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Abduction-Release Sign in Heavy Eye Syndrome.

Idan Hecht1, Sasha A Mansukhani

  • 1Department of Ophthalmology (IH, SAM), Mayo Clinic, Rochester, Minnesota; and Mayo Clinic Health System (SAM), Eau Claire, Wisconsin.

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
|April 17, 2026
PubMed
Summary
This summary is machine-generated.

A new Abduction-Release Sign is associated with Heavy Eye Syndrome (HES), a condition causing eye misalignment and severe myopia. This clinical finding aids in diagnosing HES alongside traditional methods.

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Area of Science:

  • Ophthalmology
  • Strabismus Research
  • Ophthalmic Diagnostics

Background:

  • Heavy Eye Syndrome (HES) is a progressive condition characterized by esotropia and hypotropia, often associated with high myopia.
  • Current diagnosis relies on clinical presentation and imaging.
  • A novel clinical sign is described for HES evaluation.

Purpose of the Study:

  • To identify and describe a novel clinical sign, the Abduction-Release Sign, in patients with Heavy Eye Syndrome (HES).
  • To assess the diagnostic utility of the Abduction-Release Sign in differentiating HES from other conditions causing limitation in elevation.

Main Methods:

  • A cross-sectional, retrospective analysis of 14 patients with limitation in elevation was conducted.
  • The presence of the Abduction-Release Sign was recorded and compared between 4 HES patients and 10 control patients with other diagnoses.
  • The sign involves assessing eye movement during abduction and adduction in a circular motion.

Main Results:

  • All 4 patients with HES exhibited a positive Abduction-Release Sign.
  • None of the 10 control patients (including those with thyroid eye disease and Brown syndrome) showed a positive sign (P = 0.001).
  • The HES group had a mean spherical equivalent of -17.8 D, significantly higher myopia than the control group.

Conclusions:

  • The Abduction-Release Sign is significantly associated with HES in patients with limitation in elevation.
  • This sign may serve as a valuable diagnostic aid for HES, complementing existing examination and imaging techniques.
  • Further research may explore the sign's utility in severe cases and its implications for understanding HES pathophysiology.