Acquired orbital retraction syndrome

Four patients with infiltrative orbital disease involving an extraocular muscle demonstrated a characteristic retraction-motility pattern. The cardinal feature was retraction of the globe on attempted gaze opposite the field of action of the involved muscle. Variable eye movement limitation was present in the field of action and opposite to the field of action of the involved muscle. When motility was restricted, the force-duction test was positive. Modest proptosis and episcleal vascular congestion over the extraocular muscle insertion were associted physical findings. Dysthyroid eye disease, inflammatory myositis, and neoplasms are among the infiltrative myopathies that may produce an acquired orbital retraction symdrome.