A Case of Acquired Brown Syndrome after Surgical Repair of a Medial Orbital Wall Fracture

A case of acquired Brown syndrome caused by surgical repair of medial orbital wall fracture is reported in the present paper. A 23-year-old man presented at the hospital with right periorbital trauma. Although the patient did not complain of any diplopia, the imaging study revealed a blow-out fracture of the medial orbital wall. Surgical repair with a calvarial bone autograft was performed at the department of plastic surgery. The patient was referred to the ophthalmologic department due to diplopia that newly developed after surgery. The prism cover test at distant fixation showed hypotropia of the right eye, which was 4 prism diopters (PD) in primary gaze, 20 PD in left gaze, while orthophoric in right gaze. Eye movement of the right eye was markedly limited on elevation in adduction with normal elevation in abduction with intorsion in the right eye present. Forced duction test of the right eye showed restricted elevation in adduction. Computerized tomography scan of the orbits showed the right superior oblique muscle was entrapped between the autografted bone fragment and posterior margin of the fracture. When repairing medial orbital wall fracture that causes Brown syndrome, surgeons should always be careful of entrapment of the superior oblique muscle if the implant is inserted without identifying the superior and posterior margin of the orbital fracture site.

Acquired Brown Syndrome After Retinal Detachment Surgery

PURPOSE: To report a case of acquired Brown syndrome found in the left eye of a female patient who had undergone surgery for proliferative vitreoretinopathy. METHODS: A 41-year-old female patient presented with right hypertropia and esotropia. We reviewed her history, conducted an ophthalmic examination and performed surgery. RESULTS: Prior to presentation, the patient experienced a sudden decrease in visual acuity. She was diagnosed with proliferative vitreoretinopathy caused by rhegmatogenous retinal detachment, and underwent scleral buckling. After surgery, with the eye in the primary position, the right hypertropia was 9 prism diopters and the esotropia was 30 prism diopters. The patient was unable to elevate the eye in the adducted position. A forced duction test was performed and we detected a restricted elevation in adduction. By performing a tenectomy of the superior oblique muscle and a recession of the medial rectus muscle, orthophoria was obtained in the primary position, and the elevation in adduction improved. CONCLUSIONS: Herein, we report satisfactory results of a procedure in one case of acquired Brown syndrome following retinal detachment surgery.

A Case of Acquired Brown Syndrome Following Scleral Buckling

PURPOSE: To present a case of the acquired Brown syndrome caused by scleral buckling. METHODS: A 58-year-old man presented with floaters in his right eye which had developed 20days before. Rhegmatogenous retinal detachment with a retinal tear at the location of 2 o' clock was diagnosed. Radial scleral buckling was performed. Ten days after surgery, he was unable to elevate his right eye in adduction, and right superior oblique muscle overaction was presented. RESULTS: Acquired Brown syndrome caused by scleral buckling has not been documented in Korea to our knowledge. Therefore, we report this case with review of related literatures.