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History: This 6-year-old girl presented with history of a "deviation" of the left eye since shortly after birth. She has a history of epilepsy and has been wearing glasses for low hyperopia for several years. Cycloplegic refraction is +1.50 in each eye. Visual acuity is 20/20 in each eye. She habitually assumes a 30 degree right face turn with eyes left as shown in the picture below. With her head straight and fixing with the right eye there is 10 prism diopters of exotropia and fixing with the left eye there is 25 prism diopters of exotropia. She has slight limitation of adduction of the left eye and slight narrowing of the left fissure in right gaze. The exodeviation increases in up and down gaze.
Diagnosis: Duane syndrome, Class II exotropic
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