Left Brown's syndrome.
The main feature is the failure of elevation in the adducted eye.
- in the primary position, the affected eye may be hypotropic
- there may be an abnormal head posture with the head tilt to the affected side, a face
turn to the normal side and chin elevation.
- there may be slight downshoot of the affected on adduction because of the mechanical effect of
a tight superior oblique tendon that cannot relax on adduction.
- widening of the palpebral fissure on adduction and a V pattern
- the condition is bilateral in 10% of cases
- the elevation may improve on repeated testing.
1. How do you confirm the diagnosis of Brown's syndrome and what is its differential diagnosis?