About Duane Syndrome

Duane Syndrome (also called Duane Retraction Syndrome or DRS) is a rare congenital (present from birth) eye movement disorder. It affects approximately 1 in 1,000 people and accounts for about 1-5% of all strabismus (eye misalignment) cases.

The condition occurs due to abnormal development of the sixth cranial nerve (abducens nerve) during early pregnancy. This nerve normally controls the lateral rectus muscle, which moves the eye outward. When this nerve doesn't develop properly, the brain compensates by "mis-wiring" branches of the third cranial nerve (oculomotor nerve) to the lateral rectus muscle — causing the characteristic movement limitations and globe retraction.

Key Facts

• Affects approximately 1 in 1,000 people worldwide
• More common in females (about 60% of cases)
• The left eye is affected more often (about 60%)
• About 80% of cases are unilateral (one eye only)
• Most cases are sporadic (not inherited), though some families show a genetic pattern
• Usually detected in childhood, often by age 10
• Does not typically worsen over time

What It Looks Like

People with Duane Syndrome typically have limited ability to move the affected eye in one or more directions. The most noticeable feature is globe retraction — when trying to look toward the nose, the eyeball pulls back into the eye socket, causing the eyelid opening to narrow. Some people also experience upshoot or downshoot movements.

Many people with Duane Syndrome develop a compensatory head turn — they turn their head slightly to maintain binocular vision and avoid double vision. This is actually a healthy adaptation, not a problem that needs correction.