At the strabismus symposium in Iowa City in 1950, Brown presented a preliminary report on a new syndrome,1 which he referred to as the superior oblique tendon sheath syndrome. At the more recent symposium, in New Orleans, he amplified his original presentation and stated that the following criteria were necessary for the diagnosis: paralysis of the inferior oblique, little or no overaction of the superior oblique, depression of the eye on adduction, and limitation to passive elevation of the adducted eye. Brown believed that the syndrome was due to a congenitally short sheath of the superior oblique. Whitnall2 has shown that the sheath is firmly attached to the trochlea. With the eye straight or abducted, the sheath is loose and allows full rotations. However, when the eye is adducted the congenitally short sheath acts as a tight band which prevents elevation.
FOLK ER. Superior Oblique Tendon Sheath Syndrome. AMA Arch Ophthalmol. 1957;57(1):39-40. doi:10.1001/archopht.1957.00930050045010