Brown's syndrome
Rare strabismus with limited elevation of the affected eye.
Last updated
Brown syndrome is a rare strabismus in which the affected eye has limited elevation, particularly when adducted. It may be congenital or acquired and results from a malfunction of the superior oblique muscle. The disorder was first described by Harold W. Brown, who initially named it the superior oblique tendon sheath syndrome.
Quick Facts
- First described by
- Harold W. Brown
- Original name
- superior oblique tendon sheath syndrome
- Sex ratio (female:male)
- 3:2
- Laterality
- right eye affected nearly twice as often as left
- Bilateral cases
- 10%
Facts from the source article.
Causes
Acquired cases can follow trauma, surgery, sinusitis, or inflammation of the superior oblique tendon sheath in rheumatoid arthritis. Orbital floor fractures may trap orbital tissue and simulate the condition. An intermittent form, superior oblique click syndrome, involves a click as restriction is released.
Treatments
Treatment is not obligatory if binocular vision is present and head position is correct. It becomes necessary for visual symptoms, strabismus, or incorrect head position.
Acquired cases with active inflammation may benefit from local corticosteroid injections near the trochlea. Surgical options include sheathotomy (stripping the superior oblique tendon, often with unsatisfactory results due to scar reformation) and tenotomy of the superior oblique tendon with or without a spacer, which frequently causes superior oblique paresis. Weakening of the inferior oblique muscle may be needed to compensate for iatrogenic fourth nerve palsy.
More in Disorders of Ocular Muscles, Binocular Movement, Accommodation and Refraction
Sources
Compiled from Wikipedia and the sources listed below. Text from Wikipedia is available under CC BY-SA 4.0; this entry is adapted from it.
- Wikipedia: Brown's syndrome (CC BY-SA 4.0).
- Word definitions: the Codexery glossary, each quoted from its Wikipedia article.
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