Brown's syndrome

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Brown syndrome
Specialty Ophthalmology   OOjs UI icon edit-ltr-progressive.svg

Brown syndrome is a rare form of strabismus characterized by limited elevation of the affected eye. The disorder may be congenital (existing at or before birth), or acquired. Brown syndrome is caused by a malfunction of the superior oblique muscle, causing the eye to have difficulty moving up, particularly during adduction (when eye turns towards the nose). Harold W. Brown first described the disorder in 1950 and initially named it the "superior oblique tendon sheath syndrome". [1]

Contents

Signs and symptoms

Harold W. Brown characterized the syndrome in many ways such as: [2]

Causes

Brown syndrome can be divided in two categories based on the restriction of movement on the eye itself and how it affects the eye excluding the movement: [3]

Diagnosis

Brown syndrome is usually diagnosed by taking a detailed history and performing physical exams, including certain eye movements. [4]

Treatments

If binocular vision is present and head position is correct, treatment is not obligatory. Treatment is required for: visual symptoms, strabismus, or incorrect head position. [3]

Acquired cases that have active inflammation of the superior oblique tendon may benefit from local corticosteroid injections in the region of the trochlea.

The goal of surgery is to restore free ocular rotations. Various surgical techniques have been used: [1] [3]

Epidemiology

In Brown's original series there was a 3:2 predominance of women to men and nearly twice as many cases involved the right eye as the left. 10% of cases showed bilaterality. Familial occurrence of Brown syndrome has been reported. [3]

See also

References

  1. 1 2 Emmett T. Cunningham; Paul Riordan-Eva (17 May 2011). Vaughan & Asbury's general ophthalmology (18th ed.). McGraw-Hill Medical. p. 246. ISBN   978-0071634205.
  2. Wright, KW (1999). "Brown's syndrome: diagnosis and management". Transactions of the American Ophthalmological Society. 97: 1023–109. PMC   1298285 . PMID   10703149.
  3. 1 2 3 4 Myron Yanoff; Jay S. Duker (2009). Ophthalmology (3rd ed.). Mosby Elsevier. pp.  1359–1360. ISBN   9780323043328.
  4. Fu, Lanxing; Gurnani, Bharat; Malik, Jahanzeb (2025), "Brown Syndrome", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   33085357 , retrieved 2025-08-27