Brown Syndrome
Brown Syndrome Causes
Brown syndrome may already be present at birth. This is caused by inelastic muscle-tendon complex (Wright hypothesis), anomalies of the superior oblique tendon fibers, anomalous inferior orbital adhesions, and posterior orbital bands Brown syndrome that has been acquired during one's lifetime is caused by peritrochlear scarring and adhesions, trauma (superior temporal orbit), chronic sinusitis, blepharoplasty and fat removal, and lichen sclerosus et atrophicus and morphea. Other causes include tendon-trochlear inflammation and edema - Idiopathic inflammatory (pain and click), trochleitis with superior oblique myositis, acute sinusitis, adult rheumatoid arthritis, juvenile rheumatoid arthritis, systemic lupus erythematosus, possibly distant trauma (cardiopulmonary resuscitation [CPR] and long bone fractures), and possibly postpartum hormonal changes. Acquired onset is also the result of superior nasal orbital mass - Glaucoma implant and neoplasm, tight or inelastic superior oblique muscle - Thyroid disease (inelastic muscle), peribulbar anesthesia (inelastic tendon), Hurler-Scheie syndrome (inelastic tendon), and superior oblique tuck (short tendon).
Brown Syndrome Definition
Brown Syndrome is a rare eye disorder marked by defects in eye movements. This disorder may be present at birth (congenital) or may occur as the due to another underlying disorder (acquired). Muscles control eye movements and activities. Some of these muscles turn the eyeball up and down, move the eyeball from side to side, or let the eyeball to rotate slightly in its socket. The superior oblique tendon sheath of the superior oblique is the muscle that surrounds the eyeball. The symptoms of Brown Syndrome are due to abnormalities of this tendon sheath including shortening, thickening, or inflammation. This leads to the inability to move the affected eye upward.
Brown Syndrome Pathophysiology
Brown syndrome can be divided into two: congenital and acquired.
Brown Syndrome Prevalence
Prevalence of this condition in the United States is 1 in 400-450 strabismus cases. Although familial Brown syndrome may appear to be uncommon, Wright has shown that 35% of patients with congenital Brown syndrome had a family member affected with amblyopia or strabismus. This finding might show the presence of an underlying genetic trait. Prevalence of this condition internationally is similar to that in the United States.
Brown Syndrome Symptoms and Signs
Individuals affected with Brown syndrome display symptoms such as congenital strabismus, Choroidal coloboma, decreased conjunctiva elasticity, and a widened space between eyelids when gazing upwards. They may also have symptoms such as drooping eyelids, an inability to move eye upward, squinting their eyes, absent eye muscle abduction, and restricted muscle abduction. Patients have a tendency to tilt their head backwards to enable themselves to see better.