Korean J Ophthalmol Vol.23, No.4, 2009 Fig. 1. Preoperative photographs show markedly limited abduction, mildly limited adduction, and narrowing of the palpebral fissure on adduc- tion of the right eye. A 330 B Fig. 2. Side view of the right eye shows. (A) A slight enophthalmos in the primary position. (B) Globe retraction upon attempted adduction. or forceps delivery according to the patient or his parents. A forced duction test under topical anesthesia was definitely positive in the right eye. The patient’s ocular motor impairment was concluded to have arose from a long-term medial orbital wall fracture and was diagnosed as ‘pseudo-Duane’s retraction syndrome’. Because open reduction surgery for an old orbital wall fracture would be very difficult, and fruitless for this patient, we decided only to perform surgery on the eye muscle. The 5 mm recession of the right medial rectus muscle was successfully performed in order to correct the patient’s head turn and esotropia. Neither structural anomalies nor fibrosis of the medial rectus muscle was observed during surgery. Postoperatively, the patient had orthotropia in the primary position, and the anomalous head posture disappeared, though there were still some limitations in both abduction and ad- duction in the right eye one year after the surgery. D iscussio n Duane’s retraction syndrome is a well-known congenital ocular motility disorder caused by anomalous innervation and mechanics of the lateral rectus muscle, with secondary muscle changes sometimes superimposed. In 1976, Thomas Duane reported five cases of pseudo-Duane’s retraction syn- drome showing similar, yet different, symptoms and signs