The Brown syndrome occurs very rarely, but is a rather serious illness. The eye is affected. The eyesight is enormously restricted by the Brown syndrome, which is why the people affected often lose their quality of life.
What is Brown Syndrome?
According to DigoPaul, brown syndrome is named after the ophthalmologist of the same name, Harold Whaley Brown, who discovered this symptom. It is also known as the superior oblique tendon sheath syndrome. Brown’s syndrome is an anomaly in the form of a pathological thickening of the superior oblique eye muscle (musculus obliquus superior), which severely restricts the movements of the eye.
As a result, the affected person is no longer able to consciously lower, roll or turn the eye outwards. This creates a kind of squint. Thus, the Brown symptom belongs to the area of strabismus. Brown syndrome can occur in a wide variety of age groups.
Often, parents 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 the treating ophthalmologist to know exactly the causes and symptoms.
Due to the characteristic thickening of the upper oblique eye muscle, the affected person can no longer fully control the eye. Due to the thickening, the tendon can no longer be moved easily 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 were 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.
Brown syndrome is only recognized as a congenital disease in very rare cases. In some cases, Brown syndrome is caused by allergic reactions, but rheumatic diseases can also cause the affected eye muscle to thicken. 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 either.
Symptoms, ailments & signs
The symptoms and complaints in 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. For example, in some cases it is not even possible for data subjects to get their driver’s license.
Basically, the thickening of the tendon and the associated restriction of movement of the eye cause strabismus, which is known in technical jargon as strabismus. Affected people see double images, whereby these are mostly in the middle and upper area of the field of vision, this occurs less often in the lower field of vision. Normal looking straight ahead is hardly possible.
Many affected people then hold their heads crooked – this avoids the double vision, but in the long term this also results in postural damage. Squinting and impaired vision are often associated with a certain lack of orientation.
In some cases, Brown syndrome is also associated with pain when moving the eye. Younger children may notice the first signs, especially when reading, if the child can no longer read properly or tilts their head.
Diagnosis & course
In many cases it takes a long time to make the correct diagnosis of Brown Syndrome. In children in particular, it is difficult to distinguish Brown’s syndrome from classic strabismus. Adults, too, can have the symptoms for a long time before the correct diagnosis is made.
The diagnosis of Brown syndrome is made difficult by the fact that the symptoms often appear arbitrarily, subside for some time – up to a few months – and then appear again out of nowhere. In general, adults should see a doctor if they see double vision or cannot 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, in most cases, is considered an acquired condition. As with any accident that involves particularly sensitive parts of the body such as the eye, a thorough check-up should be carried out by the doctor. But chronic diseases also promote the development. This also includes inflammatory reactions such as rheumatism or strong allergies. Caution is advised if this physical stress already exists and occurs in combination with the symptoms of Brownn’s syndrome.
In many cases, a change is announced over a longer period of time, but short phases of the disease can also indicate a thickening of the tendon in the eye. Often, due to the seemingly arbitrary nature of the disease, symptoms are misinterpreted and initially lead to misdiagnosis. There is also a risk of confusion due to the classic squint, especially in childhood. Children and adults unconsciously try to compensate for the double images in the upper field of vision by tilting their heads.
Accustomed bad posture, headaches and problems with orientation should always be clarified by a visit to the doctor. The additional pain sensation caused by the thickening of the tendon when the eye moves in the eye socket is rather atypical for common strabismus. This disease does not represent an acute emergency and the therapeutic measures are based on the severity of the symptoms.
Treatment & Therapy
Correct treatment for Brown syndrome also depends on its severity. If the symptoms are barely noticeable for the person concerned and there are no restrictions in everyday life, therapy is often not used. Cortisone is often injected for minor illnesses. 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. Also corticosteroids are often used. These are injected directly into the trochlea.
Outlook & forecast
Brown’s syndrome is itself a relatively severe limitation in the life and everyday life of the person affected. It cannot be treated completely, although this disease does not negatively affect the life expectancy of the person affected.
The symptoms and complaints of this syndrome can be very different. Some patients experience almost no discomfort, so Brown syndrome has very little loss of vision. As a rule, no special treatment is necessary here. In severe cases, the symptoms can be relieved with cortisone. A surgical procedure can also take place here, which is intended to increase the quality of life of the person affected. However, this does not completely relieve the symptoms.
If there is no treatment for Brown syndrome, there will be no improvement. However, the symptoms usually do not worsen any further. With this syndrome, early treatment has a very positive effect on the further course of the disease and can avoid various complications. Brown syndrome often leads to psychological complaints or depression, so that the person affected is also dependent on psychological treatment.
Unfortunately, there is hardly any way to prevent Brown Syndrome. In order to avoid the widespread disease rheumatism as a cause, sufficient physical activity and a balanced diet should be ensured. 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 simply taking care of yourself. Follow-up care is long-term and focuses on follow-up checks and regular eye exercises, which can improve vision. The check-ups should start once or twice a month.
The frequency depends on how well the wound heals after an operation. If the eyesight has been significantly improved by the procedure, this already speaks for a positive outcome. If there are no complications, a few follow-up checks at intervals of one month are sufficient. Later, six-month examinations are sufficient.
If complications or long-term effects occur, this can be determined as part of the follow-up care. The necessary treatment measures can then be initiated. Whether or not there are complications, eye exercises must be performed as part of the 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 load-bearing capacity of the eye. If Brown syndrome occurs as a result of eye strain, follow-up care is usually not necessary. After the drug treatment, the eye will recover on its own within a few days.
You can do that yourself
Depending on its severity, a number of treatment measures can be considered for Brown syndrome. Conservative therapy can be supported by a number of self-help measures.
First of all, general things are recommended, such as a healthy lifestyle with a balanced diet, regular exercise and avoiding alcohol, nicotine and the like. An active and healthy life cannot directly improve eyesight, but it can improve the often reduced quality of life. In addition, the avoidance of harmful influences helps to preserve the remaining eyesight. Exercise 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 eyesight. Eyebright, for example, is said to have a soothing effect on tired and overexcited eyes. Celandine helps with various eye problems and the medicinal plant calamus calms the eyelid rims.
If the effects of Brown’s syndrome (e.g. strabismus, conspicuous visual aids) lead to psychological complaints, an accompanying therapy can also be considered. Various doctors and specialist clinics can provide more information on how to manage the condition.