BROWNS-SYNDROME - NEW ASPECTS

Purpose Brown's syndrome is a form of anatomical strabismus, or retrac tion syndrome. It is defined by active and passive limitation of upwar d gaze in adduction in the field of action of the inferior oblique mus cle. The etiology of Brown's syndrome remains unknown. The defect lies at the level of the superior oblique's tendonis trajectory via the tr ochlea. We studied the frequency of clinical signs and results after s urgery in patients presenting congenital Brown's syndrome. Patients an d methods Our study involved 18 children. They all underwent complete ophthalmological examination with orthoptic testing, pre and postopera tively. Results Neither sidedness nor predominance of sex was noted. C ompensatory head posture was noted in 7 of 18 cases, Limitation of upw ard gaze in adduction was a constant finding, with a positive duction rest. Eleven cases underwent superior-oblique recession. Results of su rgery were satisfactory, with resolution of compensatory head posture in over 80% of cases. Conclusion The etiology of congenital Brown's sy ndrome remains unknown, The different surgical techniques give inconst ant results. Operative indication is decided only when in the presence of well defined clinical manifestations : CHP, deviation in primary p osition with alteration of binocular vision.