Brown Syndrome – Causes, Symptoms & Treatment


Brown syndrome is very rare, but it is a rather serious condition. The eye is affected. Brown syndrome severely limits vision, which is why those affected often lose quality of life.

What is Brown Syndrome?

Brown syndrome is named after Harold Whaley Brown, an ophthalmologist who discovered this symptom. It is also known as superior oblique tendon sheath syndrome . Brown syndrome is an abnormality in the form of abnormal thickening of the upper oblique muscle (superior oblique muscle), which severely limits eye movement.

As a result, the affected person is no longer able to consciously lower, roll or turn the eye outwards. This creates a kind of squinting. Thus, Brown’s symptom belongs to the realm of strabismus . Brown syndrome can occur in a wide range of age groups.

Parents often notice the symptoms in small children, but in many cases Brown syndrome is not recognized due to its rarity, which makes treatment considerably more difficult. It is therefore all the more important for treating ophthalmologists to know the causes and symptoms exactly.


Due to the characteristic thickening of the upper oblique muscle, the affected person can no longer fully control the eye. Due to the thickening, the tendon can no longer be easily moved through the cartilage sheath (trochlea) in the eye socket. This triggers the symptoms and leads to the typical squint.

Basically, the causes of Brown syndrome have been divided into two categories: congenital and acquired. Today, however, ophthalmologists assume that Brown syndrome is a disease of the eyes that is triggered, i.e. not congenital. Genetic causes can thus be largely ruled out.

Only in very rare cases is Brown syndrome recognized as a congenital disease. In some cases, Brown syndrome is caused by allergic reactions , but rheumatic diseases can also lead to thickening of the affected eye muscle. Eye strain or falls and accidents are also possible causes. In addition, special operations on the eye and inflammation can trigger the syndrome, although this cause is not very common.

Symptoms, Ailments & Signs

The symptoms and symptoms of Brown syndrome differ enormously in their severity. While some people are hardly restricted in their everyday life and quality of life, others suffer greatly from the symptoms. In some cases, for example, it is not even possible for the persons concerned to obtain a driver’s license.

Basically, the thickening of the tendon and the associated restriction of movement of the eye causes squinting, which is referred to in technical jargon as strabismus. Affected people see double vision, which is mostly in the middle and upper part of the field of vision, this occurs less frequently in the lower field of vision. Normal looking straight ahead is hardly possible anymore.

Many affected people then hold their heads at an angle – this avoids double vision, but this also causes postural damage in the long term. Squinting and impaired vision are often associated with a certain disorientation .

In some cases, Brown syndrome is also associated with pain when the eye is moved. The first signs can be noticed in younger children, especially when reading, when the child can no longer read properly or tilts his head.

Diagnosis & History

In many cases, it takes a very long time before the correct diagnosis is made in the case of Brown syndrome. Especially in children, it is difficult to distinguish Brown syndrome from classic strabismus. Even adults can suffer from the symptoms for a long time before the correct diagnosis is made.

Diagnosing Brown syndrome is complicated by the fact that it is not uncommon for symptoms to appear randomly, subside for some time – up to a few months – and then reappear seemingly out of nowhere. As a general rule, adults should see a doctor if they see double vision or are unable to move one eye properly. Then it can be clarified whether Brown syndrome is present and what the causes are.

When should you go to the doctor?

Brown syndrome is considered to be an acquired disease in most cases. As with any accident that involves particularly sensitive parts of the body such as the eye, a thorough check-up by the doctor should be carried out. But chronic diseases also favor the development. This also includes inflammatory reactions such as in rheumatism or severe allergies. Caution is advised if this physical predisposition already exists and occurs in combination with the symptoms of Brownn syndrome.

In many cases, a change is announced over a long period of time, but short periods of illness can also indicate a thickening of the tendon in the eye. Due to the seemingly random nature of the disease, symptoms are often misinterpreted and initially lead to misdiagnoses. There is also a risk of confusion due to the classic squint, especially in childhood. Children and adults try unconsciously to compensate for the double images located in the upper field of vision by tilting their heads.

Accustomed bad posture, headaches and problems with orientation should always be clarified by a doctor’s visit. The additional sensation of pain caused by the thickening of the tendon when the eye moves in the orbit is considered rather untypical for normal strabismus. This disease does not represent an acute emergency and the measures for therapy are based on the severity of the symptoms.

Treatment & Therapy

The correct treatment of Brown syndrome also depends on its severity. If the symptoms are hardly noticeable for the person concerned and there are no restrictions in everyday life, therapy is often dispensed with. In the case of minor illnesses, cortisone is often injected. In many cases, ibuprofen has also proven to be an active ingredient.

Surgical intervention should only be considered in very severe cases, in which normal everyday life can hardly be managed: The thickened tendon of the eye muscle is mechanically thinned by stretching it with silicone. Corticosteroids are also often used. These are injected directly into the trochlea.

Outlook & Forecast

Brown syndrome itself represents a relatively severe limitation in the life and everyday life of the person affected. It cannot be treated completely, although the life expectancy of the person affected is not negatively affected by this disease.

The symptoms and signs of this syndrome can vary greatly. Some patients experience almost no discomfort, so vision is affected very little by Brown syndrome. Usually no special treatment is necessary. In severe cases, the symptoms can be relieved with cortisone. A surgical procedure can also take place here, which is intended to improve the quality of life of the person concerned. However, this does not completely alleviate the symptoms.

If there is no treatment for Brown syndrome, there will be no improvement. However, the symptoms usually do not get worse. Early treatment of this syndrome has a very positive effect on the further course of the disease and can prevent various complications. Brown syndrome often leads to psychological problems or depression , so that the person affected also needs psychological treatment.


Unfortunately, there is little to prevent Brown syndrome. In order to avoid the common disease rheumatism as a cause, you should pay attention to a sufficient amount of physical activity and a balanced diet. A varied diet in childhood prevents allergies and allergic reactions in children. In principle, however, it is advisable to consult an ophthalmologist as soon as possible if problems arise, who can examine the eyes and make a diagnosis.


Brown syndrome is a disease of the eye that can be treated surgically or by rest alone. Follow-up care is long-term and focuses on follow-up checks and regular eye exercises, which can improve vision. The check-ups should initially take place once or twice a month.

The frequency depends on how well the wound heals after an operation. If the vision was significantly improved by the intervention, this already speaks for a positive course. If no complications occur, a few follow-up checks at intervals of one month are sufficient. Six-monthly examinations are sufficient later.

If complications or late effects occur, this can be determined during follow-up care. The necessary treatment measures can then be initiated. Regardless of whether complications arise, eye exercises must be performed as part of follow-up care. The patient should start the vision training under the supervision of an expert and can later continue it independently.

Targeted training of the affected eye muscle can increase the resilience of the eye. If Brown syndrome occurs as a result of eye strain, usually no follow-up care is necessary. After drug treatment, the eye recovers on its own within a few days.

You can do that yourself

Depending on its severity, there are a number of treatment options for Brown syndrome. Conservative therapy can be supported by a number of self-help measures.

First of all, general things such as a healthy lifestyle with a balanced diet , regular exercise and avoiding alcohol , nicotine and Co. are recommended. An active and healthy life cannot improve vision directly, but it can improve the quality of life that is often reduced. In addition, avoiding harmful influences helps to preserve the remaining eyesight. Sporting activities such as weight training, yoga or Pilates also counteract the disorientation that is typical of Brown syndrome.

In addition, various natural remedies help to strengthen the eyesight. Eyebright , for example, is said to have a soothing effect on tired and over-irritated eyes. Celandine helps with various eye problems and the medicinal plant calamus soothes the edges of the eyelids.

If the effects of Brown’s syndrome (e.g. squinting, conspicuous visual aids) lead to psychological problems, concomitant therapy can also be considered. Various doctors and specialist clinics can provide more information on how to manage the condition.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.