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What is Brownâs
Syndrome?
Brownâs Syndrome is a
well-defined clinical disorder with several causes that can be either
congenital (present at birth) or acquired. True Brownâs Syndrome is
characterized by a limitation of elevation of the affected eye,
particularly when the eye is turned in towards the nose (adduction).
This is usually due to an abnormality in the tendon of one eye muscle
(the superior oblique) which is located in this area. Elevation of the
eye is typically normal when it is facing outward toward the ear.
Sometimes the eye can even shoot downward when it is attempting to
look up and in. This may cause the patient to adopt an abnormal head
posture so that the eyes can line up straight and be used together,
while avoiding double vision.
Treatment
Often no treatment is
required. Most commonly patients with the congenital forms require
surgery. The reasons to perform surgery include, in moderate to severe
cases: abnormal head positions, pain and double vision. Acquired
Brownâs Syndrome is usually the result of inflammation and often
improves or disappears without treatment. Additionally, mild head
positions and mild eye misalignments are generally not treated.
The surgery consists of
passive rotation of the eye under anesthesia to confirm the diagnosis.
The superior oblique tendon is either incised or lengthened and
repositioned depending on the reason for surgery, the severity of the
case, and the surgeonâs expertise.
It is important to
understand that the results of this surgery are not perfect. Up to 50%
of patients may require additional surgery.
For more information on
strabismus surgery, please choose the link for ãstrabismus surgeryä on
the preceding page.
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