Abstract
IntroductionBrown syndrome is a rare ocular movement abnormality. This syndrome is characterized by an inability to elevate the affected eye in adduction. Most cases are sporadic but the occurrence in Monozygotic twins has suggested the possible autosomal dominant inheritance in Brown syndrome.Case presentationA 4-year-old girl (one pair of dizygotic twins) was referred to our pediatric ophthalmology clinic to assess her abnormal eye movement noticed by her mother. Visual acuity of both eyes was 20/20 with Snellen chart. Ocular motility showed mild exotropia in primary position with marked divergence in upward gaze (V pattern), mild hypotropia in adduction, and limitation of elevation in adduction of both eyes (Fig. 1A). We also examined her sister, all ocular evaluations including visual acuity, slit lamp examination, funduscopy and ocular motility (Ductions & Versions) were normal without any limitation.We also review the related articles that previously have reported Brown syndrome in twins.ConclusionAlthough there are few case reports of Brown syndrome in twins, combination of these reports may elucidate the genetic basis of this disease.
Highlights
Brown syndrome is a rare ocular movement abnormality
Conclusion: there are few case reports of Brown syndrome in twins, combination of these reports may elucidate the genetic basis of this disease
Brown syndrome have been reported, but we found only two reports of this syndrome in dizygotic twins[4,5]
Summary
In 1950 Brown described an eye movement anomaly as the superior oblique (SO) tendon sheath syndrome [1]. We found bilateral Brown syndrome only in one pair of dizygotic twins. A 4-year-old girl (one pair of dizygotic twins) was referred to our pediatric ophthalmology clinic to assess her abnormal eye movement noticed by her mother. Pregnancy history was negative for exposure to drugs or teratogens Visual acuity of both eyes was 20/20 with Snellen chart. The patient had mild lid retraction in the primary position, but laboratory examination and consultation with relevant specialists was within normal limits. Fundus examination of both eyes was normal without any sign of objective torsion. The past medical history of this pair was 1920 grams birth weight without any other problem
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