Brown’s syndrome

An ocular motility disorder characterized by a limitation of elevation in adduction, causing a divergence in straight upgaze. The restriction is typically of the same degree on version and duction testing, differentiating it from inferior oblique palsy. It can be congenital or acquired, with the congenital form being more common. Etiologies include a tight or inelastic superior oblique tendon-trochlea complex, inferior oblique adhesions, or a displaced lateral rectus pulley. Treatment depends on the severity of the limitation and includes surgery to weaken or lengthen the superior oblique tendon.