Rare association of Keratoconus in the contralateral eye in a case of Duanes retraction syndrome

Abstract

Duanes retraction syndrome is characterised by restriction of ocular motility, changes in palpebral fissure width and globe retraction. Keratoconus is a bilateral, progressive non-inflammatory corneal ectatic disease characterised by central or paracentral thinning and steepening causing irregular astigmatism. We report a case of rare association of DRS with keratoconus in the contralateral eye in a thirteen year old male child. The ocular motility revealed left DRS with exotropia. Corneal topography, based on new Scheimpflug and placido-disk analyser, revealed the findings consistent with features of keratoconus in the right eye. There were no associated systemic abnormalities. This case gives evidence of the importance of cycloplegic refraction which provided a clue towards suspecting keratoconus. It also highlightsthe fact that a patient with DRS should be examined thoroughly to rule out any associated ocular anomalies.