Acquired Brown’s Syndrome: A Case Report

Cathie Searle, DipAppSc(Cumb), DOBA
Susan Horne, DipAppSc(Cumb), DOBA

A case of Brown’s syndrome occurring with chronic systemic juvenile rheumatoid arthritis is presented. The patient, a nine year old child, had a sudden onset of diplopia in dextro-elevation occurring simultaneously with a severe inflammatory attack involving several limb joints. He received systemic anti-inflammatory medication which improved his general condition, and coincided with the Brown’s syndrome being resolved within three weeks without any specific ocular treatment.
It is suggested that tenosynovitis, which is commonly a feature of juvenile rheumatoid arthritis (JRA), may have been the cause of this patient’s Brown’s syndrome.
It is recommended that a thorough assessment of ocular motility be included in the ophthalmic examination of young children with JRA.