

In some cases the eye moves toward the nose, retracting into the socket (retraction), causing the eye hole to narrow, and the eye may migrate upward or downward.

Many DS patients develop a face turn to compensate for improper eye turning and maintain binocular vision.

What causes Duane syndrome?

Duane syndrome is caused by an absence of or a problem with the operation of the 6th cranial nerve. 

This is a brain-controlled nerve that regulates one of the muscles that moves the eye laterally.

The condition is assumed to begin in the third to sixth week of pregnancy when the cranial nerves and ocular muscles are still forming. The sixth cranial nerve either does not develop or does not function properly.

More research is needed to know the exact disturbance in development. However, it’s thought to be either genetic or environmental.

SEE RELATED: Does My Baby Have an Eye Problem?

If you suspect your child might have Duane syndrome contact an eye doctor near you.

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Types of Duane syndrome

Duane syndrome is commonly split into three categories, each with its own set of symptoms.

Type 1

About 78% of all DS cases are Type I. Your ability to move your eye toward your ear is limited. It’s typical or nearly normal for you to be able to move your eye toward your nose.

Type 2

Only 7% of DS cases are Type 2. Your capacity to move your eye toward your nose is limited. You can move your eye normally or with only a minor constraint toward your ear.

Type 3

Roughly 15% of DS cases are Type 3. You have a restricted ability to move your eyes horizontally in either direction.

When you try to move your eyes inward, your eyelids close and the affected eyeball retracts into its socket, regardless of the kind.


Each of these three categories can be further divided into three subgroups.

These subgroups are used describe how your eyes appear when you’re attempting to look straight ahead:

  • Subgroup A: Esotropia – the affected eye is turned inward toward the nose.
  • Subgroup B: Exotropia – the affected eye is turned outward toward the ear.
  • Subgroup C: Orthotropia: The eyes are in a primary, straight position.

What are the symptoms of Duane syndrome?

In the vast majority of instances, Duane syndrome is defined solely by the above-mentioned limited eye movement.

Other symptoms are uncommon in patients with Duane syndrome, however in rare occasions, the disorder has been associated with:

  • Hearing loss
  • Kidney problems
  • Skeletal malformations
  • A variety of other syndromes
  • Disorders of the nervous system

When symptoms do appear, they usually involve:

  • An abnormal head turn to one side
  • Closing one eye to try to see better
  • Misalignment or crossing of the eyes

Some children with Duane syndrome complain of:

  • Neck pain
  • Headaches
  • Double vision
  • Difficulty with their vision in the affected eye

How to treat Duane syndrome

People with Duane syndrome frequently develop an irregular head turn to compensate for their inability to turn their eyes.

There are several things that can be done to enhance the situation and improve the head turn.

  • Offer special seating in school
  • To assist with driving, adding extra mirrors in cars
  • Attach a prism on glasses to correct turning of the face
  • Wear a patch over the good eye
  • Vision therapy can be used to treat the inability to turn eyes toward each other

LEARN MORE:  Guide to Children’s Eye Exams 

Schedule an appointment with an eye doctor near you to discuss the optimum eye care for your child. 

If you notice your baby’s eyes are not straight or have any concern about your newborn’s eyes, early diagnosis will allow for the most effective treatment.