A case of congenital inverse Duane's retraction syndrome

Inverse Duane's retraction syndrome is very uncommon. Congenital cases are even more unusual. A 6-year-old girl with convergent squint along with seve re restriction on abduction is described. On attempted abduction, a narrowi ng of the palpebral fissure, upshoot and retraction of the eyeball were obs erved. Brain and orbit: MRI demonstrated no intracranial or intraorbit al m ass, fracture, or entrapment of the medial rectus. Forced duction test was strongly positive. The primary lesion was found to be a tight medial rectus with shortening and soft tissue contracture. Surgical tenotomy of the medi al rectus led to successful postoperative motility, but some limitation at full adduct-ion and abduction persisted. This is a case reported with conge nital medial rectus shortening, suggesting that this condition may be one o f the etiologies of the rare inverse Duane's retraction syndrome.