NATURAL-HISTORY OF PRESUMED CONGENITAL BROWN SYNDROME

Objective: To evaluate the stability of the ocular alignment in patien ts with presumed congenital Brown syndrome. Design: A retrospective re view of patients with Brown syndrome with an emphasis on nonsurgical c ases. Follow-up of at least 1 year was required for inclusion in the s tudy. Setting: Patients were selected for this study from the pediatri c ophthalmology services at the Ivey Institute of Ophthalmology, Londo n, Ontario, and the Children's Hospital of Eastern Ontario, Ottawa. Pa tients: A cohort of 71 patients with presumed congenital Brown syndrom e. Two cases were bilateral. Eleven cases were excluded because of ins ufficient length of follow-up, leaving 60 patients with an average fol low-up of 46 months. All patients were assessed and followed up by a p ediatric ophthalmologist. Results: Of 38 patients who had no hypotropi a in primary position at presentation, only two (5%) patients experien ced a worsening with the development of a small vertical strabismus du ring the follow-up period. Six (10%) of the entire group of 60 patient s experienced a complete spontaneous resolution of the deficiency in e levation at 4, 6, 8, 10, 12, and 15 years of age. Conclusion: Among pa tients with congenital Brown syndrome, those who are orthotropic in th e primary position tend to remain stable or improve over time without surgical intervention.