: The most common form of globe retraction is Duane′s retraction syndrome. In this syndrome globe retraction occurs during attempted adduction. Inverse Duane's retraction syndrome is a condition with reverse clinical features. Abduction of the affected eye is limited and is accompanied by retraction of the glob, narrowing of the palpebral fissure. Inverse Duane's retraction syndrome is very uncommon. Most reported cases are acquired. Congenital bilateral cases are even more unusual.

A 2-year-old boy presented with bilateral limited abduction.On attempted abduction is accompanied by marked glob retraction and narrowing of palpebral fissure. He has very mild changing abnormal head posture and in primary position, the eyes were nearly orthophoric without nystagmus.. On general examination, he has not ocular or systemic abnormal condition and no history of trauma to the head or orbit.(pictures and video will be presenred)

On forced duction test there was severe medial rectus restriction in both eyes. Because of mild abnormal head posture and nearly orthotropic in primary position, surgery was not done.

Bilateral Inverse Duane’s retraction syndrome is very rare.The cause of glob retraction on attempted abduction in inverse. There are some theories but exact mechanism has not been identified.