Brown syndrome (superior oblique tendon sheath syndrome)    175

General: Etiology unknown; affects both sexes; present from birth; may be congenital or acquired (secondary to trauma, orbital surgery, or injections, or following delivery).

Ocular: Bilateral ptosis with associated backward head tilt; widening of palpebral fissure with attempted upward gaze; ocular movements show failure in direction of superior oblique action; may be associated with underaction of the inferior oblique; adduction or abduction restricted or completely abolished; choroidal coloboma.

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Brown HW. Congenital structural motor anomalies in strabismus. In: Allen JH, ed. Ophthalmic symposium. St. Louis: CV Mosby, 1950:205,229.

Brown HW. True and simulated superior oblique tendon sheath syndrome. Doc Ophthalmol 1973; 34:123-l26.

Christiansen SP, Thomas AH. Postpartum Brown's syndrome. Arch Ophthalmol 1994; 112:23-25.

Fraunfelder FT, Roy FH. Current Ocular Therapy. 5th ed. Philadelphia: WB Saunders, 2000.

Nelson LB. Strabismus disorders (Brown syndrome). In: Nelson, Calhoun, Harley, eds. Pediatric Ophthalmology, 3^rd ed. Philadelphia: WB Saunders, 1991:165.

Wang FM, et al. Acquired Brown's syndrome in children with juvenile rheumatoid arthritis. Ophthalmology 1984; 91:23-26.