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July 1993

Natural History of Presumed Congenital Brown Syndrome

Author Affiliations

From the Departments of Ophthalmology, Ivey Institute of Ophthalmology, University of Western Ontario, London (Drs Kaban, Smith, and Orton) and Children's Hospital of Eastern Ontario, Ottawa (Drs Noel and Clarke); and the Northwest Eye Center, Seattle, Wash (Dr Cadera).

Arch Ophthalmol. 1993;111(7):943-946. doi:10.1001/archopht.1993.01090070061020

Objective:  To evaluate the stability of the ocular alignment in patients with presumed congenital Brown syndrome.

Design:  A retrospective review of patients with Brown syndrome with an emphasis on nonsurgical cases. Follow-up of at least 1 year was required for inclusion in the study.

Setting:  Patients were selected for this study from the pediatric ophthalmology services at the Ivey Institute of Ophthalmology, London, Ontario, and the Children's Hospital of Eastern Ontario, Ottawa.

Patients:  A cohort of 71 patients with presumed congenital Brown syndrome. Two cases were bilateral. Eleven cases were excluded because of insufficient length of follow-up, leaving 60 patients with an average follow-up of 46 months. All patients were assessed and followed up by a pediatric ophthalmologist.

Results:  Of 38 patients who had no hypotropia in primary position at presentation, only two (5%) patients experienced a worsening with the development of a small vertical strabismus during the follow-up period. Six (10%) of the entire group of 60 patients experienced a complete spontaneous resolution of the deficiency in elevation at 4, 6, 8, 10, 12, and 15 years of age.

Conclusion:  Among patients with congenital Brown syndrome, those who are orthotropic in the primary position tend to remain stable or improve over time without surgical intervention.

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