Duane Syndrome - treatmentBefore starting the treatment, patients should be tested for some refractive errors, because this kind of errors has to be corrected before taking other steps.
The purpose of surgery is to improve the life of the patient and to eliminate head turn and severe retraction. Also the misalignment of the eyes is wanted to disappear after surgery.
Unfortunately until now, the abnormal eye movements have not been eliminated by any type of surgery. Also surgery is inefficient in eliminating the innervation but by muscle recession procedures the head turns will be eliminated.
Beside surgery there are some things that may help in the case of head turns. For children with Duane syndrome, a special sit could be necessary at school or a prism on the glasses. For adults that enjoy driving, rear-view mirrors may be the solution.
The success rate of a surgery is high about 80% and the period that the possitve effects of the surgery last is about 8 years. This type of medical intervention can be done at any moment but is preferred to be done after the child is able to walk. This period is necessary because only after 3 or 4 years the visual system is developed and the communication with the patient is easier to take place.
The types of surgery depend on the type of Duane syndrome that every patient has.
For DS type 1 the medial rectus is recessed, the adduction may become smaller by fixation suturing on the medial rectus. For the second type of Duane syndrome is considered the medial rectus recession. When a patient has DS type 3 and the case is rather grave, an y cut of the lateral rectus is used in order to reduce retraction upshoot or downshoot. Also a recession of the medial muscles may be done. There is another type, type 4 where doctors include strange cases that don’t follow a pattern . If the head turn is not dramatic, or the vision is done with the eyes in the primary position, than medical intervention is not done because the results are not always satisfactory. In fact the patient is the one who decides. If he (or she) thinks that his life is seriously affected, if he is depressed and feels ugly and discriminated also if there are things that he is not able to perform because of this condition than surgery is worth trying. This is the case of a huge face turn which appears like an expression of strabismus.
The Duane syndrome is a complex illness that needs complex medical advice and time in order to improve the patient’s life. If surgery is necessary, studies have shown that the best result is registered for DS type 1.
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