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What is Weakness of both Adduction and abduction is seen in: and explain in detail?
Ans. c. Duane's retraction syndrome type 3 (Ref: Kanski 5/e p548; Khurana 5/e p355)Weakness of both adduction and abduction is seen in Duane's retraction syndrome type 3.Duane's Retraction SyndromeCongenital strabismus that is usually caused by failure of normal development of the abducens nerve.Absence of the abducens nerve and fascicle with anomalous innervation of the lateral rectus muscle by the oculomotor nervePatients may have esotropia or esotropiaMostly unilateral, commonly affecting the left eye more than rightCharacteristic feature of Duane's Retraction SyndromeRetraction of the globe and narrowing of the palpebral fissure during attempted adductionQ.This feature is caused by the simultaneous contraction of the medial and lateral rectus muscle that occurs during attempted adductionQ.Duane's Retraction SyndromeType l(Esotropic Duane's Syndrome)Type II(Exotropic Duane's Syndrome)Type III* Most common typeQ* Absence or limitation of abduction and normal adductionQ* Least common typeQ* Limited adduction with normal abductionQ.* Limitation of both adduction and abductionQDouble Elevator Palsy:All horizontal gaze movements are normal.Double elevator palsy (mono ocular elevator palsy) is caused by tight oblique contracted inferior rectus muscle or hypoplastic/ineffective superior rectus muscle.