Brown's Syndrome

Definition

Definition of Brown's Syndrome
Brown's syndrome is a rare eye disorder characterized by defects and errors in eye movement. The disorder may be congenital (existing at or before birth), or secondary (for example, due to inflammation). Brown's syndrome is caused by a malfunction of the superior oblique tendon, causing the eye to have difficulty moving upward, particularly during adduction (when eye turns towards the nose).

Symptoms

Symptoms of Brown's Syndrome
The eyes usually look normal except in side gaze positions. In side gaze (looking toward the affected side), one eye appears higher than the other, particularly when looking up. A vertical misalignment is sometimes noted when looking straight ahead.

Causes

Causes of Brown's Syndrome
There are a few classifications and potential causes for Brown's syndrome. Congenital Brown's Syndrome could be caused by an inelastic muscle-tendon complex, differences of the superior oblique tendon fibers, abnormal inferior orbital attachments, and the posterior orbital bands.

Brown's syndrome has been researched more because it can be developed due to other diseases and disorders. A cause for scarring and adhesions is because during surgery you can receive scars from having a blepharoplasty, plastic surgery on the eyelid, and having fat removed. Reasons for the tightening or shortening of the superior oblique tendon are because of the muscles surrounding the tendon. An inelastic muscle would cause the tendon to shorten because its inflexible characteristic or a superior oblique tuck would because there is a section of the tendon removed.

Diagnosis

Diagnosis of Brown's Syndrome
The eyes are usually straight when looking directly ahead and down. The hallmark sign of Brown syndrome is decreased ability to look upward. In some situations the eyes turn outward (exotropia) when looking up.

Brown syndrome can be associated with an abnormal head position (chin up, face turn, head tilt) for better eye cooperation. The affected eye can get “stuck” after looking up or down for long periods of time. When the eye becomes unstuck, a click is often heard and may be accompanied by pain or discomfort.

Treatment

Treatment of Brown's Syndrome
Treatment recommendations for Brown syndrome vary according to the cause and severity of the movement disorder. Close observation alone is usually sufficient in mild cases. Visual acuity and the ability to use both eyes at the same time (binocular vision) should be monitored closely in young children. Nonsurgical treatment is often advised for recently acquired, traumatic and variable cases. Systemic and locally injected corticosteroids have been used to treat inflammatory cases of acquired Brown syndrome. Nonsteroidal anti-inflammatory agents (like Ibuprofen) have also been used. Surgical treatment is usually recommended if any of the following are present: eye turns down when looking straight ahead, significant double vision, compromised bincocular vision or pronounced abnormal head position. More than one surgery may be needed for optimal management.

Prognosis

Prognosis of Brown's Syndrome
Consult with your doctor.

Prevention

Prevention of Brown's Syndrome
Consult with your doctor.