[Skip to Content]
[Skip to Content Landing]
November 1982

Acquired Inflammatory Superior Oblique Tendon Sheath SyndromeA Clinicopathologic Study

Author Affiliations

From the Department of Ophthalmology, University of Southern California School of Medicine, and the Estelle Doheny Eye Foundation, Los Angeles. Dr Wright is now with the Children's Hospital of Los Angeles.

Arch Ophthalmol. 1982;100(11):1752-1754. doi:10.1001/archopht.1982.01030040732003

• To our knowledge, this is the first reported clinicopathologic study of a patient with acquired inflammatory Brown's syndrome. The superior oblique tendon, trochlea, and anteror superior oblique muscle were surgically removed en bloc and studied by light microscopy. Surprisingly, the entire specimen was normal, without signs of inflammation or intrasheath scarring. The only abnormal finding was found during surgery, which consisted of perisheath adhesions anterior to the trochlea. These findings indicate that the cause of acquired inflammatory Brown's syndrome may, in many cases, be from scarring around the tendon sheath rather than an intrasheath pathologic condition, as proposed by recent literature.

Brown HW:  True and simulated superior oblique tendon sheath syndrome . Doc Ophthalmol 1973;34:123-136.Article
Von Noorden G:  Special forms of strabismus , in Binocular Vision and Ocular Motility , ed 2. St Louis, CV Mosby Co, 1980, chap 20.
Sandford-Smith JH:  Superior oblique tendon sheath syndrome . Br J Ophthalmol 1975;59:385-386.Article
Sandford-Smith JH:  Superior oblique tendon sheath syndrome and its relationship to stenosing tenosynovitis . Br J Ophthalmol 1973;59:859-865.Article
Hermann JS:  Acquired Brown's syndrome of inflammatory origin . Arch Ophthalmol 1978;96:1228-1232.Article
Sandord-Smith JH:  Intermittent superior oblique tendon sheath syndrome . Br J Ophthalmol 1969;53:412-417.Article
Killian PJ, McClain B, Lawless OH:  Brown's syndrome an unusual manifestation of rheumatoid arthritis . Arthritis Rheum 1977;20:1080.Article
Helveston EM, Merriam WW, Ellis FD, et al: Anatomy and function of the trochlea. Read before the scientific session of the American Academy of Ophthalmology, annual meeting, Chicago, Nov 6, 1980.
Burde RM:  The extraocular muscles , in Moses R (ed): Adler's Physiology of the Eye , ed 6. St Louis, CV Mosby Co, 1975, chap 5.
Duke-Elder S, Wybar K:  The anatomy of the visual system , in System of Ophthalmology . St Louis, CV Mosby Co, 1961, vol 2, chap 5.
Wolfe E:  Extraocular muscles , in Warwick R (ed): Anatomy of the Eye and Orbit , ed 7. Philadelphia, WB Saunders Co, 1976, chap 5.
Dyer JA:  Superior oblique tendon sheath syndrome . Ann Ophthalmol 1970;2:790-792.
Scott AB, Knapp P:  Surgical treatment of the superior oblique tendon sheath syndrome . Arch Ophthalmol 1972;88:282-286.Article
Berke RN:  Tenotomy of the superior oblique for hypertropia . Trans Am Ophthalmol Soc 1946;44:304.
Helveston E:  Symposium on strabismus , in Surgery of the Superior Oblique Muscle . St Louis, CV Mosby Co, 1978, chap 10.
Parks MM:  Symposium on strabismus , in Surgery for Brown's Syndrome . St Louis, CV Mosby Co, 1978, chap 11.