Abstract

This case study delves into a unique presentation of Type 3 Duane Retraction Syndrome (DRS) in a 12-year-old female, marked by apparent motility defects inconsistent with measured deviation. Despite only 18-20 prism diopters of exotropia, the patient exhibited significant ocular movement limitations, notably, abduction of -4 and adduction of -3, along with a grade 3 upshoot on adduction. This case challenges conventional understanding, showcasing the complexity of DRS presentations. The absence of visual loss and minor deviation often belie severe motility restrictions, necessitating comprehensive evaluation. Recognition of atypical DRS patterns is vital for accurate diagnosis, guiding appropriate management decisions.