Mechanical Syndroms
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Questions and Answers

What is the main cause of Duane's Syndrome?

  • Innervation of the LR by extra branches of the third nerve (correct)
  • Absence of the 6th nerve
  • Fibrosis of the LR
  • Co-contraction of the horizontal recti

    • Browns Syndrome is more common in males.

    False

    What is the aim of surgery in Duane's Syndrome?

    To place the field of binocular vision more centrally, enlarging it if possible, and to overcome or reduce the head posture

    Duane's Syndrome can be associated with ______________________ syndromes.

    <p>Goldenhar's or Kippel Feil</p> Signup and view all the answers

    What is the most common type of Duane's Syndrome?

    <p>Type 1</p> Signup and view all the answers

    Duane's Syndrome is always bilateral.

    <p>False</p> Signup and view all the answers

    Match the following conditions with their characteristics:

    <p>Duane's Syndrome = Caused by innervation of the LR by extra branches of the third nerve Browns Syndrome = Anomaly of the superior oblique muscle</p> Signup and view all the answers

    What is the result of fibrosis of the LR in Duane's Syndrome?

    <p>Mechanical deviation</p> Signup and view all the answers

    What is a characteristic of Brown's syndrome?

    <p>Limitation of elevation in adduction</p> Signup and view all the answers

    Surgery is the first line of treatment for Brown's syndrome.

    <p>False</p> Signup and view all the answers

    What is the muscle sequalae in unilateral right Brown's syndrome?

    <p>Underaction of the RSO and overaction of contralateral synergist (SR)</p> Signup and view all the answers

    In some acquired cases of Brown's syndrome, an audible ______________ may be heard when the eye suddenly shoots up.

    <p>click</p> Signup and view all the answers

    Match the following characteristics of Brown's syndrome:

    <p>Limitation of elevation in adduction = Characteristic of Brown's syndrome Chin elevation with head tilted to affected side = Characteristic of Brown's syndrome A or V pattern = Characteristic of Brown's syndrome Unilateral ptosis = Not a characteristic of Brown's syndrome</p> Signup and view all the answers

    What is the outcome in a significant number of patients with early onset of Brown's syndrome?

    <p>Spontaneous recovery over a long period</p> Signup and view all the answers

    What is the mechanical restriction that limits movement in Brown's syndrome?

    <p>SO tendon sheath</p> Signup and view all the answers

    Brown's syndrome is always bilateral.

    <p>False</p> Signup and view all the answers

    What is the characteristic of Brown's syndrome that mimics an IO palsy?

    <p>Limitation of elevation in adduction</p> Signup and view all the answers

    In some acquired cases of Brown's syndrome, an audible ______________ may be heard when the eye suddenly shoots up.

    <p>click</p> Signup and view all the answers

    Match the following muscle sequela with their descriptions in unilateral right Brown's syndrome:

    <p>Underaction of the RSO = Muscle sequela in unilateral right Brown's syndrome Overaction of the contralateral synergist (SR) = Muscle sequela in unilateral right Brown's syndrome</p> Signup and view all the answers

    What is the outcome in a significant number of patients with early onset of Brown's syndrome?

    <p>Spontaneous recovery over a long period</p> Signup and view all the answers

    What is the result of a simultaneous contraction of the MR and LR in Duane's Syndrome?

    <p>Retraction of the globe</p> Signup and view all the answers

    Duane's Syndrome is always unilateral.

    <p>False</p> Signup and view all the answers

    What is the main reason for the limitation of abduction in Duane's Syndrome?

    <p>Innervation of the LR by extra branches of the third nerve in place of an absent or atrophic 6th nerve.</p> Signup and view all the answers

    In Duane's Syndrome, the affected eye will have ______________ of the palpebral aperture on adduction.

    <p>narrowing</p> Signup and view all the answers

    What is the characteristic of the A pattern in Duane's Syndrome?

    <p>Abduct better on depression</p> Signup and view all the answers

    Browns Syndrome is more common in males and left eyes.

    <p>False</p> Signup and view all the answers

    Match the following characteristics of Duane's Syndrome with their corresponding types:

    <p>Type 1 = Marked limitation of abduction Type 2 = Marked limitation of adduction Type 3 = Limitation of both abduction and adduction</p> Signup and view all the answers

    What is the primary goal of surgery in Duane's Syndrome?

    <p>To place the field of binocular vision more centrally, enlarging if possible, and to overcome or reduce the head posture.</p> Signup and view all the answers

    What is the mechanical restriction that limits movement in Brown's syndrome?

    <p>All of the above</p> Signup and view all the answers

    Surgery is the first line of treatment for Brown's syndrome.

    <p>False</p> Signup and view all the answers

    What is the characteristic of Brown's syndrome that mimics an IO palsy?

    <p>Limitation of elevation in adduction</p> Signup and view all the answers

    In some acquired cases of Brown's syndrome, an audible ______________ may be heard when the eye suddenly shoots up.

    <p>click</p> Signup and view all the answers

    Match the following muscle sequela with their descriptions in unilateral right Brown's syndrome:

    <p>Underaction of the RSO = Muscle sequela in unilateral right Brown's syndrome Overaction of the contralateral SR = Muscle sequela in unilateral right Brown's syndrome Overaction of the IO = Acquired cases of Brown's syndrome Underaction of the LR = Not a characteristic of Brown's syndrome</p> Signup and view all the answers

    What is the outcome in a significant number of patients with early onset of Brown's syndrome?

    <p>Spontaneous recovery over a long period</p> Signup and view all the answers

    What is the primary cause of the limitation of abduction in Duane's Syndrome?

    <p>Innervation of the LR by extra branches of the third nerve</p> Signup and view all the answers

    Duane's Syndrome is always bilateral.

    <p>False</p> Signup and view all the answers

    What is the characteristic of the affected eye on adduction in Duane's Syndrome?

    <p>retraction of the globe with narrowing of the palpebral aperture</p> Signup and view all the answers

    Duane's Syndrome can be associated with ______________________ syndromes.

    <p>Goldenhar's or Kippel Feil</p> Signup and view all the answers

    Which of the following is a characteristic of Brown's Syndrome?

    <p>Anomaly of the superior oblique muscle</p> Signup and view all the answers

    Match the following types of Duane's Syndrome with their characteristics:

    <p>Type 1 = Marked limitation of abduction Type 2 = Marked limitation of adduction Type 3 = Limitation of both abduction and adduction</p> Signup and view all the answers

    Browns Syndrome is more common in females and left eyes.

    <p>False</p> Signup and view all the answers

    What is the primary goal of surgery in Duane's Syndrome?

    <p>to place the field of binocular vision more centrally and enlarge it if possible</p> Signup and view all the answers

    Study Notes

    Duane's Syndrome

    • Congenital condition that can be unilateral or bilateral, with the left eye being more commonly affected
    • Caused by extra branches of the third nerve innervating the lateral rectus (LR) in place of an absent or atrophic sixth nerve
    • Results in simultaneous contraction of the medial rectus (MR) and LR, leading to retraction
    • Fibrosis of the LR occurs, causing mechanical deviation
    • Can be associated with Goldenhar's or Kippel Feil syndromes
    • Clinical features include:
      • Limitation of abduction with widening of the palpebral aperture
      • Less marked limitation of adduction
      • Retraction of the globe during adduction with narrowing of the palpebral aperture
      • No diplopia
      • Face turns towards the affected side (AHP)
      • Upshoots of the affected eye on adduction are common
      • Bulging of fat through the septum on adduction as the fat is displaced by the retracting globe
      • Poor convergence
      • A or V patterns
    • Classification:
      • Type 1: marked limitation of abduction
      • Type 2: marked limitation of adduction
      • Type 3: limitation of both abduction and adduction
    • Management:
      • Treatment of amblyopia and correction of refractive error
      • Surgery may be indicated for decompensation, symptoms, cosmetically poor AHP, or cosmetically poor strabismus

    Browns Syndrome

    • Anomaly of the superior oblique muscle, mainly unilateral but can be bilateral
    • More common in females and right eyes
    • Can be acquired later through inflammation or trauma to the trochlear region
    • Minimal movement due to mechanical restriction of the superior oblique (SO)
    • Causes are uncertain and variable, including short tendon sheath or swelling of the SO
    • Characteristics:
      • Limitation of elevation in adduction
      • Chin elevation with head tilted to affected side
      • A or V pattern
      • Little deviation on primary position
      • Mimics an inferior oblique palsy
      • Positive forced duction test
    • In some acquired cases, an audible 'click' may be heard when the eye suddenly shoots up with the overacting inferior oblique
    • Management:
      • Spontaneous recovery over a long period in some patients with early onset
      • Surgery is considered if marked decompensation of AHP or deviation in primary position occurs

    Duane's Syndrome

    • Congenital condition that can be unilateral or bilateral, with the left eye being more commonly affected
    • Caused by extra branches of the third nerve innervating the lateral rectus (LR) in place of an absent or atrophic sixth nerve
    • Results in simultaneous contraction of the medial rectus (MR) and LR, leading to retraction
    • Fibrosis of the LR occurs, causing mechanical deviation
    • Can be associated with Goldenhar's or Kippel Feil syndromes
    • Clinical features include:
      • Limitation of abduction with widening of the palpebral aperture
      • Less marked limitation of adduction
      • Retraction of the globe during adduction with narrowing of the palpebral aperture
      • No diplopia
      • Face turns towards the affected side (AHP)
      • Upshoots of the affected eye on adduction are common
      • Bulging of fat through the septum on adduction as the fat is displaced by the retracting globe
      • Poor convergence
      • A or V patterns
    • Classification:
      • Type 1: marked limitation of abduction
      • Type 2: marked limitation of adduction
      • Type 3: limitation of both abduction and adduction
    • Management:
      • Treatment of amblyopia and correction of refractive error
      • Surgery may be indicated for decompensation, symptoms, cosmetically poor AHP, or cosmetically poor strabismus

    Browns Syndrome

    • Anomaly of the superior oblique muscle, mainly unilateral but can be bilateral
    • More common in females and right eyes
    • Can be acquired later through inflammation or trauma to the trochlear region
    • Minimal movement due to mechanical restriction of the superior oblique (SO)
    • Causes are uncertain and variable, including short tendon sheath or swelling of the SO
    • Characteristics:
      • Limitation of elevation in adduction
      • Chin elevation with head tilted to affected side
      • A or V pattern
      • Little deviation on primary position
      • Mimics an inferior oblique palsy
      • Positive forced duction test
    • In some acquired cases, an audible 'click' may be heard when the eye suddenly shoots up with the overacting inferior oblique
    • Management:
      • Spontaneous recovery over a long period in some patients with early onset
      • Surgery is considered if marked decompensation of AHP or deviation in primary position occurs

    Duane's Syndrome

    • Congenital condition that can be unilateral or bilateral, with the left eye being more commonly affected
    • Caused by extra branches of the third nerve innervating the lateral rectus (LR) in place of an absent or atrophic sixth nerve
    • Results in simultaneous contraction of the medial rectus (MR) and LR, leading to retraction
    • Fibrosis of the LR occurs, causing mechanical deviation
    • Can be associated with Goldenhar's or Kippel Feil syndromes
    • Clinical features include:
      • Limitation of abduction with widening of the palpebral aperture
      • Less marked limitation of adduction
      • Retraction of the globe during adduction with narrowing of the palpebral aperture
      • No diplopia
      • Face turns towards the affected side (AHP)
      • Upshoots of the affected eye on adduction are common
      • Bulging of fat through the septum on adduction as the fat is displaced by the retracting globe
      • Poor convergence
      • A or V patterns
    • Classification:
      • Type 1: marked limitation of abduction
      • Type 2: marked limitation of adduction
      • Type 3: limitation of both abduction and adduction
    • Management:
      • Treatment of amblyopia and correction of refractive error
      • Surgery may be indicated for decompensation, symptoms, cosmetically poor AHP, or cosmetically poor strabismus

    Browns Syndrome

    • Anomaly of the superior oblique muscle, mainly unilateral but can be bilateral
    • More common in females and right eyes
    • Can be acquired later through inflammation or trauma to the trochlear region
    • Minimal movement due to mechanical restriction of the superior oblique (SO)
    • Causes are uncertain and variable, including short tendon sheath or swelling of the SO
    • Characteristics:
      • Limitation of elevation in adduction
      • Chin elevation with head tilted to affected side
      • A or V pattern
      • Little deviation on primary position
      • Mimics an inferior oblique palsy
      • Positive forced duction test
    • In some acquired cases, an audible 'click' may be heard when the eye suddenly shoots up with the overacting inferior oblique
    • Management:
      • Spontaneous recovery over a long period in some patients with early onset
      • Surgery is considered if marked decompensation of AHP or deviation in primary position occurs

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    Description

    Learn about Duane's Syndrome, a congenital condition affecting eye movement, its causes, symptoms, and associated syndromes like Goldenhar's and Kippel Feil.

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