What are the features and treatment of Brown's syndrome?
Brown’s Syndrome is another type of congenital squint. It is caused by an abnormal pulley system for the superior oblique muscle. Brown’s Syndrome can also develop in later life as a result of damage to this pulley system. In the days before seat belt legislation road traffic accidents were a common cause of this type of injury. It can also occur as a result of inflammation of the pulley system.
Restricted upward movement of the eye when it is looking inwards
The most striking feature of Brown’s Syndrome is restricted upward movement of the affected eye when the eye is looking inwards.
This is particularly obvious in smaller children when they try to look upwards at their parents.
The vast majority of children with Browns Syndrome develop good vision in both eyes, good stereopsis and do not need any form of surgery.
Surgery is only required if there is a significant squint in the straight ahead position and / or if the upward movement of the eye is a very restricted.
The aim of surgery is to weaken the superior oblique muscle so it moves more smoothly through the pulley. This can be done either by lengthening the tendon by inserting a length of silicone into the tendon, or by moving the insertion of the muscle closer to the pulley.