Abstract

The upshoot and downshoot in Duane's retraction syndrome is believed to be related to a leash effect from the lateral rectus muscle. When the eye is rotated into the adducted position, the lateral rectus muscle slips over the globe, producing the up-and downshoot on adduction. The splitting of the ends of the lateral rectus into a Y configuration prevents the rotation of the globe up or down by stabilizing the muscle's position on the eye. Three patients with Duane's retraction syndrome demonstrated abnormal vertical movement on adduction and underwent a Y-splitting on the lateral rectus. In all patients, marked decrease in the up-and downshoot in noted after surgery.