A 6-year-old child presents with a right convergent squint noticed since infancy. On examination, the right eye shows limitation of abduction, narrowing of the palpebral fissure on attempted adduction, and mild enophthalmos on adduction. The most likely diagnosis is:
- A Congenital third nerve palsy
- B Duane retraction syndrome type 1 ✓
- C Brown syndrome
- D Congenital fibrosis of the extraocular muscles
Correct answer: B. Duane retraction syndrome type 1
Explanation
Duane retraction syndrome type 1 is characterized by limited abduction with globe retraction (enophthalmos) and palpebral fissure narrowing on adduction due to co-contraction of the medial and lateral rectus muscles. Type 1 affects abduction primarily. Brown syndrome shows limitation of elevation in adduction. Third nerve palsy would involve multiple extraocular muscles and often the pupil. CFEOM presents with bilateral ptosis and restricted motility in all directions.
Reference: Pediatric Ophthalmology and Strabismus, AAO BCSC, 2023-2024 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.